Capsule endoscopy is a procedure that uses a tiny wireless camera to take pictures of the digestive tract. A capsule endoscopy camera sits inside a vitamin-size capsule. The capsule is swallowed, as it travels through the digestive tract, the camera takes thousands of pictures that are transmitted to a recorder that is worn on a belt around the waist.

Capsule endoscopy helps doctors see inside the small intestine an area that isn't easily reached with more-traditional endoscopy procedures. Traditional endoscopy involves passing a long, flexible tube equipped with a video camera down your throat or through your rectum. Capsule endoscopy has also been approved for screening the colon for polyps in those unable to complete a colonoscopy. But how and on whom capsule endoscopy will eventually be used is still being determined because better alternatives are available. As technology improves, capsule endoscopy of the colon may become more common.

Capsule endoscopy has also been approved to evaluate the muscular tube that connects mouth and the stomach (esophagus) to look for abnormal, enlarged veins (varices). It's rarely used for this purpose because there has been limited experience with it and traditional upper endoscopy is widely available.

Why capsule endoscopy is performed?

Capsule endoscopy procedure is recommended by doctor in case:

• Find the cause of gastrointestinal bleeding- If patient has unexplained bleeding in the digestive tract, capsule endoscopy can help find the cause.

• Diagnose inflammatory bowel diseases, such as Crohn's disease- Capsule endoscopy can reveal areas of inflammation in the small intestine.

• Diagnose cancer- Capsule endoscopy can show tumors in the small intestine or other parts of the digestive tract.

• Monitor celiac disease- Capsule endoscopy is sometimes used in monitoring this immune reaction to eating gluten.

• Screen for polyps- Patient who have inherited syndromes that can cause polyps in the small intestine might occasionally undergo capsule endoscopy.

• Do follow-up testing after X-rays or other imaging tests- If the results of an imaging test are unclear or inconclusive, the doctor might recommend capsule endoscopy to get more information.

What are the risks of Capsule Endoscopy

Capsule endoscopy is a safe procedure that carries few risks. However, it's possible for a capsule to become lodged in the digestive tract rather than leaving the body in a bowel movement within several days. The risk, which is small, might be higher in patients who have a condition such as a tumor, Crohn's disease or previous surgery in the area, that causes a narrowing (stricture) in the digestive tract. If patient have abdominal pain or are at risk of a narrowing of intestine, the doctor likely will get a CT scan to look for a narrowing before using capsule endoscopy. Even if the imaging study is negative, there's still a small chance that the capsule could get stuck.

The last pictures taken by the capsule help the doctor determine when the capsule reaches the colon. Most of the time, the capsule moves through the digestive system easily and is likely to pass through your stool. However, if the doctor determines the capsule is stuck in the small intestine but it does not cause any symptoms might wait longer for the capsule to leave the body. If the capsule pass doesn’t pass through the stool, the doctor may order an abdominal X-ray to make sure it is out of the body, but this is generally not necessary unless patients have symptoms. A capsule causing signs and symptoms that indicate bowel obstruction must be removed, either by surgery or through an endoscopy procedure, depending on where the capsule is stuck.

Preparations for Capsule Endoscopy

To prepare for the capsule endoscopy, following instructions are:

• Stop eating and drinking at least 12 hours before the procedure- This will ensure that the camera captures clear images of the digestive tract.

• Stop or delay taking certain medications- The doctor will advise the patient not to take medication before the procedure because it might interfere with the camera.

• Plan to take it easy for the day- In most cases, after swallowing the camera capsule, do not do strenuous exercise or heavy lifting. If patient is working, take the advice from the doctor whether to work on the day of capsule endoscopy.

In some cases, the doctor may ask to take a laxative before capsule endoscopy to flush out the small intestine. This has been shown to improve the quality of the pictures collected by the capsule's camera. Follow doctor's instructions in preparing for capsule endoscopy. Failure to follow the directions may mean the test will have to be rescheduled.

During capsule endoscopy

On the day of capsule endoscopy, Doctor team might ask the patient to remove the shirt so that adhesive patches can be attached to your abdomen. Each patch contains an antenna with wires that connect to a recorder. Some devices don't require the patches. The recorder is worn on a special belt around the waist. The camera sends images to an antenna on abdomen, which feeds the data to the recorder. The recorder collects and stores the images.

Once the recorder is connected and ready, swallow the camera capsule with water. A slippery coating makes it easier to swallow. Once it is swallowed, patient shouldn't be able to feel it. Patient can drive, and might be able to go to work, depending on the job. doctor may recommend some restrictions, such as avoiding strenuous activity, including running and jumping.

After the capsule endoscopy

Patient should wait for two hours after swallowing the capsule to resume drinking clear liquids. After four hours, patient can have a light lunch or a snack as per the doctor’s advice. The capsule endoscopy procedure is complete after eight hours. Remove the patches and the recorder from the body, pack them in a bag and follow doctor's instructions for returning the equipment. Flush the camera capsule down the toilet.

Patient body might expel the camera capsule within hours or after several days. Each person's digestive system is different. If the capsule is not seen in the toilet within two weeks, consult the doctor. Doctor might order an X-ray to see if the capsule is still in the body.