Capsule Endoscopy

Capsule endoscopy is a modern investigative method that is used in the diagnosis of diseases of the digestive tract.

Principle

The examination is very simple. The patient swallows a small probe that goes through the digestive tract and periodically takes snapshots from within. These photos are uploaded to a device, which is stored in a small box attached by a belt to the patient's abdomen. After the examination is completed, the examiner checks and evaluates the images. There are hundreds of pictures and the examiner is helped by a special computer program aimed to find any pathologies. The actual test lasts for about 8-10 hours. The capsules have a limited power source due to their small size.

 

Capsule endoscopy

 

Scheme - Endoscopic capsule has reached the stomach and it is heading towards the intestines

 

Preparation

The patient should eat low residue diet with little amount of dietary fiber for about 3-4 days before the examination. The day before the procedure, it is advised to eat only a light breakfast and lunch. Later that day, the patient drinks a special bowel-cleansing solution, which causes diarrhea and cleans the intestines. Several hours before the examination, no food or fluids should be taken.

Indications

The capsule could be theoretically used for diagnosing virtually any disease of the digestive tract. However, due to certain disadvantages (high cost, usually worse effectiveness than endoscopy, etc.), it is preferably used  in those areas of the digestive tract that can not be examined by traditional endoscopic devices. The esophagus, stomach and duodenum are well-examinable by upper GI endoscopy and the whole colon by colonoscopy. Therefore, the best indication for capsule endoscopy are diseases of the small intestine - search for sources of bleeding, diagnosing local tumors, polyps and areas affected by Crohn's disease.

Note: The capsules should not be used in pregnant women and it is very risky for patients with any narrowing of intestines or other parts of the digestive tract.

Disadvantages

The main problem is high price and lower availability. The passage of the capsule through the digestive tract is uncontrollable, sometimes it may go very slowly and its batteries get dead before the whole small intestine is examined. Other times, the opposite problem happens when the capsule travels too quickly and the chance of catching a pathology is decreased. When there is present an intestinal stricture, the capsule may get stuck and the situation must be solved by surgery.

Completely clear disadvantage compared to a classic endoscopy is the inability of the capsule to take a biopsy for histological examination or perform a direct therapeutic intervention (stopping a bleeding, polyp removal, etc.). When the capsule finds such pathology in the small intestine and we want to handle it endoscopically, we have to perform a double-balloon enteroscopy, which is a time-consuming and exacting endoscopic method.

Advantages

The capsule method is great for its non-invasivity. The swallowed capsule is very small (it has a size of a larger pill), completely painless and very convenient. When there are no complications, the capsule leaves the body with faeces.