Capsule Endoscopy

What is Wireless Capsule Endoscopy?

Capsule endoscopy provides pictures of your small bowel to help us diagnose gastrointestinal conditions such as sources of bleeding, problems absorbing food nutrients, pain or diarrhoea. Capsule endoscopy is mainly used to pinpoint bleeding in the small bowel. A capsule investigation may also be offered when other investigations have not been able to find the cause of your problem or suggest the small bowel is the place to look.

What is involved in a Wireless Capsule Endoscopy?

Capsule Endoscopy involves swallowing a small capsule containing a camera, battery, light source and transmitter. Once swallowed, the camera moves naturally through your body. The camera takes 2-6 pictures every second for eight hours, transmitting images to a small data recorder worn around your waist. After you return the recorder, images are downloaded and reviewed. The capsule is disposable and will be passed in your bowel movement.

This procedure is painless and does not require sedation. Most people find the capsule easy to swallow. With a few restrictions you can carry out your usual activities for the remainder of the day including going to work as long as your job is not physical.

How do I prepare for a capsule endoscopy study?

For a successful test your small bowel needs to be empty so that the capsule has a clear view. This means we want you to avoid seeds, skins and other residue in your diet.

To give you the best chance of a good quality result please follow these instructions:

Eat a low fibre diet for 2 days before your test (see low fibre diet information leaflet.)
Eat lunch at midday on the day before your test.
Take only clear fluids after midday until midnight on the day before your test, this includes water, coffee or tea without milk, diabetic or diet soft drinks (avoid red or purple), strained fruit juice without pulp e.g. apple, clear soups (strained), or clear ice blocks (avoid red or purple).
Do not eat after midday or drink after midnight.
You can take the medications you have discussed with the nurse on the morning of your test with a few sips of water. Nonessential medications should not be taken.
Wear a t-shirt or similar light top. Over this a belt is places around your waist and small bag around your shoulders. You will then be able to put clothing on top of these if you need to throughout hours.

The Process

On arrival

A nurse will confirm your details and you will be asked to sign a consent form for the procedure.
A belt containing the data recorder will be placed around your waist.
You will then swallow the capsule with a drink of water containing simethicone, a medication that stops bubbles forming.
Before you leave the department we need to be sure the capsule has passed into your small bowel. This usually occurs within half an hour but can take up to two hours.
Very rarely, a longer stay may be necessary if the capsule does not pass out of your stomach and into your small bowel. In this case endoscopic placement (gastroscopy) may be required.

Immediately after

You are then free to resume your normal day with the following restrictions:

After you leave the department you must not eat or drink for a further two hours.
After two hours you can begin to drink only.
After four hours you can eat a light snack.
Avoid strenuous exercise or physical activities that involve stooping/bending or cause sweating.
Move around regularly and do not lie down.
You should avoid any powerful electromagnetic fields particularly MRI scans and amateur (ham) radios until the capsule has passed.
Contact the Endoscopy Unit immediately if you experience any abdominal pain or vomiting

In the evening

You may eat a normal evening meal.
At bed time carefully remove the record belt and place it close to you (within 1 metre) on a flat surface while you sleep. The capsule battery will run out sometime during the evening/night and recording will stop.

The next day

When you wake you can shower /eat as normal as the test will now be over. Please bring the belt and recorder back to the endoscopy department by 9 am on the day after your test.
The capsule is disposable and will be passed from your body naturally in your bowel movement. Passage of the capsule in the motions may go unnoticed, so please do not worry if you do not see it pass.