Capsule Endoscopy

What is a capsule endoscopy?

A capsule endoscopy is a test healthcare providers use to look for problems in your digestive tract. It’s especially good at finding issues in your small intestine (small bowel). For this test, you swallow a capsule that’s about the size of a large vitamin tablet. The capsule has a transmitter, light and at least one tiny camera. Some capsules have more than one camera.

As the capsule moves through your digestive tract, the camera takes about 10,000 pictures. Your healthcare provider looks at the pictures and checks for bleeding, tumors and other abnormalities inside of your small intestine.

The capsule leaves your body with your feces (poop), usually in less than a day. You can flush the capsule down the toilet. A capsule endoscopy is a safe, non-invasive procedure. It allows your healthcare provider to see areas of your intestines that other diagnostic procedures might miss.

Who gets a capsule endoscopy procedure?

Children and adults can have this procedure. If your child can’t swallow a pill, your healthcare provider can insert the capsule endoscopically (by inserting a long, thin tube down their throat). Your healthcare provider may recommend a capsule endoscopy if you or your child has symptoms of gastrointestinal (GI) problems, including:

• Celiac disease.
• Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease.
• Loss of blood from your intestines that can’t be explained through upper endoscopy and colonoscopy.
• Polyps in your colon.
• Tumors in your intestines (including benign tumors and malignant tumors).

Symptoms of these conditions and other bowel problems include:

• Abdominal cramping or pain.
• Blood in your feces.
• Diarrhea, gas and bloating.
• Fatigue.
• Nausea and vomiting.
• Unexplained weight loss.

How does a capsule endoscopy work?

For this procedure, your healthcare provider gives you a capsule that’s about the size of a vitamin. Inside the capsule is a light, a transmitter and at least one tiny camera. You swallow the capsule with water (just like you would take a pill) and then return to your daily activities.

Your healthcare provider will give you a small recording device to wear. They may attach wires from the device to your skin on your chest or abdomen, or they may give you a wireless device that attaches to a belt. The device receives pictures from the capsule’s transmitter and stores them so your healthcare provider can review them later.

Over the next several hours:

1. Your digestive system moves the capsule through your esophagus (throat) and stomach, into your intestines. This specially made capsule is sealed, so acids in your stomach can’t break it down like they break down food. The capsule stays intact while it travels through your body.
2. Cameras inside the capsule take about two pictures every second. The capsule’s transmitter sends these pictures to the recording device, which stores the pictures.
3. You return to your healthcare provider’s office the next day. They either remove the recording device from your skin or collect the belt you wore around your waist.
4. The capsule leaves your body naturally when you have a bowel movement (poop). This usually happens within 24 hours, but may take a few days for you to pass the capsule. You may see the capsule in the toilet, although some people don’t realize they’ve passed it. You can flush the capsule when you go to the bathroom.
5. Your healthcare provider downloads the pictures, views them on a computer monitor and looks for abnormalities in your intestines.

How do I prepare for the test?

Before a capsule endoscopy, you should:

• Avoid eating and drinking. Your stomach needs to be empty for the procedure. Usually, you need to fast for about 12 hours before a capsule endoscopy. Your healthcare provider may also order a bowel preparation before the test to clear your bowels.
• Share your health history with your healthcare provider, including any surgeries or problems you’ve had in your intestines. Tell your healthcare provider if you have a pacemaker or defibrillator. These devices might interfere with the capsule’s ability to transmit the pictures.
• Tell your healthcare provider about any allergies you have or medications you take, including over-the-counter drugs, vitamins and supplements. You may need to adjust your dose or stop taking certain medications before the procedure.

What should I expect during the test?

You won’t be able to feel the capsule traveling through your digestive tract. After swallowing the capsule, you should:

• Avoid heavy magnets. Don’t have an MRI until you’ve passed the capsule, and don’t get close to an MRI machine.
• Drink only clear liquids (like water or black coffee) within the first two hours after swallowing the capsule. Ask your healthcare provider when you can start eating again. You may need to wait up to four hours before having a meal.
• Take a break from sports, running, jumping or other strenuous physical activity until you’ve passed the capsule.

Your healthcare provider may tell you to remove the recording device after several hours, or they may remove it for you when you return for a visit. Follow your healthcare provider’s instructions carefully. If you disconnect or remove the recording device before the test is complete, you could damage or erase the images.

What are the risks of this test?

Complications from a capsule endoscopy are rare. Sometimes, the capsule gets stuck in a part of your intestine that’s narrower than the rest of your intestines (stricture). This complication can happen in people who’ve had bowel surgery, inflammation or a tumor in the past.

If you aren’t sure if the capsule has passed, you may need an X-ray or CT scan to see if the capsule is still in your body. A capsule that doesn’t leave your body can cause a bowel obstruction, which can be serious. Healthcare providers do endoscopic surgery to remove capsules that don’t leave the body naturally. Endoscopic procedures use a long, thin, flexible tube and tiny tools.

What are the benefits of this test?

A capsule endoscopy spots bleeding and other problems in your digestive tract. It’s one of the only tests that helps your healthcare provider examine your whole small intestine. Other diagnostic procedures (such as an endoscopic ultrasound) use a thin, flexible tube with a camera. But the tube can only reach the first six feet of your small intestine.

During a capsule endoscopy, the capsule travels through your entire digestive system. It covers more distance than a tube. The capsule can take pictures of your whole digestive tract, including your hard-to-reach small intestine.

When should I know the results of the test?

Most test results are ready in about a week. Some results may take longer, though. Your healthcare provider will contact you to discuss your results and any follow-up procedures or treatments.

When should I call my doctor after a capsule endoscopy?

Call your healthcare provider right away if you have signs of an obstruction. These include:

• Abdominal pain, bloating or swelling.
• Chest pain or difficulty swallowing.
• Constipation.
• Dehydration.
• Fever.
• Loss of appetite.
• Nausea or vomiting.