Capsule Endoscopy

What is Capsule Endoscopy (CE)?

Capsule Endoscopy enables a gastroenterologist to examine the three portions of the small intestine: the duodenum, jejunum and ileum. A pill-sized video capsule (11 millimeters by 25 millimeters) is swallowed by the patient, enabling visualization of the portions of the small intestine that are not amenable to direct visualization with an endoscope during an EGD or colonoscopy. While the video capsule travels through the body, images are sent to a data recorder worn on a belt. Afterward, a gastroenterologist will view the images on a video monitor.

Capsule Endoscopy can help to determine the cause of recurrent or persistent symptoms such as diarrhea, bleeding, anemia, or abdominal pain after an EGD or colonoscopy has been performed without finding a diagnosis.

An empty stomach allows for the best examination, so patients should have nothing to eat or drink, including water, for approximately 8-12 hours before the examination. Tell your doctor in advance about any medications you take, as you might need to adjust your usual dose for the test. Typically, all oral medications are withheld the morning of the exam and are taken three hours after the video capsule is swallowed. Patients should tell their gastroenterologist about the presence of previous abdominal surgery, swallowing problems or a pacemaker. Previous bowel obstructions are usually a contraindication to this test, and this medical history must be relayed to your doctor.

The Procedure

On the morning of the examination, you will come to our office or the endoscopy unit to swallow the capsule. External sensors will be placed in various positions on the abdomen prior to swallowing the camera. With the aid of 4 or 5 ounces of water, the capsule is easily swallowed by most patients. For approximately eight hours, it passes through the GI tract while transmitting video images to a data recorder worn on a belt. The capsule endoscope doesn't interfere with breathing or further swallowing; most patients consider the test very comfortable. You will never feel the capsule as it travels through your digestive tract. Patients can eat four hours after swallowing the capsule unless a doctor instructs you otherwise.

At the end of the procedure (approximately eight hours after ingestion) the patient will return to the office to return the data recorder, battery pack, adhesive sensor arrays and belt. The images acquired during the exam will be downloaded to a computer workstation for viewing by a trained gastroenterologist. The doctor will view a color video of the pictures taken from the capsule. Approximately 50,000 pictures will be watched in a 1-2 hour video.

The capsule is disposable and passes naturally with a bowel movement. The capsule does not need to be retrieved and does not need to be returned to the gastroenterologist.

Complications Are Rare

Although complications may occur, they are rare. Potential risks include bowel obstruction. It is important for you to recognize early signs of possible complications including fever after the test, trouble swallowing or increasing chest or abdominal pain. Should any of these symptoms occur after the test, contact your doctor immediately. Very rarely (about 1/1000 procedures) the capsule becomes lodged in a diseased area of the small intestine and cannot pass out of the body. This will likely require an abdominal surgery to retrieve the capsule and to remove the diseased area of small intestine. Very often after the diseased small intestine is removed, all symptoms are eradicated and the patient achieves an excellent quality of life, now free of chronic gastrointestinal problems.

Capsule Endoscopy is a Valuable Diagnostic Tool

Capsule endoscopy has become a valuable tool to investigate areas of the small intestine never routinely examined before. Capsule endoscopy has been used to make diagnoses and alter management in patients with chronic gastrointestinal bleeding and chronic abdominal pain. Diagnoses made by capsule endoscopy include bleeding from abnormal blood vessels, Crohn’s disease, tumors, strictures or narrowing of the small intestine and celiac sprue, to name a few.

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For Patient Instructions for Capsule Endoscopy

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For Patient Consent Form for Capsule Endoscopy