Capsule endoscopy is a test that uses a pill-sized camera that you swallow in order to examine the inside of the small intestine. The small intestine is the middle portion of your gastrointestinal tract, located between your stomach and your large intestine (colon). The small intestine is made up of three parts: the duodenum, jejunum and ileum.
Why is capsule endoscopy done?
Capsule endoscopy provides a way for your doctor to examine the inside of your small intestine. Most of the small intestine cannot be reached and inspected during a traditional upper endoscopy or colonoscopy exam. This makes it difficult to evaluate patients for problems that often occur within the small intestine, such as certain types of bleeding, inflammatory diseases like Crohn’s disease and some tumors (e.g. polyps or cancers).
How should I prepare for the procedure?
An empty stomach allows for the best and safest examination. Your doctor will likely recommend that you have nothing to eat or drink after midnight the night before the capsule endoscopy test. Your doctor may ask you to do a bowel prep to cleanse the bowel prior to the examination.
Tell your doctor in advance about any medications you take, including iron, aspirin, bismuth subsalicylate products and other over-the-counter medications. Your doctor will tell you if you need to stop any of your medications before the test. Discuss any allergies to medications and medical conditions that you may have with your doctor (such as swallowing problems, heart or lung disease). Tell your doctor if you have a pacemaker or defibrillator, have had previous abdominal surgery or if you have a history of bowel obstructions or inflammatory bowel disease.
ASK your doctor about bowel preparation to cleanse the bowel prior to the exam
TELL your doctor about prescription and/or over-the-counter medications you take
SHARE your medical history with your doctor (implants, surgeries, diseases, etc.)
REFRAIN from eating or drinking after midnight the night before your test
DISCUSS any allergies to medications or swallowing problems with your doctor
What can I expect during capsule endoscopy?
With the most commonly used capsule models, your doctor or their staff will prepare you for the examination by applying a sensor device to your abdomen, most commonly with adhesive patches. You will then be given a pill camera to swallow, which is the size and shape of a large medication pill. This camera has its own light source and is designed to take several pictures per second as it travels naturally, the same way food does, through your digestive tract.
While it travels down your intestine, the capsule endoscope sends pictures of the inside of your small intestine to a small recording device that you wear for approximately 8 hours on your belt, or on a shoulder strap. At the end of the procedure you will return to the office to return the recording device. The sensors that were attached to your skin will be removed.
The pictures from your small intestine are uploaded to a computer. A computer program displays the pictures in rapid sequence, allowing your doctor to inspect the inside of your small intestine. Most patients consider the test comfortable. The capsule endoscope is about the size of a large pill. You should not get a magnetic resonance imaging (MRI) examination or be near an MRI machine while the capsule is inside your digestive tract. You should pass the capsule in your stool within the next few days. You do not need to retrieve the capsule yourself. If you do not see the capsule pass in your stool within 2 weeks after completing the test, please let your doctor know. They may want to order an X-ray of your abdomen to make sure the capsule is not still in your intestines.
What happens after capsule endoscopy?
You will be able to drink clear liquids two hours after swallowing the capsule and eat a light meal four hours following the capsule ingestion, unless your doctor instructs you otherwise. You should avoid vigorous physical activity such as running or jumping during the study. Your doctor can usually tell you the test results of the capsule study within a week following the procedure. However, the results of some tests might take longer.
Anything else to be aware of with capsule endoscopy?
Although complications can occur, they are uncommon. The capsule can become stuck if there is an abnormally narrowed area in your digestive tract. The most common reasons for narrowing are inflammation (such as Crohn’s disease), a tumor or scar tissue from prior abdominal surgery. If the capsule is unable to pass the narrowed spot, a bowel obstruction can occur and can require urgent surgery to remove the capsule. It is important to recognize bowel obstruction early. Signs of obstruction include excessive abdominal bloating, inability to pass gas or stool, abdominal pain, nausea or vomiting. You should call your doctor immediately if you develop any of these after ingesting a capsule endoscope and before the capsule passes in your stool.
If your provider feels you may be at risk for the capsule becoming stuck in your intestine, a Patency Capsule may be performed before your actual capsule endoscopy exam. The Patency Capsule is a “test run” in which you swallow an artificial capsule that can dissolve within your intestine if it were to become stuck. An X-ray is done approximately 30 hours after you swallow the Patency Capsule to ensure it has passed through your GI tract. If it has passed through, then you should be safe to move ahead with your actual capsule endoscopy exam.
Although very rare, it is possible for the capsule to go “down the wrong pipe” (into the airway) when it is being swallowed. Please tell your doctor if you have difficulty swallowing regular medicine pills before you try to swallow a pill camera. If this is the case, your doctor may be able to directly place the capsule into your stomach by performing an upper endoscopy. Also, tell your doctor immediately if you develop a fever, trouble swallowing or experience chest pain during or shortly after having the test performed.
Be careful not to prematurely disconnect the sensors or the recording device while the test is being performed, as this may result in loss of the pictures from inside your small intestine.
About the American Society for Gastrointestinal Endoscopy (ASGE)
Since its founding in 1941, the ASGE has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal (GI) endoscopy. ASGE physicians have highly specialized training in endoscopic procedures of the digestive tract, including upper GI endoscopy, flexible sigmoidoscopy, colonoscopy, endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS).
Visit ASGE.org for details on ASGE’s Understanding Capsule Endoscopy
Important Reminder: This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition.