A capsule endoscopy is a non-invasive medical procedure that allows a physician to visualize the small intestine, a section of the digestive tract that is difficult to reach with traditional endoscopes. The procedure involves swallowing a small, disposable capsule, roughly the size of a large vitamin pill, which contains a miniature camera, battery, and light source. As the capsule travels naturally through the digestive system, it captures thousands of images that are wirelessly transmitted to a data recorder worn by the patient. Proper preparation is paramount to the success of this examination, as the small bowel must be as clear as possible from food residue and debris to ensure the camera captures sharp, diagnostic-quality images.
Pre-Procedure Dietary and Medication Guidelines
Preparation for the procedure often begins a full week before the scheduled appointment with adjustments to diet and medication intake. Patients are advised to stop consuming foods that are difficult to digest and leave behind significant residue, such as nuts, seeds, popcorn, and raw vegetables. This low-residue diet helps reduce the amount of undigested material that could obscure the camera’s view inside the small intestine.
The day before the capsule endoscopy, the diet transitions entirely to clear liquids, which are easily digested and leave no opaque residue. Approved clear liquids include:
- Water
- Clear broth
- Apple juice
- White grape juice
- Plain gelatin
- Clear sports drinks
Patients should avoid all liquids with red, purple, or blue coloring, as these can be mistaken for blood during the review of the images.
Medication management is another necessary step. Patients must stop taking iron supplements and multivitamins containing iron up to a week before the test, as iron residue significantly darkens the bowel contents, impairing visualization. Fiber supplements should also be discontinued. Patients taking blood thinners or medication for diabetes must consult with their physician for specific instructions, as these may require temporary dosage adjustments or cessation.
Bowel Preparation Protocols
Achieving a clean small intestine requires a targeted cleansing regimen that goes beyond simple fasting. This protocol is intended to wash away mucus and debris, which can otherwise cling to the intestinal walls and hide small lesions or abnormalities. The most common cleansing agents used are polyethylene glycol (PEG)-based solutions, which act as a powerful laxative.
The specific protocol can vary significantly between medical facilities. Some prescribe a single-dose regimen the evening before, and others use a split-dose approach where half the solution is consumed the night prior and the remainder is taken on the morning of the procedure. The preparation involves drinking a large volume of the mixed solution, often combined with a clear liquid like a sports drink to improve palatability.
Adequate hydration is necessary during this phase to prevent dehydration and ensure the laxative solution moves effectively. Some protocols also include an agent like simethicone, which reduces gas bubbles that interfere with image quality. Following the exact instructions provided by the physician is important, as this preparation is specifically designed to clear the small bowel.
Immediate Steps on Procedure Day
The final preparation steps occur on the morning of the appointment, ensuring the digestive tract is completely empty before the capsule is swallowed. The required fasting period is strictly enforced, with patients instructed to have absolutely nothing by mouth (NPO) for at least eight to twelve hours before the procedure time. A small sip of water may be permitted only to take necessary heart or blood pressure medications, which should be done several hours before arrival.
Upon arrival at the clinic, the patient is fitted with the necessary external equipment that receives and records the images. This setup involves placing an array of sensor patches or a specialized belt around the patient’s abdomen. These sensors are wired to a portable data recorder, worn on a belt around the waist or shoulder, which stores the thousands of pictures transmitted by the capsule.
Once the equipment is correctly positioned and tested, the patient swallows the capsule camera with a small amount of water. Following ingestion, a brief observation period may follow to confirm the capsule has successfully passed from the stomach into the small intestine, which is the target area for the examination.
Post-Swallowing Instructions and Activity Limits
After the capsule is swallowed, the patient is generally free to leave the facility and resume light activities, but strict adherence to a schedule for eating and activity is necessary. Patients must refrain from eating or drinking anything for a minimum of two hours following capsule ingestion to allow the device to progress unhindered. Two hours after swallowing, the patient may begin consuming clear, colorless liquids.
A light meal or small snack is usually permitted four hours after the capsule has been ingested, which helps to encourage the natural movement of the camera through the small intestine. Patients must avoid any strenuous physical activity, such as running or heavy lifting, for the duration of the recording period, which typically lasts eight hours. Excessive movement or sweating can interfere with the signal transmission from the capsule to the external data recorder.
Patients must also strictly avoid exposure to strong electromagnetic fields, which can damage the recorder or interfere with the image data. This means staying away from areas like MRI machines and amateur radio equipment until the study is complete. The patient is responsible for checking the data recorder light every 15 to 30 minutes to ensure it is blinking correctly, confirming the device is actively recording and transmitting data. After the recording period is finished, the equipment is returned to the clinic for data download, and the capsule itself will pass naturally from the body.