Capsule endoscopy

Capsule endoscopy is used to diagnose and investigate a number of conditions affecting the digestive tract including:

• Unexplained bleeding in the small intestine
• Unexplained abdominal pain
• Inflammatory bowel diseases like Crohn’s disease and ulcerative colitis
• Coeliac disease
• Bowel cancer
• Oesophageal varices (swollen veins in the oesophagus)
• Intestinal polyps
• Unexplained weight loss or anaemia

Capsule endoscopy is a non-invasive procedure with a lower risk of complications than traditional endoscopy. Unlike traditional endoscopy, there is no discomfort during the procedure, and it does not require any sedation. Capsule endoscopy also allows your consultant to see inside your small bowel, an area that isn't easily accessed with traditional endoscopy or colonoscopy.

At your first consultation, you will be seen by a consultant gastroenterologist, a doctor specialising in conditions affecting the gastrointestinal (digestive) tract.

Your consultant will ask you about your symptoms, general health, and medical history, and perform a physical examination. If you have had any previous tests or scans, your consultant may look at them, or they may arrange them on the day.

Why is this first consultation so important?

At Circle Health Group, your first appointment is very important as it's where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your procedure, so please ask your consultant any questions you may have.

At the end of your appointment, your consultant will decide if capsule endoscopy is suitable for you based on your symptoms, general health, and the results of any tests or scans. They will explain the procedure to you including how capsule endoscopy works, any possible risks and complications, and what to expect afterwards.

Your consultant will tell you everything you need to do to prepare for your capsule endoscopy. If there's anything you're not sure about, or if you have any questions, speak to your consultant, or call the hospital for advice.

Tell your consultant about any medical conditions or allergies you have and any medications, including over-the-counter medicines and supplements you are taking. Let your consultant know if you have a pacemaker fitted and if you have had any previous abdominal surgery.

If you are taking iron tablets or non-steroidal anti-inflammatory drugs (NSAIDs) you will need to stop taking them a week before your procedure.

To prepare for your capsule endoscopy:

• The day before your procedure you can have a light lunch followed by clear fluids (water, black tea, black coffee, clear soups, and clear juices like apple juice)
• You may be given bowel prep to empty your bowels the day before your capsule endoscopy
• You may be instructed to shave your lower abdomen before the procedure
• Do not eat or drink anything including water for ten to twelve hours before the procedure
• Don't smoke for twenty-four hours before your capsule endoscopy

On the day of your capsule endoscopy, you will have an appointment to have the equipment fitted and take your capsule.

Dress in loose-fitting, two-piece clothing that can easily be lifted at the waist. In a cubicle, you will have adhesive sensor pads attached to your abdomen and a data recorder fitted on a belt around your waist. Once this is in place, you will swallow the capsule with a glass of water. The capsule is about the size of a large vitamin pill.

You will be given a time to return to the hospital for the data recorder and sensor to be removed. Capsule endoscopy normally takes about eight hours.

Once you have swallowed the capsule:

• Do not eat or drink anything for the first two hours. After this, you can have clear fluids for the next four hours after which you can eat and drink normally
• Don't go near any electromagnetic fields such as MRI scanners or amateur radio until the capsule has been excreted
• Do not remove the belt or disconnect the data recorder or sensor until your capsule endoscopy is complete
• Avoid sudden movements, strenuous activity, sweating, bending at the waist, or stooping while wearing the equipment
• Be very gentle with the equipment and avoid knocking or banging the data recorder or exposing it to jolts, vibration, or sunlight
• Every fifteen to thirty minutes, check that the light on top of the data recorder is blinking. It should blink twice every second. If the light is not blinking, make a note of the time and contact the hospital
• The capsule will pass out of your body with your normal bowel movement within twenty-four to seventy-two hours. You do not need to collect the capsule when it has passed, and it can be safely flushed down the toilet

There is no recovery period after capsule endoscopy. The procedure is done as an outpatient, and you can go home as soon as you have taken your capsule. You can resume most activities such as walking and driving and can return to work unless your job is very physically active. Once the equipment has been removed, you can resume all normal activities.

Your consultant will explain all the possible risks and complications of capsule endoscopy to ensure you are able to make an informed decision. Please feel free to ask as many questions as you like during this time.

As a non-invasive procedure, capsule endoscopy is very safe and has a minimal risk of complications.

The main risk of capsule endoscopy is that the capsule may not pass through your gastrointestinal tract. The risk of this is less than 1%, though slightly higher if you have a condition such as Crohn's disease or adhesions from previous bowel surgery.

If your consultant suspects the capsule may not have passed, they will arrange an abdominal X-ray to locate the capsule. The capsule may then need to be removed using either traditional endoscopy or surgery.

Contact the hospital immediately if you experience:

• Fever (a temperature above 38C)
• Vomiting
• Difficulty swallowing
• Chest or abdominal pain

We answer some of your most commonly asked questions about capsule endoscopy.

What conditions can be diagnosed using capsule endoscopy?

Capsule endoscopy can be used to diagnose several conditions affecting the gastrointestinal tract including Crohn's disease, gastrointestinal bleeding, colon cancer, polyps, coeliac disease, and ulcerative colitis.

Do you need bowel prep for capsule endoscopy?

Bowel prep is a laxative given to clean the bowel before surgery. There is currently no standard protocol regarding bowel prep before capsule endoscopy and whether or not you need one depends on your consultant's preferences. Follow your consultant's instructions carefully before your procedure and call the hospital if you have any questions.

How big is a capsule endoscopy pill?

A capsule endoscopy pill is about the size of a large vitamin pill.

How is a capsule endoscopy removed?

The capsule normally passes through your gastrointestinal tract with your bowel movement and does not need to be removed. Rarely, it may remain in your gastrointestinal tract and need to be removed via traditional endoscopy or surgery. If you are worried that you haven't passed your capsule after a few days, contact the hospital for advice.

How long does capsule endoscopy take?

From swallowing the capsule to having the equipment removed takes about eight hours. It normally takes between one and three days for the capsule to pass through your body.

At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about capsule endoscopy, book your appointment online today or call a member of our team directly on 0141 300 5009

Content reviewed by Circle in-house team in March 2023. Next review due March 2026.

1. Capsule endoscopy, Mayo Clinic
2. Capsule endoscopy for small bowel, Cancer Research UK
3. Capsule Endoscopy, John Hopkins
4. What is capsule endoscopy?, North Bristol NHS Trust