Small bowel capsule endoscopy (AKA video capsule endoscopy or capsule endoscopy) is a diagnostic imaging test that involves swallowing a tiny, wireless camera about the size of a large vitamin pill. This allows doctors to visualize the full interior of the digestive system, including the small intestine.
Unlike traditional endoscopy, which requires healthcare providers to insert a flexible tube with a camera at the tip into the digestive tract through the mouth or rectum, capsule endoscopy is completely non-invasive, and doesn’t generally require sedation.
After swallowing the capsule, the pill-sized device travels through the digestive tract, with the tiny camera inside the capsule capturing thousands of high-definition images. These images are transmitted to a data recorder worn around the patient’s waist as the capsule moves through the body.
After about 8 hours, the capsule passes through the digestive system, and is excreted painlessly during a bowel movement. The capsule can then be safely flushed.
For patients, the advantages of capsule endoscopy are many, including that the procedure has a low risk of side effects and complications while still allowing physicians to get a detailed and comprehensive view of the entire gastrointestinal tract. The procedure is particularly helpful for patients who can’t tolerate sedation due to age, illness or other issues.
Capsule endoscopy is a procedure that can help diagnose, monitor and track the progress of treatment for various conditions that affect the GI tract.
Some of the conditions small bowel capsule endoscopy can help diagnose or monitor include:
Bleeding in the small intestine
Colon Polyps
Tumors
Celiac disease
Crohn’s disease
Erosions or superficial ulcers
Other suspected small bowel diseases
On the day of the procedure, you’ll be asked to swallow the capsule camera with water, and a data recording device will be attached to your waist to collect the images.
Once the pill has been swallowed, you can perform normal activities, though strenuous physical activity should be avoided. During this time, the camera capsule will wirelessly transmit images to the recording device.
After about 8 hours, you’ll return to the doctor’s office to return the recording device and discuss any questions or concerns you have with your doctor. The pill camera should pass naturally from the body in a bowel movement and doesn’t have to be retrieved.
While traditional gastrointestinal endoscopy and capsule endoscopy are both imaging techniques that help doctors visualize and create images of the interior of the digestive tract, there are several distinct differences between the two procedures:
Non-invasive vs. invasive: Traditional endoscopic procedures utilize a flexible tube with a camera at the tip that accesses the digestive tract by being inserted through the mouth or rectum. By contrast, capsule endoscopy involves swallowing a pill-sized camera with no wires or leads attached, making it almost completely non-invasive.
Areas visualized: Because traditional endoscopy utilizes a camera attached to a flexible tube that’s introduced from outside the body, the areas that can be visualized are often limited to the upper or lower parts of the digestive system. The tiny camera used in small bowel capsule endoscopy, by contrast, travels through the entire GI tract, from the mouth to the anus. As it does, the camera capsule provides detailed views of the entire length, including the esophagus, stomach, small intestine and large intestine.
Sedation: Traditional endoscopy usually requires sedation, whereas capsule endoscopy does not. This can be helpful in cases where the patient is unable to tolerate anesthesia due to age, infirmity or other issues. As long as the patient can safely swallow the capsule and doesn’t have GI issues that might cause the capsule camera to become stuck, the capsule endoscopy procedure can often be utilized.
Preparation for capsule endoscopy is crucial for obtaining clear images and avoiding rare complications. Here are the steps:
Inform your healthcare provider about any medications you’re taking, including over-the-counter drugs, vitamins, blood thinners and herbal supplements.
Tell your healthcare provider if you have a history of inflammatory bowel disease, bowel obstruction or previous bowel surgery, as these can increase the rare chance of the capsule camera becoming stuck in the GI tract.
Be sure to inform your healthcare provider before the procedure if you have diabetes, trouble swallowing, a pacemaker or any other chronic health conditions or implanted medical devices.
The day before the test, most people are instructed to follow a clear liquid diet of water, broth or light-colored juice.
Most patients will be instructed to not eat or drink for at least 10 hours before the test. Follow the instructions of your healthcare provider, but in general, after you swallow the capsule you can usually drink clear liquids again after two hours, and eat a light snack after 4 hours.
Wear loose-fitting, two-piece clothing on the day of the test so you can comfortably wear the data recording device around your waist.
Make sure not to schedule magnetic resonance imaging (MRI) testing or be close to an MRI machine until you know the capsule has left your body.
Sometimes, to make sure you don’t have a bowel obstruction or other issues that might cause the camera capsule to become stuck in your GI tract, your healthcare provider may ask you to swallow what’s known as a patency capsule, followed by an X-ray of your abdomen a few hours later. The patency capsule, which is about the same size as the capsule camera, is a kind of practice run for the actual procedure, and is designed to dissolve if it becomes stuck.
Capsule endoscopy is generally considered very safe. While complications are unlikely, they can occur. Some people may have problems swallowing the camera capsule. Or, very rarely, the capsule can become stuck in the digestive tract.
If you experience any of the following during a capsule endoscopy procedure, it may indicate the capsule is stuck, and you should contact your doctor immediately:
Bloating
Nausea or Vomiting
Chest pain
Trouble swallowing
Abdominal pain
The capsule takes approximately 8 hours to travel through the digestive system. During this time, the tiny camera inside captures and transmits images to the data recording device worn outside the body. After swallowing the capsule, patients can go about their day but should avoid intense or strenuous physical activity.
The capsule used in the procedure is roughly the size of a large pill — around an inch long and less than half inch wide. Unless patients have swallowing issues, a very sensitive gag reflex or other problems that might cause pills to get caught in the throat, most people should be able to ingest the capsule with water without much difficulty.
The capsule eventually leaves the body naturally in a bowel movement. The camera is designed for single use, won’t harm the environment or plumbing and does not need to be retrieved and returned to the healthcare provider.
After the procedure, your healthcare provider will download and analyze the images from the data recorder. Typically, patients can expect to receive their results within a few days. If you haven’t received the results after about a week, contact your doctor’s office.
Unless you have difficulty swallowing or experience complications (which are rare), capsule endoscopy is a painless procedure. Patients typically don’t feel the capsule as it moves through the digestive system. In very small number of cases, however, the capsule can become stuck — AKA “capsule retention.” This can causing a range of serious symptoms, including vomiting, abdominal pain and bloating.