Capsule Endoscopy

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What is capsule endoscopy?

Capsule endoscopy is a recently developed noninvasive technique to examine the lining of the small bowel. The most common use is to examine the small bowel in cases of iron deficiency where gastroscopy and colonoscopy have failed to identify a cause.

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Capsule endoscopy can go by several other names including PillCamTM, EndocapsuleTM or MiroCamTM.

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The technique uses a 11mm x 26mm plastic capsule (the size of a large pill) that contains a camera, battery, light source and transmitter. After swallowing the capsule (with a glass of water), it travels throughout the gastrointestinal tract like a piece of food. It takes 2 images per second during its travels which can take up to 8-10 hours – taking over 50,000 pictures! The images are transmitted to sensors and then to a data recorder placed around you waist. Following the procedure the capsule passes into your faeces and is then passed (usually unnoticed) into the toilet bowl in the next 24 – 48 hours. The capsule is single use and does not need to be retrieved.

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How long does the capsule endoscopy procedure take?

The procedure is a day procedure and does not require sedation/anaesthesia. The capsule usually takes about 8 hours to pass through the small bowel, and so we organise the appointment to start the procedure at approx. 8-9 am. We then ask you to return at about 4.30pm the same day to remove the attached equipment including the data recorder box. The images are then placed/uploaded onto a computer and the procedure/images examined in the next 24-48 hours.

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Does capsule endoscopy need special preparation?

The day before the procedure you are only allowed to have clear fluids after midday. Clear fluids include water, clear fruit juices and cordials, clear jelly, clear broth/soup. It is advisable to avoid red coloured liquids during this time.

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You will need to fast for 8 hours before the procedure. As it typically performed in the morning this means that you can have nothing to eat or drink in the morning on the day of the procedure. You are able to take your normal medications with a small sip of water two hours before the procedure (i.e at 6am).

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Following the procedure, you need to fast for 1 hour then take a glass of water every hour for the next 3 hours. After four hours you can eat and drink normally again.

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What are the ricks of capsule endoscopy?

Capsule endoscopy is a very safe procedure. Complications are very infrequent. There is a small risk that the capsule can become stuck in the bowel as a result of a narrowing due to previous surgery, disease or abnormal anatomy. Usually the capsule eventually passes. Rarely it may require an operation or procedure to remove the retained capsule.

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Although the capsule is big, most patients do not have a problem with swallowing the capsule. It is gel coated to allow easier swallowing.

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Occasionally (<1%) an x-ray is needed to check that the capsule has passed in the event that the capsule is not seen to go all the way through the small bowel.

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What are the costs of capsule endoscopy?

The capsules are expensive ($1200-1500 each), however there are no charges for specific conditions under Medicare. For iron deficiency, the government requires that a gastroscopy and colonoscopy be performed within 6 months to be eligible for funding under Medicare.