Capsule endoscopy is a new method used to check the small intestine and the colon.
The small intestine cannot be examined by conventional gastroscopy or colonoscopy, and radiological examinations do not have a high sensitivity for the diagnosis of small bowel mucosal diseases.
The endoscopic capsule allows the entire length of the lining of the small intestine to be examined, recording images, which are transferred to the software of a handheld device. The set of images recorded during the examination, which lasts about 8 hours, creates a video which is then studied by the doctor.
How is it done?
The procedure is simple and painless. It is applied to both inpatients and outpatients. It is preceded by an 8-hour fast and bowel preparation that will be determined by your doctor.
The 11mm x26mm capsule, after ingestion, records video and images that are sent to a portable device that is placed on a belt that you wear around your waist.
The capsule moves normally with the peristaltic movements of the digestive tract with continuous video recording from the inside of the stomach and small intestine. After swallowing the capsule, for the first 2 hours, you should not eat or drink anything. Thereafter, only clear liquids (water, tea, chamomile) are allowed. Light food is allowed 4 hours after the start of the test. After the test is completed, the diet is free.
During the test you can follow your daily habits and avoid intense physical activity. Under no circumstances should the belt be removed. You should also avoid contact with devices that emit electromagnetic fields such as a mobile phone or an MRI scanner. A small light flashes on the battery in your belt. If it stops flashing, record the time and contact your doctor.
The belt and the recorder are removed after 8 hours and the data are processed in the computer. The capsule is disposable and will be eliminated from the body in the next 24 hours.
Indications and contraindications
The main indication for the wireless endoscopic capsule is the investigation of anaemia and the detection of possible small bowel bleeding. The capsule also plays an important role in the diagnosis and monitoring of Crohn's disease. Other indications for the capsule are the investigation of chronic diarrhoeal syndrome and chronic abdominal pain.
Absolute contraindications for the test include narrowing or obstruction of the digestive tract, dysphagia and severe digestive tract motility disorders.
Relevant contraindications include pregnancy, the presence of a pacemaker or defibrillator, multiple diverticula, Zenker's eclopoma and gastroparesis.
Complications
A possible complication is retention of the capsule due to narrowing of the lumen of the bowel, which in some cases may even require surgery.
A very rare complication, in cases of dysphagia, is the capsule entering the airways instead of the digestive tract.
The endoscopic capsule examination does not allow biopsies to be taken or any treatment to be applied. Also, in 20% of cases, the small bowel examination may not be completed, i.e. the entire small bowel may not be visualised during the 8-hour recording.
In case of abdominal pain, nausea or vomiting, contact your doctor.
