Video Capsule Endoscopy - An Information Guide

This information is due for review September 2024

What is a Capsule Endoscopy?

This is a technique which allows us to look at the whole of the small and large intestine. Capsule endoscopy is particularly useful in the diagnosis of anaemia, malabsorption issues and underlying inflammation such as in inflammatory bowel disease (IBD).

The test involves swallowing a vitamin-pill sized capsule, which passes through your digestive tract. A data recorder is attached to your abdomen with a belt and as it moves through your intestine images are collected. After the test the images are viewed by a practitioner.

Benefits and Risk

The main benefit of having this test is that it will help your Doctor determine what is happening with your bowel or if you have a condition that needs treating.

Capsule endoscopy is a safe procedure and well-tolerated by patients, side effects are very rare. The main risk to the test is capsule retention, in other words the capsule getting stuck. It is estimated that this occurs approximately in 1 % of cases. Capsule retention usually is caused by narrowing of the bowel lumen and in this scenario the capsule identifies the area of problems. In these rare instances, the capsule could be removed either with laxatives or through endoscopy, however surgical operation may be required.

Should your doctor have any doubt about the capsule passing through your gut, a small biodegradable patency capsule (which dissolves away in the intestine should it become stuck) may be carried out first.

Alternatives

• A barium follow through X-ray, a CT or MRI of the bowel (These alternatives may be less sensitive in revealing the underlying problems. Your doctor would guide you towards the best options.)
• A push Enteroscopy (This test can provide a more extensive view of the small bowel compared to the standard gastroscopy, does not need general anaesthesia but typically can reach only a third of the small bowel.)
• A  Device assisted Enteroscopy (This service is limited and is not performed in every hospital. It is a long and more invasive procedure that usually requires general anaesthesia. Capsule endoscopy routinely is performed first as it less invasive.)

Please telephone/contact the Department if any of the following apply:

• You suffer with a combination of abdominal pain, abdominal distension and vomiting, especially after meals.
• You have a pacemaker or any cardiac device.
• You had previous small bowel surgery.
• You have been taking Non-Steroidal Anti-inflammatory drugs (such as Ibuprofen, Nurofen, Diclofenac) for 6 months or more.
• You have been diagnosed with Crohn’s disease.
• You have a stoma in place.
• You are or think you may be pregnant.
• You have a scheduled MRI after your capsule endoscopy appointment. It is mandatory to ensure the capsule has exited your body.

Before the procedure

• You will be seen in a consultation with a practitioner. At this time they will take a medical history, explain the test, run through any questions you may have and obtain your consent for the test.

If you’re unable to attend this appointment or wish to change it please phone the Endoscopy booking department on: 01282 803541 (If you require an interpreter for the consultation please inform the staff at this time).

BOWEL PREPARATION (VERY IMPORTANT):
 

Video capsule endoscopy is a visual test. The better the bowel preparation the more information can be taken from this.

 

Preparation instructions:

 

• If you take iron tablets, stop these one week before your test.
• If you take Imodium (Loperamide), codeine or other drugs which make you constipated, stop taking these two days before your test if possible.
• If you are taking any other medications you can continue these as usual, unless your doctor advised you otherwise. Ensure you take them only with few sips of clear water.
• If you are a diabetic and take either insulin or tablets to control your diabetes, please contact 01254 732320.
• If you need an interpreter, please contact the Endoscopy Department on 01254 734415.

The Day before your capsule endoscopy

• You can have breakfast as usual (avoiding high fibre foods, fruits and vegetable)
• From this time onwards, DO NOT EAT ANY SOLID FOOD, your bowel needs to be empty for the test. You can drink clear soups, soft drinks and black tea or coffee with sugar if you wish.
• During the evening you should receive the laxatives provided for your bowel preparation. Please follow the bowel preparation instructions leaflet carefully.

The Day of your capsule endoscopy

• Before the test receive your regular medications as described above
• Otherwise DO NOT EAT OR DRINK ANYTHING
• After you receive the capsule follow the advice on the table below:

After swallowing the capsule endoscope

• DO NOT remove or disconnect the belt or sensors at any time.
• Throughout the test (every 15-20 minutes) you will be asked to CHECK that the blue light on the top of the data recorder continues to blink twice a second. This signals that the capsule images are being transmitted or sent correctly. Please contact the Specialist Nurse 01254 732320 if the light goes off.
• For the duration of the test, AVOID any strenuous exercise or physical activities that may involve stooping/bending or cause sweating.
• Contact the Specialist Nurse 01254 732320 IMMEDIATELY if you experience any abdominal pain, vomiting or excessive bloating.
• You will be asked to return to the Endoscopy Department at approximately 17:00 on the day of the procedure. Once completed the practitioner will remove the sensor belt and data recorder. You are now free to resume your normal activities and diet.
• You should pass the disposable capsule from your body naturally in the toilet a few days after the test. Please contact us when you have seen the capsule and are confident that it has passed.

YOU SHOULD AVOID ANY POWERFUL ELECTROMAGNAETIC FIELDS PARTICULARLY MRI SCANS UNTIL THE CAPSULE HAS PASSED.

What happens if I cannot swallow the video capsule?

Most people can swallow the capsule because of its size and design. If you have difficulty swallowing please discuss this with your doctor who has sent you for the test or with the practitioner at your consultation. Your doctor may decide that you need to have the capsule placed into your stomach or small bowel using a flexible tube called an endoscope. This procedure is the same as an OGD (gastroscopy) which you may have had done in the past. A different information leaflet can be provided to you about this procedure from the endoscopy department.

What happens during the capsule endoscopy?

• Following admission a belt containing the radio sensors will be placed around your waist and the data recorder will be attached. This will remain in place for the 8 hour duration of the test.
• Once these are fitted in place the practitioner will instruct you to swallow the Capsule with a mouthful of water.
• The practitioner will check in half an hour to see if the capsule has left the stomach. If this has not happened you may be given a medication to speed up the process or the nurse may lie you in a certain position for a period of time to aid the capsules movement.
• Once the practitioner is happy that the capsule has entered the small bowel, you may leave the department.

Discharge advice and follow up

After the test is completed the information (images) from the data recorder will be processed and a video will be created and subsequently reviewed. Once the video has been reviewed the results will be sent to your doctor. Your doctor will organise to give you the results in an outpatient appointment or by a written letter. If it becomes apparent during the video review that you have retained the capsule (it is still in your bowel), we will contact you to come to the hospital for an xray.

Contact Details:

Questions or problems:

If you have any questions or problems, such as what to do about medication, before or after your test, please contact the Specialist Nurse on 01254 732320

Open between 8.30am-5.30pm Monday to Friday

Who to contact out of hours

At all other times, if you have concerns after your test please contact your GP or the Emergency Department at Royal Blackburn Teaching Hospital.

This information is due for review September 2024