What is capsule endoscopy?
Capsule endoscopy is an exciting new technology that has become available to the medical community in the last few years. This is a revolutionary way to image, in most patients, the entire small intestine. This is an area of the body that had previously been out of reach of traditional endoscopy. In this modality, a patient swallows a small pill which emits a radio frequency which is picked up by sensors that the patient wears on the abdominal wall. This study lasts several hours. Images are then downloaded as a continuous movie and viewed by your physician.
The battery of the capsule typically lasts approximately 8 hours, meaning we can reliably image the small intestine (n.b. there are over twenty feet of small intestine in most individuals) as well as partial imaging of the stomach and proximal colon. Most individuals will pass the capsule out of the stomach within one hour, and pass it out of the small intestine within 6 hours, but colonic transit time can be hours to days. Therefore this capsule form of endoscopy is not suited for inspection of the colon, and as such, will not replace the need for colonoscopy.
Insurance company approval of this technology is growing but indications remain limited, primarily being evaluation of suspected gastrointestinal bleeding, and small intestinal Crohn’s disease. Check with your Associates in Gastroenterology physician about how this procedure might help with your evaluation.
What happens before your procedure?
- You will need to stop by the office 2-3 days prior to your procedure to pre-register.
- On the day of the procedure arrive at the office at your assigned time. There, the nurses will go over the procedure with you. You will be given an opportunity to ask questions.
Capsule endoscopy is a technology first developed by the Given corporation. Information about the procedure can also be found on their web site.
What preparation is required for capsule endoscopy?
You will need to pick up the following items at your local pharmacy
- Four Dulcolax (bisacodyl) tablets ( usually come in a packet of 24- sorry, you will only need four of them)
- Miralax Powder ( 119 grams )
- Gatorade, or other electrolyte drink- one 32oz bottle (NO RED OR PURPLE). Diabetics use Propel or other sugar free drink, preferably an electrolyte solution
- DO NOT TAKE THIS PREP IF YOU HAVE KIDNEY PROBLEMS, CONGESTIVE HEART FAILURE OR IF YOU ARE ON A SALT RESTRICTED DIET.
DAY BEFORE YOUR EXAM
- No smoking 24 hours prior to the test.
- You will be on a clear liquid diet the entire day before the exam (fruit juices without pulp i.e. apple, white grape, water, clear broth bouillon, coffee without cream, Gatorade, soft drinks, Jell-O, popsicles) Do not have anything red or purple! Drink as much clear liquid as you can during your prep.
- Between 12 noon & 2 P.M. take 4 Dulcolax tablets- do not chew tablets- swallow whole.
- At 6PM, drink one 8oz glass of the Miralax/Gatorade mix. Repeat every 15 minutes until you have finished the 32 oz. bottle of the Miralax/Gatorade mix (this should take approximately 2 hours) Do Not take extra fluids while drinking the Miralax/Gatorade.
- After completing the prep, stay on clear liquids until 10pm. Drink at least 1 or more glasses of water before 10 PM.
- Nothing to eat or drink after 10 PM
DAY OF EXAM
- You may take needed medications up to 2 hours before the exam with a sip of water if you need to.
- Do not apply body lotion or powder to your abdomen.
- Wear loose fitting, two piece clothing. Your upper clothing should be opaque not sheer (ex. COTTON t-shirt that is long enough to reach at least to hip level and not ride up above the belt)
What happens during the procedure?
The study consists of ingesting the video capsule pill, and then you will return later that day (approximately 8 hours later) for data recorder retrieval. Return to your physician’s office at 4:30 P.M.
What happens after your procedure?
Your study report will be ready within seven days of the procedure. Typically, the time is even less. Your primary/referring Associates in Gastroenterology physician will then have access to your report and advise you of the findings. If you have not heard from your physician, please call 719-635-7321 to discuss the findings.
What are the possible complications of capsule endoscopy?
This is a less-invasive modality than conventional endoscopy, however, there are some rare risks. The potential to have the capsule become lodged in the small intestine exists, primarily if scarring or adhesion’s from prior surgery or inflammatory bowel disease complicate your medical history. A capsule that remains in the small intestine will require a minor surgical procedure for removal.