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Capsule Endoscopy

Also known as: video capsule endoscopy (VCE) or a pillcam

Capsule endoscopy is a diagnostic technique used to examine the gastrointestinal tract with a swallowable capsule, roughly the size of a large vitamin pill.

Gastroenterology
01442 331 900
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What is capsule endoscopy?

Capsule endoscopy is a diagnostic procedure that involves examining the gastrointestinal tract using an ingestible capsule about the size of a large vitamin pill. This capsule, equipped with a light source, batteries, a radio transmitter, and an antenna, is swallowed and travels through the digestive system. Its primary purpose is to capture images of the small bowel, also known as the small intestine.

Swallowing the capsule is a straightforward process where the tiny camera inside takes thousands of pictures as it moves through the digestive tract. These images are wirelessly transmitted to a data recorder worn on the waist.

This procedure is particularly useful for diagnosing conditions such as unexplained bleeding, inflammation (e.g., Crohn’s Disease), and other gastrointestinal issues. The capsule endoscopy is painless and allows for the visualisation of the small bowel – the middle 4 meters of the 6-meter-long gastrointestinal tract, which is challenging with conventional endoscopy methods.

Which symptoms might necessitate a capsule endoscopy procedure?

A capsule endoscopy is often advised when experiencing a combination of the following symptoms:

  • Heartburn and reflux
  • Indigestion
  • Bloating and distension
  • Abdominal discomfort
  • Abdominal pain
  • Altered bowel habits

A capsule endoscopy can also be used to investigate new and/or monitor existing conditions of the gastrointestinal tract such as:

  • Stomach ulcers
  • Polyps
  • Colon cancer
  • Diverticulosis
  • Barrett’s oesophagus
  • Crohn’s disease
  • Malabsorption
  • Inflammatory bowel disease

Main advantages of small bowel capsule endoscopy:

The capsule endoscopy procedure offers significant advantages, primarily due to its painless nature, as patients simply swallow the capsule and continue with their daily activities. This method allows for the visualisation of approximately 4 meters of the small bowel, a task that is quite challenging with traditional endoscopy techniques like gastroscopy or colonoscopy. Although there is a minimal risk of the capsule becoming lodged in parts of the gastrointestinal tract, such as the oesophagus or colon, this occurs in only about 1% of cases. To further mitigate the risk of the video capsule getting stuck, patients may be asked to swallow a dissolvable dummy capsule, known as a patency capsule, as a preliminary test. This trial run ensures that if the capsule encounters an obstruction, it will dissolve, thereby preventing any potential complications.

Types of Capsule Endoscopy

Capsule endoscopy is a versatile diagnostic tool that comes in different types, each designed to examine specific parts of the digestive system. The two main types of capsule endoscopy are:

Small Bowel Capsule Endoscopy: This type of capsule endoscopy is designed to examine the small intestine, a long, thin tube that connects the stomach to the large intestine. The small bowel capsule contains a single camera that takes thousands of pictures as it travels through the small intestine. This allows for a detailed examination of the small bowel, which is often difficult to visualise with traditional endoscopy methods.

Colon Capsule Endoscopy: This type of capsule endoscopy is designed to examine the large intestine, also known as the colon. The colon capsule is equipped with two cameras, one at each end, which take pictures of the colon and rectum as the capsule travels through the large intestine. This dual-camera setup provides comprehensive imaging of the colon, making it a valuable tool for detecting polyps, tumours, and other abnormalities in the large bowel.

Both types of capsule endoscopy offer a non-invasive way to visualise the digestive system, providing valuable insights that can aid in the diagnosis and management of various gastrointestinal conditions.

Hospital fee guide price: £1,730

Procedure price subject to bespoke quotation
*Additional consultant fee not included

More about pricing

Before treatment

Before scheduling your capsule endoscopy, an initial appointment is necessary to discuss the procedure and its requirements. During this session, your expert will review the consent form with you, providing information to help you decide if this procedure is the right choice. Feel free to ask questions and share any concerns you may have; it might be helpful to jot these down beforehand.

Preparing for a capsule endoscopy

To prepare for the capsule endoscopy, you’ll need to follow specific instructions. Seven days before the procedure, you’ll be asked to discontinue certain supplements, such as iron or charcoal tablets, as well as fibre supplements. Two days prior, you should begin a low-residue and low-fibre diet, with detailed guidance on which foods to avoid.

The day before your appointment, you’ll visit the endoscopy clinic for a dummy capsule appointment with a nurse. During this visit, you’ll swallow a “fake” capsule, which acts as a “trial run” to minimise the risk of the video capsule becoming lodged in your gastrointestinal tract. This patency capsule is the same size as the real one, and if it encounters a narrowing, it will dissolve after 30 hours, thus preventing any blockage. You’ll also be prescribed a bowel preparation, such as Moviprep, a strong laxative to clear the small bowel for a clear view during the procedure.

You will receive instructions on when to start taking the laxative, which will lead to frequent bathroom visits. To alleviate any discomfort, consider using wet wipes and barrier cream. Staying hydrated is crucial, so drink plenty of fluids to avoid feeling cold. You might want to bring a blanket to help keep you warm and a phone or a book to keep you occupied. Three hours before your appointment, you should stop drinking fluids.

During treatment

Immediately before your appointment, you’ll be asked to change into a hospital gown. The doctor will discuss any remaining concerns and walk you through the procedure process to ensure you’re comfortable proceeding with the capsule endoscopy.

Once it’s confirmed that the capsule has moved through the small bowel and into the large bowel, or has exited the body, we can proceed with the video capsule endoscopy.

During the procedure, we’ll guide you through attaching the belt and ingesting the capsule, accompanied by water and a small amount of infracol/simethicone (a medication used for colic in infants, which improves image clarity).

A nurse will secure a data recorder to a belt around your waist, which you’ll need to wear throughout the procedure. You’ll then swallow the PillCam™ capsule with water. As it journeys through your digestive tract, you can continue with your usual daily activities. The capsule, which is disposable, will naturally and painlessly exit your body during a bowel movement, typically within 24 hours.

Before you’re discharged, we’ll check the live video images to ensure the capsule has passed through your stomach and into the small bowel. The capsule captures thousands of still images, each transmitted to a special belt that records them. You’ll wear this belt for up to 8-12 hours, or until the blue light on the recorder turns red (further details will be provided during your appointment).

After the capsule enters the small bowel, we will provide you with patient instructions regarding fasting post-procedure, and details on where and to whom the equipment should be returned once the recording is complete; then you can be discharged.

After treatment

After you leave the hospital, it’s crucial to adhere to your doctor’s instructions. You can start drinking clear liquids two hours after the capsule has entered the small bowel. Four hours after, you’re allowed a light snack, and after eight hours, you can resume eating normally. It’s important not to remove any equipment; the recording device and belt must remain attached at all times to ensure we capture images of your bowel.

Keep an eye on the blue flashing light atop the recorder every 15 minutes. If it starts flashing red, it indicates a loss of contact with the capsule.

After 12 hours, or if the recorder flashes red consistently, gently remove the recorder and belt. To do this, unplug the recorder from the belt by squeezing the clip next to it, then take off the shoulder strap and undo the Velcro belt. Keep all equipment together until it’s ready for return.

If you notice the capsule has passed into the toilet, it’s safe to flush it away. The capsule is disposable and designed for single use, typically passing within 48 to 72 hours. Once we’ve received the equipment, we’ll download the data for analysis. Your expert will review the video and prepare a report, which will be discussed with you at your next consultation or communicated via letter. The exact timeline for this will be clarified by your expert in advance.

Appointment and Treatment Plan

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Appointment

Based on your previous consultation with a doctor, an appointment will be arranged between you and your expert.

Treatment plan

During this appointment, you’ll go through your medical history, your symptoms, and together, you’ll decide whether further investigation, such as an endoscopy is the best next step.

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Preparation

If endoscopy is an option, then the specialist will provide you with instructions on how to best prepare for your procedure.

Procedure

Prior to going through the endoscopy, our team will ensure that you’re prepped once again. If everything is confirmed, you’ll undergo the procedure and then we’ll explain the aftercare instructions.

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Aftercare

If necessary, you’ll stay in a ward for a while to ensure that you’re ready to go home after the procedure.

Follow-Up

You’ll come in to meet your doctor, discuss your results and agree on further steps.

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Experts

We are proud to provide patients with access to a wide range of clinicians, chosen specifically for their knowledge and reputation in their area of expertise. Our experts align with our values: putting you at the centre of your care and educating you on your options at each step of the journey. We encourage you to learn more about our clinicians and how they can help you below. As always, please contact our patient services team if you require any additional information.

We offer 3 ways to pay for your treatment

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Our payment options are designed to offer you easy access to our treatments and services. You can choose to pay on the day, spread the cost, or use your private medical insurance.

Our patient services team will guide you through the process, providing clear costs and support throughout your course of treatment so you can focus on the thing that matters most – your health.

Whether you pay in advance, spread the cost, or use your private medical insurance, rest assured you will be receiving exceptional care 365 days a year.

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Many of our treatments have a pay monthly option that allows you to spread the cost of your treatment over 12 months with no credit checks required.

A minimum spend of £300 does apply. We’ll take your first payment upfront and then arrange a direct debit for your monthly payments thereafter. It’s that simple.

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Please bring along your policy details including your scheme details, membership or policy number, expiry date and confirmation of eligibility to claim (i.e. your authorisation number). If you do not have these details with you, we will require payment from you on the day. Patients are liable for any amounts not settled by their insurer.

Hospital fee guide price: £1,730

Procedure price subject to bespoke quotation
*Additional consultant fee not included

What's included in the Hospital Package?

What’s included? Hospital Only Fixed Price Package
Consultant fees
Anaesthetist fees X
Initial consultation X
Standard pre-admission assessments
Accommodation
Meals
Nursing
Theatre charges
Histology
Drugs and dressings
Standard prosthesis charges
Take-home medications
Post-op consultation X

Medically reviewed by Dr Mani Naghibi - Consultant Gastroenterologist on 21/12/2024