Capsule Endoscopy (cont.)
What is capsule endoscopy?
Capsule endoscopy is a technology that uses a swallowed video capsule to take photographs of the
inside of the esophagus, stomach, and small intestine. For capsule endoscopy, the
intestines are first cleared of residual food and bacterial debris with the use
of laxatives and/or purges very similar to the laxatives and purges used before
colonoscopy. A large capsule-larger than the largest pill-is swallowed by the patient. The
capsule contains one or two video chips (cameras), a light bulb, a battery, and
a radio transmitter. As the capsule travels through the esophagus, stomach,
and small intestine, it takes photographs rapidly. The photographs are
transmitted by the radio transmitter to a small receiver that is worn on the waist
of the patient who is undergoing the capsule endoscopy. At the end of the
procedure, approximately 24 hours later, the photographs are downloaded from the
receiver into a computer, and the images are reviewed by a physician. The
capsule is passed by the patient into the toilet and flushed away.
What are the limitations of capsule endoscopy?
While the capsule provides the best means of viewing the inside of the
small intestine, there are many inherent limitations and problems with its use,
the most important of which is that the capsule does not allow for therapy. Other problems
include:
- Abnormalities in some areas of the intestine are missed because of rapid
transit of the capsule and blurred, uninterpretable photographs.
- At times, transit is so slow that the capsule examines only part of the
small intestine before the battery fails.
- If abnormalities are discovered that require surgical resection or
further investigation, it may be difficult to determine where in the small
intestine the abnormality is and thereby help direct therapy.
- If there are narrow areas due to scarring (strictures) or tumors in the
small intestine, the capsule can get stuck in the narrow area and cause an
obstruction of the intestine that requires surgical removal of the capsule.
(For this reason, in patients who are suspected of having a stricture, a
self-dissolving, dummy capsule is swallowed first. If the dummy capsule
sticks, it can be seen on an x-ray of the abdomen and the location of the
stricture determined. Because it dissolves with time, however, the
obstruction will resolve without surgery, and the real capsule will not be
swallowed.)
- Finally, reviewing the tens of thousands of photographs is very time
consuming for the conscientious physician.
Next: What type of diseases can be diagnosed with capsule endoscopy? »
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