Wireless Capsule Small Bowel Endoscopy
Capsule endoscopy (CE), also known as capsule enteroscopy or video capsule endoscopy lets your doctor examine the lining of your small intestine that is unreachable by standard upper endoscopy. This includes the portions of the small intestine called the jejunum and ileum which extend beyond its first portion also known as the duodenum.
This camera has its own light source and takes pictures of your small intestine as it passes through. These pictures are sent to a small recording device (receiver) that you have to wear on your body for 8 hours. At the end of the procedure you will return to the office and the data recorder is removed so that images of your small bowel can be put on a computer screen for physician review. The procedure is painless and you do not need to have an adult driver to take you home since you will not receive any sedation for the procedure.
Your doctor will be able to view these pictures at a later time and might be able to provide you with useful information regarding your small intestine. Although examination is possible, the test is not intended to examine the stomach or the colon.
The most common reason for doing capsule endoscopy is to search for a cause of bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease (Crohn’s disease), ulcers, and tumors of the small intestine.
You should have nothing to eat or drink, including water, for approximately twelve hours before the examination. Your doctor may determine that you drink a bowel cleansing solution the day before the procedure.
It is very important that you tell your doctor of the presence of a pacemaker or defibrillator, trouble swallowing, previous abdominal surgery, or previous history of bowel obstructions in the bowel, inflammatory bowel disease, or adhesions since these conditions may cause the capsule to get stuck at a narrowed area of the small intestine causing bowel obstruction (blockage). It is important to recognize obstruction early. Signs of obstruction include unusual bloating, abdominal pain, nausea or vomiting. You should call your doctor immediately for any such concerns. Be careful not to prematurely disconnect the system as this may result in loss of pictures being sent to your recording device.
Your doctor will give you a pill-sized video camera for you to swallow. In preparation for the examination, a sensor device may be attached to your abdomen with adhesive sleeves (similar to tape). The capsule endoscope is about the size of a large pill. After ingesting the capsule and until it is excreted in your stool, you should not be near an MRI device or schedule an MRI examination.
You will be able to drink clear liquids after two hours and eat a light meal after four hours following the capsule ingestion, unless your doctor instructs you otherwise. You will have to avoid vigorous physical activity such as running or jumping during the study. Your doctor generally can tell you the test results within the week following the procedure; however, the results of some tests might take longer.
There are limitations to capsule endoscopy. The capsule is pushed by intestinal motility (movement). At times, it may idle for a long time in the stomach or parts of the small intestine, and at times it may rush quickly preventing thorough evaluation. The capsule lacks the ability to remove debris that can be found in the intestine hence decreasing the visibility of lesions and is unable to put air to distend the intestine for better visualization. Finally, the capsule lacks the ability to obtain samples of lesions (biopsies) or provide any treatment (e.g. treatment of an area of bleeding).