Before the development of the endoscope, many gastrointestinal conditions went undiagnosed or sometimes misdiagnosed. But with the ability to have a direct visualization of the digestive tract, everything changed. Yet as groundbreaking as the endoscope has been for diagnosing illnesses, the fact remains that the procedure can feel invasive and uncomfortable for the patient. In 2001, however, the Food and Drug Administration approved the first version of the capsule endoscope, a revolutionary way to give doctors a direct look at the digestive system without the usual discomfort.

Understanding Capsule Endoscopy

A capsule endoscopy procedure is a diagnostic test that gastroenterologists use in lieu of a traditional upper endoscopy. The procedure involves swallowing a small, disposable recording device that is contained in a capsule the size of a large vitamin pill; for this reason it is sometimes referred to as a “pillcam.” After swallowing, the wireless capsule endoscopy naturally progresses through the gastrointestinal tract, while images are transmitted to a data recorder worn by the patient. The images can be viewed by a doctor later to evaluate each area for problems or abnormalities.

Unlike a typical gastrointestinal endoscopy inserted through the esophagus or a colonoscopy inserted through the rectum, the video capsule endoscopy has the advantage of not requiring an actual procedure. Because the insertion of an endoscope is known to be somewhat uncomfortable and usually requires sedation, being able to simply swallow the tiny camera pill and go home is preferable for most people. Another advantage is that it can get full images of the small intestine (known as a capsule enteroscopy), an area that is much more difficult to access with other diagnostic tools

Reasons A Doctor May Order a Capsule Endoscopy

Since a colonoscopy can only reach the colon and ileum (last part of the small intestine), and most endoscopic procedures can only reach just past the opening from the stomach to the duodenum, a capsule endoscopy provides the chance to see the totality of the small intestine as well as the rest of the digestive tract. Below are some of the conditions and problems a gastroenterologist might be looking for with this diagnostic procedure:

  • Bleeding: One of the most common reasons for capsule endoscopy is to look for signs of bleeding or to evaluate the cause of blood in the stool. When a source of gastrointestinal bleeding cannot be identified through traditional endoscopy or colonoscopy, capsule endoscopy can help visualize the narrower and harder to explore small intestine. It may also be used in cases where the patient has unexplained anemia and gastrointestinal bleeding is a potential culprit.
  • Abnormal growths: Capsule endoscopy can also be used to detect tumors, polyps, lesions, or any other kind of abnormalities that can grow in the mucosal lining of the digestive tract. This is a helpful process when abdominal pain, bloating, or other gastrointestinal symptoms are present without an obvious explanation. Also, if such growths are detected by other means, the capsule endoscopy can help to confirm what was already suspected or to help the doctor determine a treatment plan.
  • Inflammatory bowel disease: Inflammatory bowel disease (IBD) is a group of inflammatory conditions that affect the digestive tract. Capsule endoscopy can be used to diagnose IBD and either of its two principal types: Crohn’s disease and ulcerative colitis. The tiny camera contained in the capsule can help the doctor assess the severity of inflammation and possible ulcers as well as whether there may be complications.
  • Celiac disease: While not the primary diagnostic tool for detecting celiac disease, a capsule endoscopy may be used when traditional endoscopy or biopsy results are inconclusive or when there is a need to assess the extent of small intestine involvement.
  • Malabsorption problems: In cases where malabsorption syndromes are suspected, capsule endoscopy can provide insights into the condition of the small intestine's mucosal lining.
  • Additional gastrointestinal symptoms: Since many digestive symptoms can present for a wide variety of conditions, a capsule endoscopy can sometimes be used as a way of narrowing down possibilities or ruling out a problem. Examples include strictures, fistulas, or bowel obstructions.

    How to Prepare for a Capsule Endoscopy

    A wireless capsule endoscopy procedure is by design minimally invasive, so it fortunately doesn’t require a lot of preparation in most circumstances. Your healthcare provider will assess whether any current conditions, medications, or allergies might influence or affect the procedure, but most people are able to tolerate the procedure without any issues. Nevertheless, there are a few guidelines for how to prepare:

    • Dietary restrictions: You will typically need to fast and follow a clear liquid diet for a specified period before the procedure: water, clear broth, apple juice, or tea without any cream. In addition to keeping you hydrated, the clear liquids will make it easier to get clear visuals of the GI tract.
    • Medications: Some medications may need to be adjusted or temporarily stopped before the procedure. Examples can include aspirin, arthritis medications, anticoagulants, or insulin.
    • Data recorder: After the capsule has been swallowed, the patient is provided with a data recorder device that is responsible for recording images while the capsule is in transit. The recorder typically looks like a belt that gets attached to the waist.
    • Duration: The capsule usually takes around eight hours to make its way through the entire digestive tract. During that time, the camera captures thousands of images that all get fed into the data recorder. You can go about your normal daily activities during this time, though you should also avoid strenuous exercise.
    • Completion: Each person’s digestive system is different, but most people will naturally pass the pillcam through the rectum during their next bowel movement. It may be a matter of hours or in some cases it may take a week or two.

    Cary Gastroenterology for Digestive Health

    The development of the capsule endoscopy has provided gastroenterologists with another useful tool in diagnosing digestive health problems. It is a truly minimally invasive procedure that allows the doctor to get clear visuals of the GI tract without the kind of insertion that makes people dread a colonoscopy. If you’ve been experiencing symptoms that you don’t understand, it may be time to get checked out by the friendly and professional staff at Cary Gastro. Please contact us today to request an appointment.