Capsule Endoscopy

Capsule Endoscopy

What is capsule endoscopy?

Capsule endoscopy is a fairly new method used to evaluate the lining of the small bowel.  It is otherwise known as the “pill cam.”  The bowels are divided into three portions – the upper portion includes your stomach and can be easily reached by gastroscopy.  The lower portion is your colon, which can be thoroughly seen via colonoscopy.  The middle section, the small bowel, is too long and winding to be reached effectively with an endoscope.  Capsule endoscopy is a means by which the small bowel lining can be seen.  Capsule endoscopy involves swallowing a small capsule with a battery and camera inside.  As the capsule meanders through your small bowel, images are taken of the small bowel lining.

What can I expect the day of the procedure?

The capsule is about the size of a vitamin pill.  Once it is swallowed, images of your bowel are obtained continuously for eight hours.  You will wear a sensor device to store the images.  At the end of the day you will return to the office, the sensor will be removed, and the images will be downloaded to a computer, so that your physician can review the images.  The capsule will spontaneously pass through your system and be eliminated within a bowel movement.  Passage of the capsule does not hurt and you may not realize when the capsule passes. Most patients consider the test comfortable.  You should not be near MRI equipment while wearing the sensor.

Images will be clearer if the bowel is free of waste material, so you will be asked to drink a flushing solution the day prior to swallowing the capsule.  Once you have ingested the pill camera, you can drink clear liquids after two hours and eat a light meal after four hours, unless instructed otherwise by your physician.  You should avoid vigorous activity like running or jumping during the capsule exam.  Results are generally available within one week.

As is the case with all new tests, some insurance companies do not provide benefits for capsule endoscopy.  Please check with your insurer and our office prior to arranging for your capsule endoscopy appointment.

Why perform capsule endoscopy?

As alluded to earlier, evaluating the lining of the small bowel can be difficult.  There are several tests available, such as CT scan, x-rays, or upper GI with small bowel follow-through.  None of these tests, however, provides images of the bowel lining.  Capsule endoscopy is unique in this sense – it allows your physician to see inside of the bowel.  Although any suspected condition of the small bowel can be a reason to have capsule endoscopy, some of the more common causes include Crohn’s disease, gastrointestinal bleeding of unclear source, malignancy, polyps, and ulcers.  Capsule endoscopy is not an adequate test for evaluating the colon and cannot be used in place of colonoscopy.

Risks of the procedure

The most serious complication is entrapment of the capsule within the gastrointestinal tract.  If this occurs, surgery or conventional endoscopy could be necessary to remove the capsule.   Please alert your physician if you have had prior abdominal surgery, bowel obstructions, adhesions, or inflammatory bowel disease.  If you experience abdominal pain, bloating or vomiting during the capsule test, call your doctor immediately.  If you develop chest pain, difficulty swallowing or a fever after the test, please call your physician immediately.  Be careful not to prematurely disconnect the sensor, as data could be lost.

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