Answers
What is capsule endoscopy (the pill camera)?
Short answer
Capsule endoscopy uses a camera the size of a large tablet, which you swallow. It takes thousands of pictures as it passes through the small intestine, a part that a normal endoscopy or colonoscopy cannot fully reach. It is mainly used to find hidden bleeding, unexplained anaemia and Crohn's disease of the small bowel.
Why it is done
- Bleeding or iron-deficiency anaemia when endoscopy and colonoscopy are normal
- Suspected Crohn's disease of the small intestine
- Small bowel growths or polyps
- Sometimes, celiac disease that is not responding to diet
Preparation and the day
You usually take a clear liquid diet the day before, sometimes with a bowel preparation, and fast overnight. Sensors or a belt recorder are attached, and you swallow the capsule with water. You can go about light activities; clear fluids are allowed after about 2 hours and a light meal after about 4 hours. The recorder is returned after about 8 to 12 hours, and the capsule passes in the stool and is flushed away.
Risks and limits
- The main risk is the capsule getting stuck at a narrowing, which is uncommon. In people with suspected narrowing, a dissolvable 'patency' capsule or a scan is used first.
- It cannot take biopsies or treat problems. If something is found, a special scope (enteroscopy) or other treatment may be needed.
- Tell the doctor if you have a pacemaker, swallowing problems, or previous bowel surgery or blockage.
Results
The doctor reviews the video, which takes time, and the results are usually explained within a few days.
Food before and after the capsule
Before the test
- Light, low-fibre meals the day before, then clear liquids from the afternoon as advised
- Nothing to eat overnight before the test
- Clear fluids about 2 hours, and a light meal about 4 hours, after swallowing the capsule
Avoid
- Iron tablets for a few days before, as advised, since they darken the view
- Seeds, leafy vegetables and fibre the day before
- Coloured drinks on the morning of the test
Good to know
- Do not have an MRI until the capsule has passed. If you are not sure it has, an X-ray can check.
- Normal food can be resumed after the recorder is removed.
Common questions
Does the capsule need to be collected?
No. It passes out in the stool, usually within a day or two, and is flushed away.
Is it painful?
No. It is swallowed like a large tablet with water, and most people do not feel it at all.
What if the capsule does not pass?
This is uncommon. If it is held up at a narrowing, it can usually be removed through an endoscope, and the narrowing treated.