Capsule Endoscopy

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.

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 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.