Having a Small Bowel Video Capsule Endoscopy

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Having a Small Bowel Video Capsule Endoscopy

Introduction 

This document has been prepared to help you understand the procedure. It includes answers to questions most frequently asked by patients. Please read it carefully and feel free to ask your doctor or nurse any questions before the procedure is scheduled.

Please do not bring children to the unit as we do not have facilities to accommodate. 

What is video capsule endoscopy?

A capsule endoscopy is a test which examines your entire small intestine. Your specialist nurse will ask you to swallow a vitamin-pill sized video capsule, which has its own camera and light source. The small bowel (or intestine) is part of the gastrointestinal tract between the stomach and large bowel (colon). During the six to eight hour examination, you are free to move around and most patients find the test comfortable. Afterwards your doctor/nurse practitioner will view the images on a video monitor.

Why do I need a video capsule endoscopy?

The most common reason to perform video capsule endoscopy is to help your doctor determine the cause for recurrent or persistent symptoms such as abdominal pain, diarrhoea, unexplained anaemia (iron deficient anaemia) or intestinal bleeding, in whom conventional endoscopy to examine the stomach (gastroscopy) and large bowel (colonoscopy) has failed to reveal a diagnosis. 

Are there complications or risks?

There is a small risk the test may need to be repeated if the small bowel views are not clear enough or if the procedure was incomplete. Should this be the case, we will contact you to make another appointment. 

You should be aware that: 

  • A capsule endoscopy cannot be carried out during pregnancy. 
  • Magnetic Resonance Imaging (MRI) cannot be carried out until the Pillcam has been excreted from the body. 

It is important to inform us if you have a pacemaker or internal electromedical device, previous abdominal surgery, swallowing problems or previous history of obstructions in the bowel. 

A potential risk is retention of the capsule at a site of narrowing within the small bowel, and there is around a 1% chance of this overall. However, if there is a reason to suspect this might be a risk in you, a dummy or patency capsule will be provided to test whether the capsule will safely pass and you nurse will discuss this with you further as needed. 

It is important for you to recognise signs of possible complications early. If you have a fever after the test, trouble swallowing or increasing chest or abdominal pain, tell your doctor immediately, contact us or attend your nearest A&E. 

What happens if the pill camera does not pass through my body? 

If the pill camera reveals Crohn’s disease (most common cause for pill not to pass through), treatment with anti-inflammatory medication may allow the narrowed part of bowel to heal in order for the pill to pass spontaneously. If the video capsule is retained in the extreme upper or lower part of the small bowel, it may be possible to retrieve it using an endoscope. In rare cases the small bowel can be severely ulcerated, scarred or blocked therefore an operation might be necessary not only to remove the pill, but to treat the disease. 

How should l prepare for the procedure? 

Please wear loose fitting clothing when attending for your test. Bowel preparation is an essential part of this examination and involves dietary advice and use of purgatives (laxatives). Your referring doctor will have indicated if you are able to take the bowel preparation or not. Please find separate detailed preparations instructions enclosed.

Please make sure you bring an up-to-date list of all medication you are taking when you attend for your appointment. 

What can l expect during a video capsule endoscopy? 

The specialist nurse will prepare you for the examination by applying a sensor belt around your waist. The video capsule is swallowed with water and passes naturally through your digestive tract while transmitting video images to a data recorder which you will carry in a bag for approximately six to eight hours. You may go out/home during this time. You will be able to drink two hours after the capsule has been seen in the small bowel by the specialist nurse and a light lunch after four hours. You should return to the endoscopy unit at the time specified by the nurse specialist. 

What happens after the video capsule endoscopy?

The images taken during your exam will then be downloaded to a workstation for your doctor/nurse to review. After swallowing the capsule and until it passes through your body, you should not have a Magnetic Resonance Imaging (MRI) examination or be near an MRI machine.  

How will l know the results of the video capsule endoscopy?

Results can take two to four weeks to process. This is because of the time it takes to look at the large number of images. Results are sent to your referring doctor and GP. If results are required urgently your doctor can contact us. 

How does the capsule pass through my body and will I feel it come out?

The capsule is disposable and passes naturally with your bowel movement. You should not feel any pain or discomfort. Do not worry if you do not see the pill camera pass as most people don’t. Please do not send it back to us as it cannot be reused.

Valuables                       

Lockers are available for your personal belongings (a £1 coin is required at some sites which is refundable) but please do not bring valuables or too much money with you as the Trust is not responsible for any loses. 

Interpreters

If you need an interpreter at your appointment please contact the department on the telephone number at the bottom of this information.

Car Parking           

At St Mark’s hospital parking is available in the multi-storey car park at the front of the hospital and outside the entrance to St Mark’s (Car Park 4). Car parking charges apply and pay and display is in operation so please bring some change with you.  

Contact Details

This leaflet has been produced by staff in the endoscopy department of the London North West Healthcare NHS Trust. Please do not hesitate to telephone the endoscopy department at St Mark’s on 020 8235 4136 if you have any questions. For more information regarding the hospital and how to get here please visit: www.stmarkshospital.nhs.uk. Other sources of information are available at: www.bsg.org.uk

Video Capsule endoscopy. First published: March 2015. Review date: May 2023. Next review date: May 2024

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