Introduction

Double balloon enteroscopy (DBE) has revolutionized the way we view and treat small bowel disorders. The small intestine is now routinely visible and reachable with the endoscope, a task that was thought to be impossible only a few years ago. We are discovering new diseases, having a new view of old diseases, and employing new modalities to treat small bowel disorders. Knowledge of chronic inflammatory and immunologic diseases such as Crohn’s diseases, celiac disease and ulcerative jejunitis is rapidly increasing. The small bowel has been always an important source of small bowel bleeding pathologies, but failure to diagnose, reach and treat these conditions had led to an overly simplified classification of gastrointestinal (GI) bleeding into upper (above the ligament of Treitz) and lower (below the ligament of Treitz). Now the small bowel has received its true “credit” and GI bleeding that has not originated from above the ligament of Treitz and the ileocolonic region is rightly called “mid GI bleeding”.

I am pleased to present a fine collection of articles dealing with the art and science of DBE. My aim was to compile an issue that would be very useful for practicing gastroenterologists, endoscopists, and GI fellows. The topics were selected to cover all aspects of the current uses of DBE. This is the first of two issues on DBE. The first issue will focus on the development of DBE, DBE and its accessories, teaching, training and learning aspects of DBE and single balloon enteroscopy, technique of performing DBE and the three major small bowel pathologies: mid GI bleeding, Crohn’s disease and celiac disease. The second issue will expand on therapeutic interventions using DBE, DBE-assisted endoscopic ultrasound, and uses of the DBE outside the small bowel (e.g. colonoscopy, ERCP, DBE in patients with gastric bypasss surgery). The enthusiastic contributions by all of these pioneers and world experts in DBE have made these issues a superb collection of DBE which will serve as a valuable illustrated reference for any endoscopist using these techniques.