Whenever you have a problem with your food pipe (esophagus), stomach, or intestines, it's hard for doctors to understand what's going on. To see what the problem is, doctors need a way to visualize the gastrointestinal (GI) tract in its entirety. Unfortunately, conventional procedures like upper and lower endoscopy can only visualize a portion of the GI tract, meaning patients must undergo more than one procedure.

The solution is capsule endoscopy. Capsule endoscopy is a common procedure that lets doctors visualize inside your gastrointestinal tract. It involves swallowing a small camera, or "pillcam," that takes pictures along the full length of your GI tract. The result is thousands of pictures that a doctor can comb through to find the source of the problem.

What is Capsule Endoscopy?

Capsule endoscopy is a noninvasive procedure that allows doctors to see the inside of your GI tract using a tiny camera. Patients are asked to swallow a "pillcam" that records photos or video of its journey from the esophagus and through the stomach and intestines. The capsule contains a transmitter and light to ensure everything is visible.

Given that the capsule contains everything it needs – alongside a power supply – it is a fully wireless capsule endoscopy. This is, in contrast, to other forms of cameras, like endoscopes, that can be quite uncomfortable for patients to swallow.

The footage from your GI tract feeds back to a recorder for later analysis. The quality of this diagnostic method depends on the quality of the imaging, recording time, battery life, and any issues with data transmission.

Why Is Capsule Endoscopy Performed?

There are several reasons why your doctor might recommend capsule endoscopy, including:

• Identifying the Cause of Intestinal Bleeding: This is the primary reason for undergoing a capsule endoscopy. It helps pinpoint the source of bleeding within the small intestine.

• Diagnosing Inflammatory Bowel Diseases: Capsule endoscopy is a valuable tool for detecting inflammation and irritation in the small intestine, particularly in conditions like Crohn's disease or ulcerative colitis.

• Cancer Detection: This procedure can reveal tumors in the small intestine and other parts of the digestive tract, aiding in the early diagnosis of cancer.

• Monitoring Celiac Disease: Capsule endoscopy assists in diagnosing and observing the progression of celiac disease, which is an immune reaction triggered by consuming gluten.

• Examining the Esophagus: The procedure is also used to inspect the esophagus for varices, which are enlarged veins in the tube connecting the mouth to the stomach, potentially indicative of serious conditions.

• Screening for Polyps: It can detect polyps that are often associated with genetic syndromes, aiding in the screening process for familial intestinal conditions.

• Follow-up Diagnostic Testing: When results from X-rays or other imaging techniques are inconclusive, capsule endoscopy can provide additional detailed insights, helping to refine diagnoses.

For those experiencing symptoms of gastric reflux that are difficult to diagnose through traditional methods, gastric reflux testing at The Functional Gut Clinic offers a comprehensive evaluation to pinpoint the causes of discomfort and guide effective treatment.

Potential Risks

Unlike other forms of endoscopy, wireless capsule endoscopy carries much fewer risks. Because the pill is small and round, there's less chance of any intestinal or esophageal tears or perforations. That being said, the capsule may become stuck during its transit. Usually, this lasts only a few days; however, people with narrowing like stricture or tumor might have bigger issues.

If the capsule doesn't pass in your bowel movement, then it's important to speak to your doctor. Regular endoscopy (or even surgery) can be used to remove it. It should be noted that this complication is rare.

Preparing for the Procedure

If you're planning to undergo capsule endoscopy, you'll have to prepare as you would for the other procedure. The preparation includes:

• Do not drink or eat for at least 12 hours before the procedure. The camera needs a clear digestive tract to take pictures. Your doctor might even ask you to take a laxative to ensure your small intestine is as clear as possible.

During the Procedure

On the day, your doctor will explain how the specific device works. They will show you the pillcam so you know what to look for when it passes out of your body. The procedure is not painful, and you shouldn't feel anything. Often, it has a slippery coating to help it slide down into your stomach.

The device will then either record the data internally or transmit it to a recorder you'll need to carry for the duration of the test. It's advised that you avoid any strenuous activity. However, everyday tasks like driving or working at a desk are fine.

What Happens After the Procedure

You need to wait at least 2 hours after swallowing the capsule before you can start drinking clear fluids. Then, wait a total of 4 hours before you can eat. Stick to a light lunch or snack first.

On average, it should take around 8 hours for the pillcam to pass through your system. Inspect your bowel movements going forward to see if the pillcam is present. If it is, you can remove the patches and recorder from your body. Then, flush the pillcam down the toilet.

You'll need to return the recorder to your doctor for analysis. They can tell you if there's anything wrong and the best course of action.