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Small Bowel Capsule Endoscopy

What is a small bowel capsule endoscopy?

A small bowel capsule endoscopy is an endoscopic procedure where a capsule, which has a camera and a battery in it, is swallowed by the patient and used to take multiple pictures of the small intestine. Approximately 60,000 pictures are transmitted which when put together essentially make a movie of the small intestine. A small bowel capsule endoscopy is usually performed to diagnose the cause of unexplained bleeding or anemia. It may be used to look at the small bowel to further evaluate an abnormal x-ray, abdominal pain or diarrhea.

What should I expect the day before the procedure?

You will receive instructions from your doctor regarding the necessary preparation . Most patients will be allowed to eat normally the day before the exam. Patients will be instructed not to take anything by mouth after 7 pm the night before the exam. It is very important to follow the instructions given to you by your doctor. There will also be additional instructions regarding your medications. In most cases, your medications will be continued as usual a few hours after the capsule is ingested. However, in certain circumstances, especially in patients on blood thinners (i.e. coumadin, warfarin, plavix, aspirin, antiinflammatories) and in diabetics, special instructions will be given.

What happens on the day of the procedure?

You will be asked to arrive at the endoscopy center or office 30minutes before your exam. This is to allow time to fill out paper work and prepare for the exam. You will be asked to place a vest on which will hold the monitors which will receive the transmitted pictures. After the vest is placed on, the capsule will be activated and then swallowed.

After the capsule is swallowed, you will be able to leave the endoscopy unit/office. You well wear the vest for the next 8 hours. You will be able to drink clear liquids two hours after the exam and a regular meal after four hours. After the 8 hours, you will return to the endoscopy unit/office and the vest will be removed.

When will I get my results?

After the exam is completed the pictures are downloaded into a computer program that generates a movie of your small bowel. It may take the physician several hours to fully view this exam. Results are generally available within a week. You should be called by the ordering physician's office with the results.

What are the risks of the exam?

In general, the small bowel capsule endoscopy is a very safe procedure. Overall, complications occur in less than 1% of patients. Most complications are not life-threatening, however, if a complication occurs, it may require hospitalization and surgery. Prior to the exam, a consent form will be reviewed with the patient by the nursing staff.

The capsule can get stuck in the intestine causing an obstruction. This would likely require a surgery and hospitalization.

It is very important that the patient contact the doctor's office immediately if symptoms arise after the procedure such as worsening abdominal pain, bleeding, or fever.

Like any other test, a small bowel capsule endoscopy is not perfect. There is a small, accepted risk that abnormalities including cancers can be missed at the time of the exam. It is important to continue to follow-up with your doctors as instructed and inform them of any new or persistent symptoms.

What are alternatives to a small bowel capsule endoscopy?

To an extent, the alternatives to the exam will depend on the reason for needing to undergo the small bowel capsule in the first place. In most cases, the esophagogastroduodenoscopy is the best method to evaluate abnormalities in the small intestine. However, an x-ray called a small-bowel-follow-through can evaluate the small intestine as well. An enteroscopy can also be used to evaluate the upper portion of the small intestine and can be used for therapy.

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