Capsule Endoscopy

What is Capsule Endoscopy?

Capsule endoscopy is also known as pill camera or wireless endoscopy. It is usually used to locate bleeding in the small bowel after a gastroscopy and colonoscopy has excluded upper or lower gastrointestinal bleeding. It can also be used to assess for small bowel tumours and also inflammatory conditions in the small bowel such as Crohn’s disease.

The technology uses a small capsule (up to 27mm) which contains a small camera inside. It is usually swallowed and then travels through the gastrointestinal system whilst taking high resolution images at 2-6 images per second up to 11 hours. There are about 60 000 images in total. The images captured by the capsule are transmitted to a data recorder worn in a harness around the waist.

What can I expect during Capsule Endoscopy?

On the day of the procedure, the capsule is swallowed. This is done in our rooms whilst our practice nurse is assisting. A harness holding the data recorder is strapped on and worn for 8 hours. Gentle activity is recommended to encourage the progress of the capsule along the small bowel.

No fluids should be consumed 2 hours after the capsule is swallowed. Solid food is permitted 4 hours after the capsule ingestion.

Eight hours after the capsule has been swallowed, the patient returns to our surgery to have the harness and leads removed. The information from the data-recorder is downloaded onto a computer. These will be reviewed by the doctor later.

The capsule is single used only and does not need to be retrieved. It will pass through the gastrointestinal system in 1-3 days. It can be safely flushed from the toilet.

What do I need to prepare for capsule endoscopy?

You should fast for 6 hours prior to the test. Diabetics may need to withhold their medication during fasting. Please discuss with your doctor prior to the test.

Your doctor may request a fluid meal only prior to the procedure. Sometimes a small amount of bowel preparation is required. Strongly coloured food and iron tablets should. Be avoided 24 hours prior to the procedure.

Are there any risks with capsule endoscopy?

This is a very safe procedure. Complications are rare but 1% of patients may have difficulty swallowing the capsule in which case it will need to be inserted with the help of a gastroscope. 1% of patients retain the capsule in the small bowel and are unable to pass it. This can happen if there is a narrowing in the small bowel (stricture). Usually the capsule will eventually pass but on rare occasions, the capsule may need to be removed by surgery. The cause of the narrowing can be also removed at the same time. A dissolvable test capsule  may be tried first if there is a suspicion of narrowing which may hold up the capsule.

In 10% of people, the capsule may not reach the large bowel before the battery runs out. This means that no all of the small bowel will be imaged. An Xray will be arranged to make sure that the capsule has passed through the small bowel.

Further Information

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