What is a small bowel capsule endoscopy?
A small bowel capsule endoscopy is a procedure in which a tiny, wireless camera is used to take pictures of the organs that make up the gastrointestinal tract (GI tract). The capsule is about the size of a vitamin and contains a camera that can take thousands of pictures and send them to a recorder which is worn around the waist.
The main purpose of a small bowel capsule endoscopy is to show the inside of the small intestine and give your doctor a better idea of what’s going on in the small intestine. This is a space that isn’t easy to reach with a traditional endoscopy procedure, which involves a long, thin tube equipped with a video camera that is inserted into the mouth and down the throat or through the rectum.
Who needs a small bowel capsule endoscopy?
There are several reasons why your doctor may suggest a small bowel capsule endoscopy. Read on to learn more about reasons for a small bowel capsule endoscopy.
- Identifying the cause of bleeding in the small intestine (most common)
- Diagnosing IBD, or inflammatory bowel disease (Crohn’s or Ulcerative Colitis)
- Diagnosing cancer
- Diagnosing celiac disease
- Analyzing the esophagus
- Screening for polyps
- As follow-up testing after x-rays or other imaging tests to confirm a diagnosis and get more information.
What are risk factors for a small bowel capsule endoscopy?
A capsule endoscopy is a generally safe procedure with nominal risks, however it’s possible that a capsule gets stuck in the digestive tract when it’s supposed to leave the body via bowel movement. This is more common in those with a stricture located within the digestive tract, which can occur in patients with a tumor, Crohn’s disease or a previous surgery performed in the area.
If you have a known history or at risk of having a narrow area in your intestine, you may need a CT scan to identify said area before a capsule endoscopy is performed. Even if there are no narrowings or limitations, there’s a small chance the capsule could still get stuck. If symptoms indicate that the capsule is blocking the bowel, an endoscopy procedure can be used to remove it depending on the placement where it’s lodged.
How do I prepare for a small bowel capsule endoscopy?
Prior to a capsule endoscopy, a member of your care team will provide a list of steps to prepare you for the procedure. Following these steps closely is imperative, as if you don’t, you may be informed that your endoscopy needs to be rescheduled.
You’ll likely be asked to fast for at least 12 hours leading up to your capsule endoscopy to ensure clear images of the GI tract are able to be taken for the most accurate assessment and diagnosis. You may also be asked to refrain from taking certain medications leading up to the procedure, too. Your doctor will always discuss these preparations beforehand.
You should be able to go about your day normally following the procedure, but likely be asked to take it easy for the remainder of the day physically. Those with physically demanding jobs may be required to take the remainder of the day off to avoid any complications following the procedure.
What should I expect during a small bowel capsule endoscopy?
On the day of your capsule endoscopy, your care team will walk you through what to expect. You may be asked to remove your shirt to allow for sticky patches that have wires connecting to the recorder. Some devises, however, don’t need these patches. The recorder which will aggregate the images from the camera inside the capsule will be placed in a special belt which you’ll wear around your waist. In the event you do have to wear sticky patches, those will feed the data to the recorder, which collects and stores the images.
During your small bowel capsule endoscopy, you’ll swallow the camera capsule with water. There’s a slippery coating on the capsule which will make it easier to stomach. Once swallowed, you should feel virtually normal. You will then be able to go about your day as normal, driving, working, and the like! Your care team will advise you on what to avoid, such as hard activity (i.e., running, jumping, etc.).
What should I expect after a small bowel capsule endoscopy?
You will likely be advised to wait at least two hours from the time your capsule was swallowed to drink clear liquids. After about four hours, you’ll be able to snack or have a light lunch, unless your care team has asked you to refrain.
After eight hours, the procedure is complete. The procedure could end sooner if a camera capsule is spotted in a bowel movement. The camera capsule can be discarded and flushed down the toilet. This could take several days or merely a few hours depending on your specific digestive system. You’ll then remove the patches, if applicable, and recorder from your body, and pack them for return. If you don’t see the capsule in the toilet within two weeks, you may need imaging to see if the capsule has been expelled or not.
The thousands of photos captured by the capsule camera are sent to a computer with software that puts the images together to create a video. A member of your care team will watch the video and spot anything of concern within your GI tract. It could take over a week to receive your results, but your doctor or a member of your care team will be able to interpret them with you and discuss treatment options following.