What is capsule endoscopy (Pillcam) and why is it done?

Capsule endoscopy allows your doctor to examine the lining of the entire small bowel. The most common reason for doing capsule endoscopy is to look for a source of unexplained internal bleeding or iron deficiency anaemia. Internal bleeding from the small bowel often presents as black stools and occasionally as bright rectal bleeding.

Your doctor will give you a large pill to swallow. This pill has a built in camera and once it is swallowed it sends images of the small bowel to a recorder that is worn around the waist or the shoulder. Your doctor will review these images at a later date looking for small bowel bleeding, small bowel tumours or ulcers and other conditions of the small bowel.


How should I prepare for the procedure?

An empty stomach/small bowel is required for a thorough examination of the small bowel. Some medications may need to be discontinued before capsule endoscopy. Specific details about how to prepare for capsule endoscopy can be found here.


What can I expect during capsule endoscopy?
Your doctor or an assistant will attach a sensor device to your abdomen and a recorder will be attached. You will then be asked to swallow the pill camera. You will then be free to leave the office.


What happens after capsule endoscopy?
You can drink clear fluids two hours after ingesting the pill camera and you can have a light lunch four hours after.

It is important that you avoid exercising while the equipment is attached as that can interfere with the transfer of images. You should not drive while the equipment is attached.

You are required to return to the office 8 hours after the pill camera is swallowed. It is important not to have an MRI examination until the pill camera has been excreted.

On return to the office the equipment will be removed and the images downloaded to a computer for review. Your doctor will generally can tell you the test results within the week following the procedure.


What are the possible complications of capsule endoscopy?
Capsule endoscopy is extremely safe. The main risk is the pill camera becoming stuck at an area of abnormality in the small bowel. This may lead to blockage of the small bowel which may require surgery. Possible symptoms of small bowel bloackage include abdominal pain, bloating, nausea or vomiting. If you develop any of these symptoms you must contact your doctor right away.

In some instances the pill camera move slower through the small bowel and may not examine the entire small bowel by the end of the procedure. In these cases the procedure may need to be repeated.