Capsule Endoscopy Test and Procedure
Overview
Capsule endoscopy is a diagnostic procedure that uses a small, wireless camera inside a swallowable capsule. After you swallow the camera capsule, it moves through your gastrointestinal (GI) tract by natural digestion.
This method captures thousands of images, especially of the small intestine, and sends them to a recording device worn on a belt. The video capsule endoscopy shows areas in the digestive system that are hard to reach otherwise.
Doctors may use different types of capsules to assess various parts of the GI tract, such as the small bowel, colon, or esophagus. Unlike traditional endoscopy procedures—which use a flexible tube called an endoscope—capsule endoscopy does not require insertion through the throat or rectum.
Reasons for Capsule Endoscopy
Doctors use capsule endoscopy to find and diagnose problems in the digestive system. It helps identify the source of unexplained symptoms and monitor certain conditions. Common reasons include:
- Unexplained GI Bleeding: Capsule endoscopy helps locate bleeding in the small intestine when other tests cannot.
- Crohn’s Disease: It can detect inflammation, ulcers, or narrowing in the small bowel.
- Celiac Disease: Capsule images may reveal damage to the lining of the small intestine.
- Tumors or Polyps: It helps identify growths in areas that are hard to reach with standard endoscopy.
- Iron Deficiency Anemia: When blood loss is suspected in the GI tract.
- Surveillance: For patients with a history of small bowel conditions or polyps.
Doctors choose this method when other diagnostic tools are inconclusive or cannot access the area of concern.
Possible Problems
Capsule endoscopy is generally safe, but there are a few risks to know about. The most serious is that the capsule can sometimes get stuck in the digestive tract. Doctors call this capsule retention.
This happens more often in people with strictures or narrowing in the intestines, such as from Crohn’s disease, past surgeries, or tumors. If the capsule gets stuck, you might have symptoms such as:
- Abdominal pain or bloating
- Nausea or vomiting
- Fever
- Signs of bowel obstruction (trouble passing stool or gas)
People with a history of bowel obstructions, swallowing disorders, or certain allergies face a greater risk. If you have a pacemaker or defibrillator, check with your doctor before the test.
| Conditions That May Increase Risk | Possible complication |
|---|---|
| Narrowing (stricture) | Capsule retention |
| Previous GI surgery | Bowel blockage |
| Pregnancy | Unknown risks |
| Difficulty swallowing | Choking/aspiration |
In rare cases, doctors may need to remove the capsule through surgery or endoscopy, especially if it causes discomfort or blockage. Most capsules pass without problems, but let your doctor know if you have symptoms after the test or a history of digestive tract issues.
Steps to Get Ready
Eating, Drinking, and Medications
Before the procedure, avoid all food and drinks for at least 12 hours. This means no snacks, chewing gum, or even water unless your care team tells you otherwise. You may be advised to follow a clear liquid diet the day before, such as:
| Clear Liquids | Examples |
|---|---|
| Water | Plain or flavored water |
| Clear Broth | Chicken, beef, or vegetable |
| Sports Drinks | Lemon-lime or clear flavors |
| Gelatin | No red or purple coloring |
A laxative may be recommended to clear the digestive tract. You may need to take regular medications earlier than usual or pause them briefly. Check with your provider about any medicines to avoid.
Extra Tips and Safety
After swallowing the capsule, avoid heavy lifting and hard exercise for the rest of the day. If your job requires a lot of activity, ask your healthcare provider if it’s safe to return to work right away. Always follow the instructions and reach out to your care team for advice if unsure.
What You Can Expect
On the day of the capsule procedure, a nurse or doctor explains what will happen and answers questions. You may need to remove clothing above the waist so that small sensor pads can be placed on your skin.
These sticky sensors usually connect to a sensor array, which links to a recording device worn on a belt around your waist. Some capsules send images directly without using patches.
Checklist Before the Procedure
- Discuss any medications or allergies.
- Follow any instructions about fasting.
- Remove jewelry or metal items.
- Apply sensor patches (if needed).
- Put on the recorder belt.
If your doctor suggests a patency capsule, you may swallow it before the test to make sure your digestive tract is open enough for the camera capsule to pass.
Swallowing the Capsule and the Process
You swallow the camera capsule with water. Its smooth cover helps it glide down easily. Most people swallow it without trouble, and the sensation usually fades quickly. You do not need sedation during this test.
Once the capsule starts moving through your digestive system, you can go about daily activities like walking, light chores, or even working (unless advised otherwise). Avoid heavy activity and vigorous exercise. The wireless camera inside the capsule collects images and sends them to the recorder. Common points during the test:
- Swallow the capsule with water.
- Resume light daily activities.
- Avoid exercise and heavy lifting.
- The capsule sends images to the recorder throughout the test.
| Step | Notes |
|---|---|
| Swallow capsule | Use water, capsule is slippery and small |
| Wear sensor/recorder | Collects images for the computer to analyze |
| Daily activities | Normal routine, no strenuous exercise |
| Battery life | Lasts about 8 hours |
Finishing Up and What Happens Next
After about two hours, you can drink clear liquids like water or juice. Around four hours after swallowing the capsule, you can usually have a small meal or snack. The entire process usually lasts eight hours, or it ends if the camera capsule shows up in a bowel movement earlier.
When the test is complete, remove any sensors and the recorder, then return them as instructed. The capsule itself passes naturally during a bowel movement and can be flushed with the toilet. No sedation means you can drive home or go about simple activities.
Important Notes
- The capsule may leave the body in hours or take a few days.
- If you do not see the capsule in a bowel movement within two weeks, contact the clinic. You may need an X-ray.
Test Outcomes
As the capsule moves through your digestive system, it captures thousands of clear color images. These are transmitted to a computer where special software turns them into a video.
A healthcare provider reviews the footage to identify any problem areas. Final results may take several days to over a week. Cost, insurance coverage, and comparisons with other tests like X-rays, MRI, or CT scans may also be discussed during follow-up.
