Capsule Endoscopy

Ever wish there was a way to explore your gut health without the hassle of traditional tests? Enter capsule endoscopy – a tiny camera you swallow that takes pictures as it travels through your digestive tract.

If you’re considering options for evaluating your digestive health or seeking clarity on gastrointestinal (GI) concerns, learn more about how capsule endoscopy works and how it might benefit you. 

What is capsule endoscopy?

Capsule endoscopy is a unique approach to exploring your digestive system, specifically the small intestine (small bowel). This area isn’t easily reached with other endoscopy procedures that involve passing a long, flexible tube down the throat or through the anus and rectum. 

Unlike traditional endoscopies, capsule endoscopy is very simple. The procedure involves swallowing a tiny wireless camera enclosed in a pill-size capsule (pill cam). As the capsule travels through the digestive tract, it takes thousands of high-definition images of the small intestine’s lining. These images are sent to a recorder worn on a belt around the waist.

The images are reviewed by a gastroenterologist to detect, diagnose and treat gastrointestinal conditions and diseases.

Why might I need a capsule enteroscopy?

Capsule enteroscopy is used to diagnose conditions that may affect the small intestine, an area that cannot be reached by upper endoscopy or colonoscopy. 

The most common reason for doing capsule enteroscopy is to find the cause of bleeding in the small intestine. Your health care provider may also recommend a capsule enteroscopy to:

• Investigate symptoms: A capsule enteroscopy can identify the cause of chronic belly (abdominal) pain, persistent diarrhea, unexplained weight loss or gastrointestinal bleeding.
• Diagnose a condition: This procedure can diagnose conditions like Crohn’s disease, ulcerative colitis, small intestine tumors or polyps, colon and rectal cancer and problems with the blood vessels (vascular malformations). It can also be used to examine the esophagus for conditions like Barrett’s esophagus.
• Monitor a chronic condition: If you have GI conditions like Crohn’s, a capsule enteroscopy can monitor treatment and look for any complications that may happen over time.

If you are experiencing unexplained GI symptoms or have been diagnosed with a condition affecting the small intestine, talk to your health care provider about whether capsule enteroscopy may be appropriate.

Possible risks and limitations of capsule enteroscopy

While capsule enteroscopy is generally a safe and simple procedure, there are some risks and limitations to consider:

• Capsule gets stuck: In rare cases, the capsule may not pass through the entire small intestine. It may get stuck in the digestive tract near narrow areas or obstructions. People with Crohn’s disease and other GI conditions may be at higher risk. If you have these conditions, your provider may use imaging techniques and medications to prevent the capsule from getting stuck. Contact your provider if you notice bloating, nausea, vomiting, stomach pain, fever or trouble swallowing after the procedure. 
• Incomplete exam: The capsule may not capture images of the entire digestive system due to a technical issue or fast movement of the capsule through the intestines.
• Limited control: Unlike traditional endoscopies, providers can’t control the movement of the capsule inside your body. 
• No real-time treatment: This method does not allow for procedures such as a biopsy or polyp removal. Additional endoscopy or surgery may be needed for these purposes.

It’s important to talk to your provider if you have any worries or questions about getting a capsule enteroscopy. They’ll help you understand everything and ensure your safety during the procedure.

What to expect before the procedure

Your provider will give you specific instructions on how to prepare, but generally you’ll need to:

• Sign a consent form: You may be asked to sign a form giving your provider permission to perform the procedure. Read the form carefully and ask your provider questions if anything is unclear.
• Fast and bowel prep: This type of endoscopy may require you to fast and/or take a laxative or other bowel prep methods before the procedure. Your provider will give you instructions for the day before and/or the day of the procedure, depending on whether you have a morning or afternoon appointment.
• Adjust medications: Your provider may ask you to temporarily stop certain medications, especially blood thinners, to reduce the risk of bleeding during the procedure. Do not take any antacids, aspirin or ibuprofen. If you have ongoing conditions such as diabetes or heart disease, your provider will give you specific instructions about your medications.

Let your provider know if you are pregnant, have a previous history of obstructions in your digestive tract or have an implantable medical device like a pacemaker.

What to expect during the procedure

The method by which a capsule endoscopy is performed may vary depending on your condition and your provider’s practices. In general, it follows this process:

• When you arrive at your provider’s office, you will be fitted for the recording device, which is worn around your waist. This device records and stores images taken by the capsule. Some devices have electrode patches that are placed on your chest and stomach area. 
• You will swallow the pill camera with water. The capsule is smooth and about the size of a large vitamin pill. The capsule will travel naturally through your esophagus, stomach and into the small intestine.
• You can go on with your day but should avoid strenuous exercise. Wait two hours after you swallow to start drinking clear liquids. After four hours, you can eat a light meal or snack unless told not to. 
• Avoid MRI machines (or other sources of electromagnetic fields) until the capsule is no longer in your body. You can safely use your phone or computer.

What happens after the procedure

After around eight hours (or sometimes longer), you will return to the office to return the recorder device. The images are then downloaded from the recorder and reviewed by a specialist.

Your gastroenterologist will carefully review the images to look for abnormalities or issues in the small pictures, such as bleeding, ulcers or tumors. Depending on the findings, your provider may recommend further tests or treatments.

You do not need to retrieve or save the capsule. Depending on your bowel movement, the capsule should exit your body within hours or a few days. It is safe to flush the capsule down the toilet.

Contact your health care provider if you haven’t passed the capsule after several days. They can provide guidance on what to do next.

Call your provider immediately or go to the nearest emergency department if you have any of the following:

• Severe or worsening stomach pains
• Persistent nausea and vomiting
• Fever and chills
• Dark or bloody stools (poops)
• Feel dizzy or faint
• Have not had a bowel movement three days after your procedure

Call 911 if you experience any of the following:

• Sudden chest pain
• Difficulty breathing and swallowing or gasping for air 
• Sudden loss of consciousness

What happens if the results are abnormal?

If your provider finds anything unusual, like swelling (inflammation) or signs of a condition, they will talk to you about what it means and what to do next. They might suggest additional testing, treatments (such as enteroscopy) and follow-up care.

If you have any questions about the results, ask your provider to help you understand.

Expert care 

Is your doctor suggesting a capsule endoscopy? Banner Health’s experts are here to help. Our team of endoscopy specialists offers minimally invasive procedures and personalized care plans. Schedule an appointment today.