What is an endoscopic capsule and why is it done?

The endoscopic capsule is a method of imaging and investigating the entire small intestine. The small intestine cannot be investigated by conventional gastroscopy or colonoscopy except for its beginning and end, which represent a very small part of its total length.

The endoscopic capsule allows the investigation of the mucosa of the small intestine along its entire length, capturing thousands of images. This material is transmitted wirelessly to an image recorder. The set of images taken during the examination, which lasts about 8-10 hours, creates a video which is then studied by the doctor to draw conclusions about the examination.

The main indication for its implementation is the investigation of visible or invisible gastrointestinal bleeding, it can also offer important information in the diagnosis of Crohn’s disease or tumors of the small intestine, coeliac disease, the investigation of chronic diarrhoea and chronic abdominal pain.

Absolute contraindications for the examination are:• Narrowing or blockage of the digestive tract• Dysphagia and severe motility disorders of the digestive system

Relative contraindications are:• Pregnancy• The presence of diverticulae• Multiple Zenker diverticulum• Gastroparesis• History of multiple abdominal surgeries

There must be a preparation of the bowel with laxatives and fluids for 24 hours before the procedure and nil by mouth to ensure that the camera will capture clear images as it travels through the digestive tract.

The equipment is removed in the afternoon of the same day, and the doctor sees the recording on a video on the computer.

Patients that have a permanent pacemaker may need to be hospitalized during capsule endoscopy for electrocardiographic monitoring during the procedure.

The unit nurse will apply the recording system to the patient which consists of 8 special stickers-sensors which are placed in the abdomen and chest of the patient and a special belt that holds the recording machine.

The patient swallows the capsule with a little water and during its passage records two images per second. The images are sent wirelessly to the recorder which collects and records the images and at the end of the examination they are sent to a computer for the analysis of the data by the doctor with the help of a special software.

At this point the patient can go home and continue his daily habits avoiding only intense physical exercise and contact with water.

Two hours after swallowing the capsule the patient can drink water and a light meal is allowed after four hours. Under no circumstances can the belt be removed.

The duration of the examination is about 8-10 hours. The patient returns to our unit where the recording equipment is removed. The capsule is disposable and is naturally eliminated from the body within the next few days.

The patient can return to his daily activities and there is no restriction on his feeding.

Complications from the use of the endoscopic capsule are very rare. It is a safe procecedure with minimal risks.

A possible complication is the retention of the capsule due to narrowing of the intestinal lumen, which in some cases may require surgery to remove it.

A very rare complication, in cases of dysphagia, is the entry of the capsule into the airways instead of the digestive system.

Although complications are rare during or after the capsule, contact us in case of severe abdominal pain, nausea or vomiting.