It is the least invasive investigation to visualize the inner lining of the small bowel, using a miniature camera contained in a plastic capsule around one inch in size.
While oesophagus, stomach, duodenum and colon are approachable by standard endoscopy, examination of the inner lining of the entire length of small bowel with such an approach is more difficult due to its tortuosity and thin wall. Capsule endoscope is ingested and propelled by normal movement of the bowel, and minimizes the chance of injuring the small bowel.
How should you prepare for it?
The preparations before the examination are the same as you would prepare for colonoscopy.
If you have previous abdominal surgery, please inform our doctors before examination.
What will happen during and after the examination?
Our staff will attach several electrodes on your body connected to a portable monitor, which will pick up the signal emitted by the capsule endoscope.
You will be given a plastic capsule to swallow. Your physician may give you an injection after capsule injection to hasten the bowel movement and ensure completeness of examination.
In the ensuing hours, you may continue to take clear fluids until the examination is completed.
Your physician will review the footage recorded during the examination and get back to you.
What if the Capsule Endoscopy cannot be egested?
Under normal circumstances, the capsule will flow into the small intestine once it leaves the stomach, then to the colon. This is usually done in eight hours. When the capsule enters the colon, it will be egested along with the stool. As the capsule is hidden in the stool, it cannot be detected by human eyes normally. In fact, cases with capsules retained in the intestine are rare, except for certain conditions when the intestine is too narrow to allow the capsule to pass through causing obstruction. Patients may have symptoms of nausea and abdominal distension if such case happened. An abdominal Xray will be performed to confirm whether the capsule is retained in the small intestine, then small bowel enteroscopy or laparoscopic surgery may be performed to remove the capsule.
The capsule will pass out with defecation. In the rare instance that the capsule remains inside the small bowel before battery is used up, your physician may arrange a follow up X-ray to confirm that you have passed the capsule out.
Do I need capsule endoscopy before small bowel enteroscopy ?
Capsule endoscopy should be considered as a preliminary screening before small bowel enteroscopy , to determine the condition of the small bowel. For example, a female patient with anemia, capsule endoscopy will be arranged when gynecological problems or problems with the stomach and colon are ruled out. Capsule endoscopy can determine if there is any bleeding, polyps, ulcer or tumor. Small bowel enteroscopy will be arranged for biopsy or hemostasis if indicated. Since the small intestine is around five meters long, preliminary screening is required to confirm the location of abnormalities, thus decide the entrance of enteroscope from either through the mouth or anus .