Capsule Endoscopy

Capsule endoscopy, also known as wireless or video capsule endoscopy or capsule enteroscopy, is a diagnostic procedure that involves swallowing a small wireless capsule that is resistant to stomach enzymes to visualize the entire gastrointestinal (GI) tract. The capsule is about the size of a vitamin tablet and contains a battery, a transmitter, an LED light source, and a color video camera. Sensors placed on the patient’s chest and abdomen receive signals transmitted by the capsule. A wireless recorder (placed over the waist) receives and records the data sent by the sensors. The data can be visualized as images or video on a monitor by your physician.

Traditional endoscopic procedures involve passing an endoscope – a long, thin, flexible tube with a tiny video camera and light source attached – through the throat or the rectum to look inside your GI tract. Capsule endoscopy is a diagnostic choice to view midportions of the GI tract, such as sections of the small intestine, that cannot easily be seen or reached with more traditional endoscopic procedures.

Indications

Capsule endoscopy is recommended for the diagnosis of GI tract conditions, such as:

• Crohn’s disease
• Ulcerative colitis
• Tumors, polyps, or ulcers
• Unexplained GI bleeding
• Unexplained abdominal pain
• Celiac disease

Preparation

Preparation for capsule endoscopy may involve the following:

• A review of your medical history and routine blood work.
• You will need to stop eating and drinking at least 12 hours prior to the procedure.
• Your physician may recommend taking a laxative to completely empty the stomach.
• You should inform your doctor of any medications you are taking, as dose adjustments may be required prior to the procedure.
• Your physician may also ask you to stop taking certain medications, such as blood thinners, aspirin, or NSAIDs.
• You should inform your doctor of any allergies to medications or any conditions you have such as heart or lung disease.

Procedure

A typical capsule endoscopy procedure will involve the following steps:

• Once you arrive at the medical facility, your technician will attach adhesive sensors to your chest and abdomen.

• The sensors connect to a wireless data recorder that you wear on a belt around your waist for approximately 8 hours.
• You will be asked to swallow the capsule with water.
• After swallowing the capsule, you can leave the medical facility and resume your daily activities for the next 8 hours.
• In the meantime, the capsule passes naturally through your GI tract and captures a series of pictures as it travels along, which are stored in the data recorder.
• You are allowed a clear liquid diet after 2 hours of taking the capsule and a light snack and medications after 4 hours.
• You should avoid strenuous activities, sudden and unexpected body movements, or bending during the 8-hour window.

At the end of the procedure, you should return to the facility and your technician will remove the sensors and data recorder to analyze the captured images on a computer monitor.

Post-Procedure Care

Following the procedure, your body should expel the capsule in your bowel movement within hours or a few days.  Call your doctor if the capsule has not passed in your stools after 5 to 7 days. You may continue your normal daily routines without any functional limitations post procedure. Your doctor will discuss the results of your capsule endoscopy during your follow-up visit after a week and provide appropriate recommendations based on the results.

Benefits

Some of the benefits of capsule endoscopy over standard endoscopy procedures include:

• No need for anesthesia or sedation
• Non-invasive and painless
• No need for a hospital stay
• Helps with early and accurate diagnosis of GI problems

Risks and Complications

Capsule endoscopy is a relatively safe procedure. However, as with any diagnostic procedure, some risks and complications may occur such as nausea, vomiting, abdominal pain, and the risk of the capsule becoming lodged in the GI tract rather than leaving your body, which may cause bowel obstruction requiring medical intervention.

Summary

The small intestine has been a difficult organ in which to detect abnormalities or make diagnoses using standard endoscopy. However, improved therapeutic and diagnostic capabilities have been particularly useful in screening and uncovering conditions affecting only the small intestine, such as Crohn's disease. Capsule endoscopy is one such non-invasive technology that helps to expand the diagnostic capabilities in the small intestine not possible by other standard endoscopy procedures.