Video capsule endoscopy is a diagnostic procedure that uses a small, pill-sized camera to take pictures of the digestive tract. The patient swallows the capsule, which then travels through the gastrointestinal system, capturing thousands of images along the way. This non-invasive tool allows doctors to examine parts of the digestive system that can be difficult to view with other methods. The capsule contains a camera, light source, battery, and transmitter to send the images to a recording device.
Purpose of the Procedure
Video capsule endoscopy is primarily used to investigate the small intestine, a long and winding part of the digestive tract that is not easily reached by traditional endoscopes. One of the most common reasons for the procedure is to find the source of obscure gastrointestinal bleeding, which is bleeding that persists without an identifiable cause after an upper endoscopy and colonoscopy.
The procedure is also valuable for diagnosing and monitoring inflammatory bowel diseases, particularly Crohn’s disease. It can detect inflammation, ulcers, and other characteristic signs of Crohn’s disease throughout the small intestine. For individuals with celiac disease, capsule endoscopy can be used to assess the extent of damage to the intestinal lining. Additionally, this technology is effective in identifying small bowel tumors, polyps, and other abnormalities that may cause unexplained abdominal pain or anemia.
The Patient Experience
Patients are typically required to fast for about 12 hours before the procedure. A clear liquid diet may be instructed for the afternoon before the test. In many cases, a bowel preparation involving laxatives is prescribed to cleanse the small intestine of residual food and fluids, which improves the quality of the images.
On the day of the procedure, the patient will visit the clinic to be fitted with a sensor array and a data recorder. The sensors are often applied to the abdomen as adhesive pads, and they connect to a small data recorder worn on a belt around the waist. After the equipment is in place, the patient swallows the capsule, which is about the size of a large vitamin, with a small amount of water.
For the next eight to twelve hours, the capsule travels through the digestive system, capturing images at a rate of about two per second. During this time, patients can generally go about their normal, light daily activities. They are advised to avoid strenuous physical exertion and to stay away from strong magnetic fields, such as those created by an MRI machine, which could interfere with the equipment.
After a few hours, they can typically resume drinking clear liquids and may have a light snack later on.
After the Capsule is Swallowed
Once the recording period, which typically lasts around eight hours, is complete, the patient returns the data recorder to the doctor’s office. There is no need to retrieve the capsule itself. A technician will then download the tens of thousands of images from the recorder onto a computer. The physician will carefully review this large volume of pictures, which have been compiled into a video format, to look for any abnormalities within the small intestine.
The capsule is designed to be disposable and will continue its journey through the digestive tract after the recording is finished. It is eventually passed naturally from the body in a bowel movement, usually within a day or two, although it can sometimes take longer. Patients typically do not feel the capsule as it passes and will not need to retrieve it from the toilet.
Comparison with Traditional Endoscopy
The most significant benefit of video capsule endoscopy is its ability to visualize the entire length of the small intestine, a region largely inaccessible to standard endoscopes. The procedure is also painless and does not require sedation, allowing patients to remain comfortable and active during the test.
However, traditional endoscopy holds a major advantage in its ability to perform therapeutic interventions. While a capsule can only take pictures, a traditional endoscope allows a physician to take tissue samples (biopsies) for analysis or to remove polyps and treat bleeding sources directly during the procedure. The capsule is a tool for diagnosis, while traditional methods offer both diagnostic and treatment capabilities.