Capsule Endoscopy (PillCam™)
Updated: Jul 4, 2018
Dr. Ken D. Nguyen is the president and co-founder of Pacifica Digestive Health. His clinical interests include screening and management of gastric cancer in Asian patients, viral hepatitis (including hepatitis B and hepatitis C), advanced liver disease and cirrhosis, colon cancer screening, and international medicine.
What is a Capsule Endoscopy?
Capsule Endoscopy, also called a video capsule endoscopy or PillCam™, is a procedure that uses a small camera inside a capsule to examine the esophagus, stomach, and, most commonly, the lining of the small intestine. The capsule is ingested through the mouth and travels through the digestive system as the camera captures and sends images to a recording device worn by the patient. This procedure can be used to diagnose various gastrointestinal (GI) conditions, especially in the small intestine, which would be otherwise difficult to capture with conventional X-rays or CT scans and difficult to reach by conventional endoscopic procedures.
What is the Purpose of a Capsule Endoscopy?
Your doctor uses images captured by the camera inside the capsule to look for abnormalities in the small intestine such as bleeding, polyps, tumors, Crohn’s disease, ulcers or erosions (superficial ulcers), and any other suspected small intestine diseases. One of the most common reason to have a capsule endoscopy is to evaluate for anemia, or low blood count, after having a normal upper GI endoscopy and colonoscopy.
How Do I Prepare for a Capsule Endoscopy?
When schedule your capsule endoscopy procedure, make sure that you provide your doctor and your doctor's office with all your relevant health information. These include:
Any medication you are currently taking and any allergies you may have.
Pre-existing conditions such as diseases like diabetes, heart and lung problems or blood clotting problems.
If you have any implants such as pacemakers or any other electromechanical devices.
If you had stomach or bowel surgery, swallowing problems or other gastrointestinal issues.
You must not eat or drink for 10 hours before the procedure. Your doctor may prescribe an bowel prep to clear out your bowels before the test. Do not take any medication in the two hours leading up to your test. Make sure you are wearing a two-piece loose-fitting clothing when you go for the procedure so that the recording tool can comfortably be placed around your waist.
What Should I Expect During a Capsule Endoscopy?
Capsule endoscopy can be performed at your doctor's office, surgery center, or hospital. Performing a capsule endoscopy is as easy as just swallowing the capsule and waiting for it to make its way through your GI tract. After you swallow the capsule, you may eat a light snack four hours after the procedure unless your doctor instructs you otherwise. You may have a normal meal eight hours after swallowing the capsule. Try to go through your day as usual without over-exerting yourself (such as going to the gym) or bending. Perform moderate to light activities are acceptable.
During the test, you are given a special belt that wraps around you belly which is connected to a recording device. A small light on the recording device will blink when the images are being recorded. If you experience a bowel movement, check to see whether the light is still blinking to make sure the capsule did not pass through and end up in the toilet as this would mean the test is complete. If it suddenly stops blinking continuously, call your doctor immediately. During the procedure you can go home and do your normal activities, but you should not be around any strong magnetic fields. After about 12-24 hours, you will go back to your doctor’s office, surgery center, or hospital and the sensors will be removed and the data will be retrieved.
If, for whatever reason, you cannot swallow the capsule, your doctor may perform an upper GI endoscopy and place the capsule directly into your small bowel. This may also happen if you are on medication that slows down the emptying of the stomach or if your bowel moves very slowly.
What Are the Risks and Complications of Capsule Endoscopy?
Capsule endoscopy is a very safe procedure overall with very low risk for any complication. The only very rare complication, especially in patients with prior bowel surgery or Crohn's disease, is getting the capsule stuck in a narrowed segment of bowel. If this happens, you may need surgery to have the capsule removed.
What to Expect After a Capsule Endoscopy?
We will download the information from the device and view a full-color video of your GI tract. We will get back to you in a few days with results from your exam. The capsule containing the camera should be passed through a normal bowel movement. There is no need to retrieve or return the capsule. You may or may not see it in your stool but this should not worry you. Your doctor will check that the capsule have reached your large intestine from the videos. If not, an x-ray may be ordered after 2 weeks to check if you have passed the capsule.