Video capsule enteroscopy

Video Capsule Enteroscopy*

The 'Pillcam' -

a pill that takes a film of the small intestine as it passes through you

*Spire Lea Hospital only

What this test involves

The Pillcam (shown dissected opposite) is a camera, with a light, battery and radio transmitter all contained within a capsule that is small enough to swallow (easily!).

Whilst the Pillcam technology can be adapted to help other areas of the gastrointestinal tract (oesophagus, stomach and colon) it is still inferior in these areas to undergoing formal 'tube' endoscopy. It is however extremely useful in visualising the small intestine - between stomach and colon.

You will be asked to attend the Spire Lea hospital at around 0800 hours to swallow the Pillcam. You will be fitted with a belt (which acts as an antenna to pick up the radio signals from the transmitter in the pill), which is attached to a small bow (data recorder) that you wear over your shoulder. You are then free to leave the hospital - we would recommend only drinking water for the following 4 hours after which you can eat and drink as normal). You will be asked to return in the late afternoon for the equipment to be taken off and the film downloaded. The Pillcam itself is disposable and we do not want it to be returned!

This test is extremely good at picking up bleeding points in the intestine where there is unexplained blood loss causing anaemia, polyps, and ulcers in the part of the intestine out of reach of the normal endoscope.

There are representative video clips of normal stomach and intestine at the bottom of this page.

Risks and safety

Capsule enteroscopy is very safe and associated with minimal complications.

The most important risk is that there is an undiagnosed kink or blockage in the intestine that the capsule cannot pass through. Under these circumstances, an operation may rarely be required to remove it (at the same time as dealing with the stricture). Given that the Pillcam has , under these circumstance, identified a problem that could not be found with other tests, it is questionable whether this represents a complication of the test or not! it is reported in about 1 in every 100 cases, but the proportion is much lower in individuals without risk factors.

Occasionally some people find that the pill is not easy to swallow and we can then use a gastroscope to introduce it if necessary.

The procedure may need repeating if the capsule does not leave the stomach - if there is a delay in stomach emptying due to diabetes for instance.

We do not recommend this test in anyone who is pregnant although the radio signal is weak and almost certainly safe.

It would be unusual for the radio signal from the capsule to affect a cardiac pacemaker, however we recommend checking the pacemaker device before and after the procedure as a precaution.

You will be asked to sign a consent form prior to the procedure to acknowledge that you understand these risks.

Instructions and preparation for the test

You will be asked to attend the endoscopy department having not had anything to eat or drink for at least 6 hours prior to the time of the procedure. This ensures that your stomach is empty. It is quite alright to take essential medications with a small amount of water if necessary.

We will discuss the procedure in detail with you before the day of the test and answer any questions you may have, prior to asking for your consent to proceed.

Please make sure that you inform us prior to the procedure about:

Any severe cardiac or respiratory condition including a pacemaker device.
Whether or not you might be pregnant.

After the procedure

You will be free to leave the hospital. Whilst the Pillcam usually passes through the small intestine in 3-4 hours, it can take 1-2 days to pass through the colon, depending on how often you open your bowels. You may not see the pill passing in your motions - do not worry about this as it usually has.

If the Pillcam does become retained in the intestine by a narrowing, I will usually be able to see this on the film and will let you know. This rarely causes any symptoms, but I may ask you to have an X-ray of the abdomen to see if it has passed after a few days.

I will be in touch when I have had the opportunity to review the film and will send you a report (with still images) of any important findings.

If you do experience any untoward symptoms after the test, please contact the hospital who will put you in touch with me.

Video capsule clip of normal stomach

Video capsule clip of normal small intestine