What Happens During a Capsule Endoscopy?
Similar to colonoscopy, capsule endoscopy is an examination of the tissue lining your gastrointestinal tract. It is a non-invasive procedure that is sometimes used as an alternative to enteroscopy if the small bowel needs to be examined, and a traditional colonoscopy wouldn’t be able to reach. The capsule endoscopy procedure is usually done so that doctors, mainly gastroenterologists, can get a better look at parts of your small intestine—the duodenum, jejunum and ileum—for abnormal growths and signs of other health conditions such as colon cancer or inflammatory bowel disease (IBD).
During the capsule endoscopy procedure, you will need to swallow a tiny video camera with a light attached to it. You’ll be wearing a device on your body that displays what the camera sees as it moves down your gastrointestinal tract (GI tract). It’ll take approximately 8 hours for the camera to completely pass through your system—you do not have to stay in a doctor’s office for the duration of the test, but you’ll obviously have to return to give back the device and submit your results (you do NOT need to recapture the actual camera as the images are transmitted remotely to the external recording device.) The test has not been reported to be uncomfortable or much of a daily hindrance for most patients. Patients only need to be aware that the test is being performed and refrain from practicing too much physical activity, such as running, jumping or having sex, while the device is working. Also make sure that the device is turned on and stays connected throughout the day. People who have had abdominal surgery before should discuss with their specialist about the need for a ‘patency’ capsule prior to undergoing the actual exam – as this can help to ensure that the pill will pass without becoming trapped in the small bowel or colon prior to proceeding.
In general, the risks of capsule endoscopy are minor; however, the most serious risks include retention of the capsule and development of small bowel obstruction as a result of the capsule. This is especially important for those who have had prior abdominal surgeries, as they are at much higher risk of this happening (see above for section regarding patency capsule.)
Why Should I Get a Capsule Endoscopy?
If the middle part of your GI tract needs to be tested for cancer, IBD or other pathology, you may want to order a capsule endoscopy. This area, called the small bowel, is not always reachable during upper endoscopy (examines the esophagus, stomach and duodenum) and colonoscopy (examines the large intestine), cannot always reach the small intestine. Usually, the test is ordered if the patient finds blood in his or her stool and needs to check the entirety of the GI tract for a source of internal bleeding, such as ulcers or inflammation near the ileum. Capsule endoscopy should not be considered an alternative for colon cancer screening, as it is unreliable at looking at the colon lining. Remember to check first whether your insurance company will reimburse you prior to pursuing this procedure.
What Should I Do Before and After a Capsule Endoscopy Procedure?
You’ll need to prepare your bowels by fasting (no food or drink) for nearly 12 hours before you swallow the pill-sized camera, you also need to prepare your bowels similarly to a colonoscopy or sigmoidoscopy exam, where you will drink 4 liters of laxative the night prior to completely clean out the small bowel. This will ensure that the clearest pictures possible are captured. You’ll be able to drink clear fluids 2 hours after swallowing and eat food 4 hours after swallowing. If you are taking any medications, even over-the-counter medications such as aspirin, you should tell your doctor to find out if they will affect the procedure. You may or may not be advised to stop taking some, or simply adjust your dosage before the capsule endoscopy. As always, also tell your doctor if you have recently been diagnosed with a medical condition, if you have recently had surgery or other procedure or if you have allergic reactions to any medications.
It may take a couple of days for the camera to exit the body via stool through the rectum. During this time, it is not safe to have x-ray procedures or MRI scans. Other complications of capsule endoscopy are very limited, but include the camera getting stuck inside your GI tract (bowel obstruction), normally if the capsule has not passed within 2 weeks the doctors will ask for a plain film x-ray of your abdomen to evaluate for a retained capsule (which can require endoscopic or surgical procedures to remove).
Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014