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Everything You Need to Know
The point of a capsule endoscopy is to look inside of your small bowel. It uses a miniature wireless camera to take pictures of your small bowel (also called the small intestine). The capsule used is the size of a large vitamin tablet and contains a camera, a light source, and a radio transmitter. This tiny camera will take pictures of your digestive tract and bowel as it travels through your body and send pictures wirelessly to a data recorder that you wear on your waist. The small bowel is the middle 4 metres of your gastrointestinal tract. The gastrointestinal tract is 6 metres long and runs from the mouth to the back passage.
Common reasons for having a small bowel capsule endoscopy include:
- Looking for unexplained or suspected blood loss.
- Diagnosing inflammation of the small bowel (e.g., Crohn’s Disease)
- Clarifying imaging tests. MRI or CT scans may have coincidentally shown abnormality and a capsule may help make a diagnosis.
- Diagnosing poor blood supply to the small bowel.
- Looking for polyps and tumours in the small bowel.
- Looking for signs of coeliac disease.
- Investigating iron deficiency anaemia where no gastric or colonic cause has been found and in patients with chronic diarrhoea.
Main advantages of small bowel capsule endoscopy are:
- It is painless – you just swallow the capsule and get on with your day.
- It can visualise 4 metres of the small bowel, which is difficult with conventional endoscopy (gastroscopy or colonoscopy).
Very rarely the capsule can become lodged in other parts of the gastrointestinal tract (e.g., the oesophagus or colon), but overall, retention occurs only in approximately 1% of cases. To minimise the risk of the video capsule becoming stuck in the gastrointestinal tract, we may ask patients to swallow a dissolvable dummy capsule (also called a patency capsule) as a “trial run” beforehand: if the capsule becomes stuck, it will dissolve.
Before
Before we can get you scheduled in for your capsule endoscopy, you’ll need to book an initial appointment to go through the procedure and its requirements. Your consultant will sign the consent form with you and should provide you with enough information about the procedure to enable you to decide whether it’s the right choice for you. We encourage you to ask questions and inform us of any concerns that you may have. It may be helpful for you to write these down as a reminder.
To prepare for the capsule endoscopy, you’ll be given some instructions to follow prior to the procedure:
- Seven days before we’ll ask that you stop taking certain supplements, such as iron or charcoal tablets, or fibre supplements
- Two days before you should start eating a low residue & low fibre diet. You will receive detailed instructions on what foodstuffs you should avoid.
- The day before your appointment, you’ll come in to our endoscopy clinic for your patency capsule appointment with a nurse. During this appointment, you’ll be given a dummy capsule to swallow. This dissolvable capsule works as a “trial run” before the real thing, to minimise the risk of the video capsule becoming stuck in your gastrointestinal tract. The patency capsule is the same size as the real capsule – if the real capsule were to get stuck in a narrowing, so should the patency capsule. Don’t worry – even if it were to potentially cause a blockage, the patency capsule begins to dissolve after 30 hours, so this should only be temporary. During this appointment, you’ll also be prescribed a bowel-prep (Moviprep) – a strong laxative to help purge the small bowel to allow for a clear view during the procedure.
- You’ll be instructed on when exactly, prior to the appointment, you should start taking the laxative. Once the laxative starts working, you’ll need the toilet frequently. Use wet wipes and a barrier cream to help reduce soreness. Keep a phone or book with you to pass the time. It’s easy to get dehydrated when going to the loo so frequently. This can make you feel cold, so drink plenty of fluids and wrap up warm.
- Three hours before the appointment, stop drinking.
- Before your appointment, you’ll be given the space to get changed into a hospital gown and the doctor will sit down with you and discuss any concerns, the process of the procedure, and whether you’re still happy to go ahead.
During
Once you are ready to go ahead, we will ask if you have definitely passed the patency capsule. If you have not, or are unsure, we will take an X-ray or a CT scan of the abdomen. We will get the result that morning.
Provided that the capsule has passed through the small bowel and into the large bowel, or has left the body, we will proceed with the video capsule.
As we proceed with the actual VCE: we will talk you through the attachment of the belt, and the intake of the capsule followed by water with a bit of infracol/simethicone (a medicine used for infants with colic which helps us get better views.).
Before discharging you, we will check your live video images to make sure the capsule has passed through your stomach and into your small bowel. The capsule takes thousands of still images. Each picture is transmitted to a special belt which records each image. You wear the belt for 12 hours, or until the blue light turns red on the recorder (this will be further explained during your appointment). Once capsule is swallowed, the body then propels the capsule naturally through the gastrointestinal tract, just as it would with food. The capsule eventually passes into the toilet. It is painless.
Once the capsule has entered the small bowel, we will provide you the patient instructions regarding the nil by mouth status following the procedure, and to whom and where the equipment should be delivered once the recording is done; then you can be discharged.
After
After you leave the hospital, make sure you follow your doctor’s instructions:
- You can drink clear liquids 2 hours after the capsule has entered the small bowel.
- You can have a light snack 4 hours after the capsule has entered the small bowel.
- You can eat normally 8 hours after the capsule has entered the small bowel.
- Do not take anything off – you must keep the recording device and belt always attached. If not, we simply will not get images of your bowel.
- Keep checking the blue flashing light on the top of the recorder every 15 minutes (it looks a bit like a man bag). If the light flashes red, it means that it is out of contact with the capsule. If it consistently flashes red, it may mean that you have passed the capsule and can remove recorder and belt.
- After 12 hours has elapsed or if the recorder flashes red consistently, take off the recorder and the belt. Please be gentle with the device. Unplug the recorder from the belt by squeezing the clip next to the recorder. Then, take off the shoulder strap and the recorder and undo the velcro belt. Keep all the equipment together until it is ready to be returned.
- If you notice that you have passed the capsule into the toilet, you can then flush the capsule down the toilet safely. The capsule is disposable and is single use only. The capsule is usually passed in the toilet by 48 – 72 hours.
Once we have received the equipment, we will then download the data. Your consultant will then read the video and produce a report. Your consultant will discuss your report with you at your next consultation and/or inform you by letter of the findings. The exact timescale of this will be explained to you beforehand by your consultant.
Hospital Fee Guaranteed
£2,245
The price shown includes all costs associated with your treatment, from admission to discharge.
Doesn’t include surgeon or anaesthetist fee.
Our hospital fee is guaranteed at the price quoted and valid for one month from the date issued, subject to pre-assessment.
How to pay for your treatment
If you’re… paying for yourself
Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.
For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.
If you’re… insured
St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.