What is capsule endoscopy?
Capsule endoscopy (also referred to as Pillcam or wireless endoscopy) is a medical procedure used to evaluate the small bowel. It is mainly used to locate a site of bleeding and is a very sensitive test to evaluate for this.
Capsule endoscopy uses a capsule the size of a jelly bean which contains a tiny camera, battery, light source and transmitter. After swallowing the capsule, it travels through the gastrointestinal system, taking 2 pictures per second, providing high-resolution images of the stomach and small intestine. The images are transmitted to a data-recorder worn in a harness around the waist.
How do I prepare for capsule endoscopy?
Avoid seeded breads for 3 days prior to the test. On the day before the procedure, have breakfast and a light lunch. Following this, only drink clear fluids eg water, apple juice, sports drinks, lemonade, black tea or coffee. Icy poles and jelly (avoid red) are allowed. Drink at least 10 glasses of clear fluid which helps to flush the small intestine and allows for clearer pictures.
From 12 midnight, do not eat or drink, except for necessary medication with a sip of water. Tablets should be avoided within 2 hours of the scheduled capsule endoscopy. Iron tablets should be avoided for 2 days prior. Diabetics should withhold their diabetic medication during the fasting period. If you take insulin, this should be discussed with your doctor.
Wear loose-fitting, two piece clothing (shirt and pants/skirt).
What happens during the procedure?
Nursing staff will attach a belt with data recorder. The capsule is swallowed with some water. You will be free to leave shortly after, returning to home or work and able to walk, sit, lie down or drive. Avoid physical exertion and keep the system dry, avoiding handling. Avoid MRI machines and radio transmitters.
Check the blue light on top of the data recorder every 15 minutes. If the light stops blinking, note the time and call Keilor Private on 8340 6400.
After swallowing the capsule, you must wait 2 hours before you can drink clear liquids (water, apple juice, lemonade, black tea or coffee) and 4 hours until you can eat a light meal and take your medications (unless otherwise advised).
Return to Keilor Private at the scheduled time 6-8 hours later to have the equipment removed. Thereafter, you may eat and drink as normal.
After the capsule endoscopy
The information from the data-recorder is downloaded onto a computer and the images are composed into a video to be examined by the doctor.
The capsule is single use only and should not be retrieved. It will pass naturally in a stool within 1-3 days. Most patients are not aware it has passed. It can be safely flushed down the toilet.
Capsule endoscopy is a very safe procedure. Complications are very infrequent.
The capsule has a gel coating making it easy to swallow. Less than 1% of patients have difficulty swallowing it. Abdominal pain or nausea are rare and should be reported immediately by phoning Keilor Private on 8340 6400.
The rate of capsule retention in the bowel is around 1% and only occurs where there is a narrowed bowel due to pathology or unusual anatomy. The capsule will usually pass. On rare occasions surgery is required to remove the capsule and would allow for treatment of the underlying pathology.
In around 10% of patients, the capsule will not reach the colon during the study period. In such instances, an abdominal x-ray several days later can be used to confirm that the capsule has passed out of the bowel. Until the capsule has passed, MRI scanning should be avoided.
Results are generally available within 1-2 weeks of the procedure and reports will be sent to the referring doctor.