What is capsule endoscopy?
Video or wireless capsule endoscopy is a noninvasive diagnostic procedure for examining the gastrointestinal tract, particularly the small intestine.
Capsule endoscopy is performed with a capsule endoscope, which is a large capsule containing a micro-camera, a light bulb, a battery, and a radio transmitter.
The patient swallows the capsule endoscope which transmits images of high resolution and magnification as it passes through the digestive tract. These images are recorded and can be viewed on a computer to check for abnormalities.
Capsule endoscopy history and development
Traditional endoscopy and colonoscopy enable a doctor to visualize the upper gastrointestinal tract (esophagus, stomach and duodenum) and the colon, respectively, but are not helpful in studying the entire small intestine.
Technical advances in imaging, optical design and light-emitting diodes enabled the development of capsule endoscopy in the late 1990s. Currently research is underway on the development of magnetically guided capsule endoscopy.
Why is capsule endoscopy done?
Capsule endoscopy is primarily performed to evaluate the small intestine’s health, though it is useful in diagnosing disease in any part of the digestive tract.
Currently, it is recommended after upper endoscopy and colonoscopy have not been successful in finding the cause for
What conditions can be diagnosed with capsule endoscopy?
Capsule endoscopy is especially useful in diagnosing conditions affecting the small intestines including:
- Obscure gastrointestinal bleeding from lesions (angiodysplasia)
- Inflammatory bowel disease (IBD) such as
- Crohn’s disease
- Ulcerative colitis
- Tumors and cancer
- Celiac disease (gluten intolerance)
- Henoch-Schonlein purpura (a disease that causes inflammation and bleeding of the small intestines)
- Intestinal graft-versus-host disease (when immune cells in donor tissue attack the patient’s healthy cells) after small bowel transplant
- Capsule endoscopy may also be indicated in patients with
- HIV displaying gastrointestinal symptoms
- Malabsorptive syndromes other than celiac disease
How is a capsule endoscopy performed?
Capsule endoscopy is usually performed by a gastroenterologist as an outpatient procedure. It is noninvasive and requires no sedation.
- The patient must not eat or drink anything for 12 hours prior to the procedure.
- The patient may have to take laxatives to ensure that the digestive tract is clear of gastric contents.
- The patient may go through imaging tests to ensure there are no strictures or obstructions in the bowel.
- The doctor attaches eight antennas to the abdominal skin, connected to a recorder worn around the patient’s waist.
- The patient swallows the capsule endoscope with a little water.
- The capsule sends two images per second as it passes through the gastrointestinal tract.
- The patient may drink liquids two hours after swallowing the capsule and eat after four hours.
- The batteries in the capsule endoscope last for eight hours and the antennas and recorder will be removed after that period.
- The patient will be able to go through normal daily activities during the period.
- The capsule will be excreted along with stools normally.
- The recorded images will be analyzed by the doctor for abnormalities.
How long does it take to pass a capsule endoscopy?
The time taken by the capsule endoscope to pass through the digestive system varies from individual to individual. It may take 8-72 hours, or in some cases, even a week or two.
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What are the limitations of capsule endoscopy?
Capsule endoscopy has a few limitations such as
- Slow transit, resulting in incomplete examination before battery failure
- Rapid transit resulting in blurred images
- Getting stuck in strictures or obstructions
- Unsuitability for therapeutic purposes such as
- removing polyps
- extracting tissue for biopsy
- treating bleeding sites
Is capsule endoscopy safe?
Capsule endoscopy is a safe and well-tolerated procedure for most people. It is the safest non-invasive diagnostic tool currently available for examining the small intestine.
What are the complications of a capsule endoscopy?
Capsule endoscopy has few risks. It is safe for even children and the elderly. The procedure’s main risk is the capsule’s retention in the bowel, which may
- cause bleeding
- necessitate surgery for removal
Retention of the capsule is primarily due to existing stricture or obstruction of the bowel.
These conditions can be detected by having the patient first swallow a similar-sized capsule (patency capsule) that dissolves in 40 hours. The decision to perform capsule endoscopy can be made based on whether the patency capsule passes out or dissolves in 40 hours.
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Balloon EndoscopyBalloon endoscopy is a procedure to view the small intestine and the digestive track. There are two types of balloon endoscopy, single balloon and double balloon. Balloon endoscopy requires approximately one to three hours for the procedure. Balloon endoscopy is used to treat of diseases of the
- duodenum, and
- colon (large intestine).
Capsule EndoscopyCapsule endoscopy is a video capsule that is swallowed and takes photographs of the small intestine. Preparation for capsule endoscopy is similar to that of colonoscopy. There are limitations to capsule endoscopy, however capsule endoscopy is generally able to diagnose angiodysplasias, small intestinal tumors, and Crohn's disease.
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Endoscopy (EGD) Procedure
Endoscopy is a broad term used to described examining the inside of the body using an lighted, flexible instrument called an endoscope. Endoscopy procedure is performed on a patient to examine the esophagus, stomach, and duodenum; and look for causes of symptoms such as abdominal pain, nausea, vomiting, difficulty swallowing, or intestinal bleeding.
Endoscopy vs. ColonoscopyBoth endoscopy and colonoscopy are nonsurgical procedures that involve use of a flexible tube with a light and camera to examine parts of the digestive tract. A colonoscopy is a type of endoscopy.
IBS vs. IBD: Differences and Similarities
IBS (irritable bowel syndrome) and IBD (inflammatory bowel disease) are both problems with the digestive tract (gastrointestinal or GI tract), but they are not the same disease. IBS is a functional disorder (a problem with the way the GI tract functions), and IBD is a disease that causes chronic prolonged inflammation of the GI tract, that can lead to ulcers and other problems that may require surgery. The most common forms of IBD are Crohn's disease and ulcerative colitis, or UC.
Researchers do not know the exact cause of either disease, but they believe that IBS may be caused and triggered by a variety of factors (foods, stress, and the nervous system of the GI tract), while IBD may be genetic or due a problem with the immune system.
Common symptoms of both diseases are an urgent need to have a bowel movement, diarrhea, nausea, vomiting, and abdominal pain and cramping.
There are differences between the signs and symptoms of irritable bowel syndrome and inflammatory bowel disease, for example, symptoms unique to IBD are:
- Joint pain or soreness
- Skin changes
- Rectal bleeding
- Eye redness or pain
- Unintentional weight loss
- Feeling tired
Symptoms unique to irritable bowel syndrome include:
- Sexual problems
- Abdominal bloating
- Whitish mucous in the stool
- Changes in bowel movements and in the way stools look
- An urgent need to urinate
- Urinating frequently
Treatment for IBS is with diet recommendations from a doctor or nutritionist, medication, and lifestyle changes like stress management and avoiding foods that trigger the condition. Treatments for IBD depend upon the type of disease, its symptoms, and health of the patient. Surgery may be necessary for some individuals.
Brown, AC, et al. "Existing Dietary Guidelines for Crohn's Disease and Ulcerative Colitis." Medscape.
Lehrer, J. "Irritable Bowel Syndrome." Medscape. Updated: Apr 04, 2017.
Rowe, W. "Inflammatory Bowel Disease." Medscape. Updated: Jun 17, 2016.
Romanowski, A, MS, RD. "Matching the Right Diet to the Right Patient." Medscape. Jan 27, 2017.
Inflammatory Bowel Disease (IBD) Diet
Inflammatory bowel disease (IBD) is a name for a group of diseases in which there is inflammation of the digestive tract (gastrointestinal tract). Crohn's disease and ulcerative colitis (UC) are the most common types of inflammatory bowel disease. While there is no specific recommended diet for a person with IBD, doctors and specialists recommend a low-residue (low fiber) diet for people with inflammatory bowel disease. Nutritionists, registered dieticians, and other health-care professionals can recommend specific foods, create meal plans, and recommend vitamins and other nutritional supplements.
Foods to avoid with IBD
- Examples of foods to avoid that may trigger symptoms include if you have IBD include products alcohol, diary products, fatty, fried, and spicy foods, beans, and creamy sauces.
Foods to eat with IBD
- Examples of a low-residue (low-fiber) diet that may help relieve symptoms after a flares of the disease are plain cereals, canned fruit, rice, oatmeal, and bananas.
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