Capsule Endoscopy

This is a test where the patient swallows a capsule and subsequently the video of the passage of the capsule is recorded on a monitor. It is then downloaded onto a computer and the physician then views it at a later time. Important points about it are as follows

  • There are 3 types of capsules available.
    • For the esophagus
    • For the small bowel
    • For the colon
  • The capsule can get obstructed. Usually it occurs in the area where there is disease. The obstruction rate is 3% but can be as high as 10%. I always recommend a small bowel evaluation prior to the capsue to decrease the chances of an obstruction. My preferred mode of evaluation of the SB is CT enterography. If that cannot be done due to renal problems or allergy to IV dye, I will do a SBFT (small bowel follow through)
  • In my opinion, the capsule endoscopy for the SB is most helpful in diagnosing obscure GI bleeding cases.
  • At present, I do not think it is valuable for colon polyp evaluation for several reasons. Failure to remove polyps and it can only identify large polyps.
  • They are actively working on ways to manipulate the capsule so it can be used for therapeutic purposes and giving the physician an ability to control the movement of the capsule also