Capsule endoscopy is a non-invasive diagnostic procedure that allows physicians to examine the lining of the small intestine, an area that is difficult to evaluate with traditional endoscopy or colonoscopy.
During the procedure, you swallow a vitamin-sized capsule containing a miniature camera, light source, battery, and transmitter. As the capsule travels naturally through your digestive tract, it captures thousands of images that are transmitted to a recording device worn on a belt or harness.
The images are later reviewed by a physician to identify abnormalities within the small intestine. The capsule is disposable and passes naturally through the digestive system, usually within 24 to 72 hours.
Reasons for capsule endoscopy
Your physician may recommend capsule endoscopy for the following reasons:
- Evaluation of unexplained gastrointestinal bleeding
- Investigation of iron-deficiency anemia
- Assessment of suspected Crohn's disease
- Evaluation of small bowel inflammation
- Detection of small bowel tumors or polyps
- Investigation of unexplained abdominal pain
- Evaluation of chronic diarrhea
- Assessment of malabsorption disorders
- Investigation of abnormal imaging studies involving the small intestine
- Surveillance of inherited polyposis syndromes
- Evaluation of celiac disease when additional information is needed
Reasons for a repeat capsule endoscopy
A repeat capsule endoscopy may be recommended to:
- Monitor Crohn's disease activity
- Evaluate response to treatment
- Follow up on previously identified abnormalities
- Investigate recurrent gastrointestinal bleeding
- Assess progression of small bowel disease
- Obtain additional information when prior examinations were incomplete
Benefits of capsule endoscopy
Capsule endoscopy is a highly effective diagnostic tool for evaluating the small intestine. Benefits include:
- Non-invasive examination of the small bowel
- No sedation required
- No endoscope insertion
- Ability to visualize areas not easily reached by conventional endoscopy
- Minimal discomfort
- Ability to continue most normal daily activities during the examination
- High-quality imaging of the small intestine
How to prepare
Proper preparation is important for clear images. Please inform your healthcare team if you have difficulty swallowing, a history of bowel obstruction, previous abdominal surgery, Crohn's disease with known narrowing, diabetes, a pacemaker or implanted medical device, or any other significant medical condition.
- Do not eat or drink for at least 8–12 hours before the procedure, as directed by your physician.
- Follow any bowel preparation instructions provided by your healthcare team.
- Inform your physician of all medications you are taking.
- Follow specific instructions regarding diabetic medications and insulin if applicable.
What to expect during the procedure
- Sensors may be placed on your abdomen and connected to a recording device worn on a belt.
- You will swallow the capsule with water.
- No sedation or anesthesia is required.
- The capsule travels naturally through your digestive tract while capturing images.
- Most patients can leave the facility shortly after swallowing the capsule.
- You may be instructed to drink clear liquids a few hours later and resume eating later in the day.
- The examination typically records images for approximately 8 to 12 hours.
- You will return the recording device at the designated time for image analysis.
After the procedure
- The capsule usually passes naturally during a bowel movement within 24 to 72 hours.
- Most patients do not notice when the capsule passes.
- You may resume normal activities as directed by your physician.
- The recorded images will be reviewed by your physician, with results typically available within several days.
- A report will be sent to your referring physician.
Important instructions after the procedure
- Do not undergo an MRI examination until your physician confirms that the capsule has passed from your body.
- Monitor for passage of the capsule if instructed by your physician.
Contact your physician if you experience
- Severe abdominal pain
- Persistent nausea or vomiting
- Fever or chills
- Abdominal distention
- Difficulty swallowing
- Failure to pass the capsule when instructed to monitor for passage
Risks and possible complications
Capsule endoscopy is generally very safe and well tolerated. Possible complications include:
- Capsule retention within the digestive tract
- Temporary difficulty swallowing the capsule
- Aspiration of the capsule into the airway (rare)
- Incomplete examination due to poor bowel preparation or battery expiration
Capsule retention is uncommon but may occur in patients with bowel narrowing, strictures, tumors, or severe inflammatory bowel disease, and may occasionally require an additional procedure to retrieve the capsule. In selected higher-risk patients, your physician may recommend additional testing before capsule endoscopy to reduce this risk.