SMALL BOWEL CAPSULE ENDOSCOPY

What Is Capsule Endoscopy?

Small bowel capsule endoscopy  is a procedure that involves swallowing a large vitamin pill sized video capsule containing a miniature camera, light source, and battery which will pass naturally through your digestive system while taking pictures of your small intestine.  Images are continuously transmitted over eight hours via an array of sensors which are placed on the abdomen and stored in a recording device worn on a belt around the waist.  After eight hours the sensors and recording device are disconnected at your gastroenterologist’s office.  Data images are then read and interpreted by a physician.  The small bowel capsule is disposable and will be excreted naturally in your bowel movement.  In the rare case that it is not excreted naturally, it will need to be removed endoscopically or surgically. 

Why Is Capsule Endoscopy Performed?

Small bowel capsule endoscopy is used most often to find bleeding in portions of the small intestine that are hard to reach with a conventional endoscope.  It can also be used to help identify suspected Crohns disease or other small bowel abnormalities.

How Do I Prepare For Small Bowel Capsule Endoscopy?

An empty stomach and clear gastrointestinal tract is needed in order to get the best visualization and most accurate information from this examination.  For that reason, follow carefully the instructions described below:

Before preparing for the exam, please make sure that you have notified the physician performing your exam of your complete medication list and any of the following:

A.   A personal history of diabetes including the medications you take for it.

B.  Previous abdominal surgery, swallowing problem, or history of bowel obstruction.

C.  A pacemaker or automatic internal defibrillator.

D.  Tell your doctor if you could be pregnant.

DAY BEFORE EXAM:

1.  In the morning, mix the colyte bowel preparation you picked up from the pharmacy with
     water to the “fill” line, shake and put in refrigerator.
2.  Have a normal breakfast. This will be your last solid food until after your procedure.
3.  Have a clear liquid lunch and dinner. Drink generous amounts of clear liquids
     throughout the day and evening to prevent dehydration. Clear liquids are pulp free
     fluids such as clear juices (apple, white grape), Gatorade, sports drinks, plain broth
     (chicken, beef, bouillon), Jell-O, popsicles, soda pop, black tea or coffee, and water.
4.  At 6:00 pm begin drinking colyte at a rate of 8 ounces every 15-20 minutes, as
     tolerated. You must drink one-half of the 4 liter bottle (½ gallon). At some point during
     or after drinking the preparation you will begin to have diarrhea. The timing of this varies
     from person to person. Using flushable baby wipes may make you more comfortable.
5.  If you become too full or develop nausea while drinking your preparation, stop for one
     hour then resume at a slower pace. Preparation should be consumed within 2-4 hours.

6.  It is normal to feel chilled during and after drinking the preparation so you may want to
     wear warm clothing.
7.  After 10:00 pm, do not eat or drink, except to take prescribed medication with a small
     sip of water.

8.  Abstain from smoking 24 hours prior to your exam.

9.  MALE PATIENTS should shave their abdomen six inches above and below the navel.  
     If you need assistance, contact your physician’s office to arrange to have this done in
     advance.

DAY OF EXAM:

1. Do not take any medication 2 hours prior to your exam. 

2. Do not use body lotion or powder.

3. Wear a loose fitting, two-piece outfit.

4. At your physician’s office, you will have a pre-procedure interview.  During this interview you should be informed that small bowel capsule endoscopy is associated with a small chance of intestinal obstruction.  You will be asked to give your informed consent.

5. Sensors will be applied to your abdomen with adhesive pads and a data recording device will be connected to a belt worn around your waist.

6. You will be instructed to swallow the capsule.

 AFTER SWALLOWING THE CAPSULE: 

After swallowing the capsule you may go about your daily routine, following the guidelines described below:

1.   Have nothing by mouth for the first 2 hours after leaving your physician’s office.

2.   After 2 hours, you may begin drinking clear liquids.

3.   After 4 hours, you may have a light snack.

4.   After the examination is complete, you may return to your normal diet.

5.   Avoid strenuous activity, especially if it involves sweating and do not bend over or
      stoop during your exam.

6.   Avoid being near any source of powerful electromagnetic fields such as an MRI device
      or amateur Hamm radio until the capsule has been excreted.

7.   Occasionally, some images may be lost due to radio interference with amateur radio
      transmitter, MRI, etc.  On rare occasions this may result in the need to repeat the
      capsule endoscopy.

8.   Capsule endoscopy lasts approximately 8 hours and is considered complete
      according to your physician’s instructions.  Do not disconnect the equipment or
      remove the belt at any time during this period. 

9.   The recording device is a small computer.  Treat the equipment with the utmost care
      and protection.  Avoid exposing it to shock, vibration, or direct sunlight, which may
      result in loss of information.

10.  Call your physician immediately if you experience unusual bloating, pain, vomiting,
       fever, trouble swallowing, chest pain, or other symptoms or changes.

11.  Verify every 15 minutes that the small light on top of the data recorder is blinking twice
       per second.  If, for some reason, it stops blinking at this rate, record the time and
       contact your physician. 

12.  Record the time and nature of any event such as eating, drinking, your activity and
       unusual sensations.  Bring the completed Event Form to your follow-up appointment
       later that day.

AFTER COMPLETING THE CAPSULE ENDOSCOPY:

1.   Return to your physician’s office as directed to have the equipment disconnected,
      usually 8 hours after you swallow the capsule.

2.   If you did not positively verify the excretion of the video capsule from your body and
      you develop unexplained post procedure nausea, abdominal pain, or vomiting, contact
      your physician’s office.

3.   Undergoing an MRI while the capsule is inside your body may result in serious
      damage to your intestinal tract or abdominal cavity.  If you did not positively verify the
      excretion of the video capsule from your body, you should contact your physician
      before undergoing an MRI examination.

Link to Capsule Endoscopy Consent Form