Capsule endoscopy

What is it?

Capsule endoscopy is a non-invasive examination in which the patient swallows a small capsule, about the size of a vitamin capsule, containing a video camera. As it travels through the digestive tract, the capsule captures thousands of images of the lining, which are transmitted to a data-recording device attached to the patient’s body. After the examination, a doctor reviews and assesses all the recorded images.

Capsule endoscopy is not a routine examination. It is used only in certain cases when standard investigations, such as gastroscopy, colonoscopy or radiological imaging, have not identified the cause of a condition, or when the small intestine needs to be examined in detail. It is most commonly performed to investigate gastrointestinal bleeding of unknown origin, suspected Crohn’s disease of the small intestine, tumours or other changes to the lining.

It is important to understand that capsule endoscopy is a diagnostic examination. It cannot be used to take tissue samples (biopsies), stop bleeding or perform other therapeutic procedures. If abnormalities are detected, further examinations such as balloon enteroscopy, gastroscopy or colonoscopy may be required.

How should I prepare?

• You will usually need to avoid eating for 10–12 hours before the examination.
• In many cases, special bowel preparation using a bowel-cleansing solution is prescribed before the examination. It is therefore essential to follow the instructions provided by the healthcare facility.
• Instructions regarding drinking water and other clear fluids before the examination and after swallowing the capsule depend on the healthcare facility’s recommendations.
• Tell your doctor if:
  • you have had or are suspected of having a bowel obstruction or narrowing of the bowel;
  • you have Crohn’s disease;
  • you have a pacemaker or another implanted electronic device;
  • you are pregnant or think you may be pregnant.

How is the examination performed?

• Special sensors or a data-recording device are attached to your abdomen.
• You swallow the capsule with water.
• The capsule travels naturally through the digestive tract and captures images of the intestinal lining.
• During the examination, you can usually return to your normal daily activities while following your doctor’s instructions.
• The examination itself takes approximately 8–12 hours, during which the capsule transmits images to the recording device.

After the examination

• You can usually drink clear fluids after approximately 2 hours and have a light meal after 4 hours, unless your doctor tells you otherwise.
• The capsule usually passes naturally in your stool within 1–3 days.
• You must not undergo magnetic resonance imaging (MRI) until you are certain that the capsule has passed.
• If the capsule does not pass, or if you develop severe abdominal pain, nausea, vomiting or abdominal bloating, seek medical advice immediately.

Is the examination safe?

Capsule endoscopy is a safe and well-tolerated examination. Serious complications are rare. The main potential complication is retention of the capsule in a narrowed section of the bowel. Patients with a suspected bowel narrowing may therefore be advised to undergo additional investigations or use a special dissolvable test capsule (patency capsule) before the examination.