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. The gastroenterologist will use a pill-sized video capsule (11 millimeters by 25 millimeters) as an endoscope, which has its own lens and light source. While the video capsule travels through your body, images are sent to a data recorder worn on a belt. Afterwards, a doctor will view the images on a video monitor, which usually takes 1-2 hours.

Capsule Endoscopy helps to determine the cause of recurrent or persistent symptoms, such as diarrhea, bleeding, anemia, or abdominal pain after an (EGD), or after a colonoscopy has been performed without a diagnosis being found. In certain chronic gastrointestinal diseases, CE can also help to evaluate disease extent or check healing after therapeutic intervention.

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 CE. For instance, if a diabetic takes insulin, the usual dose of morning insulin will need to be reduced, until the patient is able to take something by mouth (usually 3-4 hours after capsule ingestion). Typically, all oral medications are withheld the morning of the exam and are taken three hours after the capsule endoscope is swallowed.  One should tell the gastroenterologist about the presence of previous abdominal surgery, swallowing problems or a pacemaker.  Previous bowel obstructions are usually a contraindication to CE, and this medical history must be relayed to your doctor.

The Procedure

On the morning of the examination, you will come to the doctor’s office, hospital, or endoscopy unit, and you will prepare to swallow the capsule endoscope. To prepare for the examination, sensor detectors are placed in various positions on the abdomen. This is very similar to how EKG leads are placed during an EKG. With the aid of 4 or 5 ounces of water, the capsule endoscope is swallowed without difficulty. 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 will be able to eat after four hours following the capsule ingestion, unless a doctor instructs you otherwise.

At the end of the procedure, approximately eight hours, the patient will need to go 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 is not retrieved and is not returned to the gastroenterologist.

Complications Are Rare

Although complications may occur, they are rare. Potential risks include complications from bowel obstruction; and it is important for you to recognize early signs of possible complications.  If one has a fever after the test, trouble swallowing or increasing chest or abdominal pain, return to the hospital or endoscopy center; and tell your doctor immediately. Very rarely (about 1/1000 procedures) the capsule becomes lodged in a diseased area of the small intestine and does not pass out of the body. This will likely require an abdominal surgery to not only retrieve the capsule, but to resect or remove the diseased area of small intestine. Very often after the diseased small intestine is resected, 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 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