Capsule Endoscopy

What Is A Small Bowel Capsule Endoscopy?

A small bowel capsule endoscopy is an endoscopic procedure where a pill capsule, which has a camera and a battery in it, is swallowed by the patient and used to take multiple pictures of the small intestine. Approximately 60,000 pictures are transmitted which when put together essentially make a movie of the small intestine.

A small bowel pill capsule endoscopy is usually performed to diagnose the cause of unexplained bleeding or anemia.

It may be used to look at the small bowel to further evaluate an abnormal x-ray, abdominal pain or diarrhea.

What Should I Expect Before My Capsule Endoscopy?

You will receive instructions from your doctor regarding the necessary preparation for your capsule endoscopy. Most patients will be allowed to eat normally the day before the exam. Patients will be instructed not to take anything by mouth after 7 pm the night before their capsule endoscopy. It is very important to follow the instructions given to you by your doctor. There will also be additional instructions regarding your medications. In most cases, your medications will be continued as usual a few hours after the pill capsule is ingested. However, in certain circumstances, especially in patients on blood thinners (i.e. coumadin, warfarin, plavix, aspirin, anti-inflammatories) and in diabetics, special instructions will be given.

What Happens On The Day Of The Capsule Endoscopy Procedure?

You will be asked to arrive at the endoscopy center or office 30 minutes before your exam. This is to allow time to fill out paperwork and prepare for the exam. You will be asked to place a vest on which will hold the monitors which will receive the transmitted pictures. After the vest is placed on, the pill capsule will be activated and then swallowed.

After the pill capsule is swallowed, you will be able to leave the endoscopy unit/office. You will wear a vest for the next 8 hours. You will be able to drink clear liquids two hours after the exam and a regular meal after four hours. After the 8 hours, you will return to the endoscopy unit/office and the vest will be removed.

When Will I Get My Results From My Capsule Endoscopy?

After the exam is completed the pictures from the capsule are downloaded into a computer program that generates a movie of your small bowel. It may take the physician several hours to fully view this exam. Results are generally available within a week. You should be called by the ordering physician’s office with the results.

What Are The Risks Of A Capsule Endoscopy?

In general, the small bowel capsule endoscopy is a very safe procedure. Overall, complications occur in less than 1% of patients. Most complications are not life-threatening, however, if a complication occurs, it may require hospitalization and surgery. Prior to the exam, a consent form will be reviewed with the patient by the nursing staff.

The pill capsule can get stuck in the intestine causing an obstruction. This would likely require surgery and hospitalization.

It is very important that the patient contact the doctor’s office immediately if symptoms arise after the capsule endoscopy such as worsening abdominal pain, bleeding, or fever.

Like any other test, a small bowel capsule endoscopy is not perfect. There is a small, accepted risk that abnormalities including cancers can be missed at the time of the exam. It is important to continue to follow-up with your doctors as instructed and inform them of any new or persistent symptoms.

What Are Alternatives To A Small Bowel Capsule Endoscopy?

To an extent, the alternatives to the exam will depend on the reason for needing to undergo the small bowel capsule in the first place. In most cases, the esophagogastroduodenoscopy is the best method to evaluate abnormalities in the small intestine. However, an x-ray called a small-bowel-follow-through can evaluate the small intestine as well. An enteroscopy can also be used to evaluate the upper portion of the small intestine and can be used for therapy.