What is endoscopic capsule?
The endoscopic Capsule implies a major advance by allowing the visualization of the entire small intestine and being able to diagnose many lesions that, until now, have gone unnoticed.
This is a non-invasive diagnostic method that is highly tolerated by the patient and has, for more than a decade, been considered the first detection method for abnormalities inside the small intestine.
The endoscopic Capsule is a device measuring10mm x 25mm that contains a light and camera inside. After being swallowed by the patient, it allows for the study of images of the parts of the digestive tract it passes through during its exploration.
The images are transmitted through the abdominal wall and recorded on a small portable device that the patient carries attached to his body.
The recorded images are then downloaded to a computer so that the medical specialist can evaluate them and prepare a report.
Preparation for endoscopic capsule
The process of placing the capsule requires that the patient go to a digestive service with 6-8 hours of fasting (prior a specific preparation with a diet and evacuating sachets).
The patient will have patches adhered to his/her abdominal skin at the medical office (antennas), which are in turn connected to cables that carry the information to a small recorder.
The patient is required to swallow the endoscopic Capsule with a little bit of water, remain fasting for 4 more hours, and later begin the ingestion of liquids or a soft diet. The lifespan of the battery is approximately 8 hours, meaning that if the capsule is inserted in the morning, the patient will be asked to return to the doctor’s office in the afternoon of the same day to retrieve the recorder and download the images.
Finally, the endoscopic Capsule will be eliminated through the rectum during the first week after the procedure.
Its principle indications are for digestive bleeding with unknown origins, chronic iron deficiency anaemia with prior normal endoscopic studies, recurring episodes of digestive bleeding in the form of melenas or haematochezia without aetiology after normal endoscopic studies, Crohn’s disease, small intestine malignancies, hereditary polyposis syndromes, or Celiac disease.
When to avoid it: Contraindications
The use of the endoscopic Capsule should be avoided in pregnant women and in patients bearing any kind of pacemaker. The user must also avoid exposure to waves that may interfere in the transmission of the images or magnetic sources (magnetic resonance) until confirming that the capsule has been eliminated.
One of the main complications of the technique is that the capsule gets stuck in narrow areas of the intestine. For this purpose a prior test capsule, known as Patency, has been designed. The Patency capsule is a capsule filled with barium whose shell disintegrates if it remains more than 72 hours in the small intestine.
In the absence of stenosis, the capsule is expelled whole during the first 72 hours, and in case of retention (> 72 hours) it dissolves and is eliminated deformed and empty.
Its indications, according to the European Society of Endoscopy, are among others:
- Digestive bleeding of unknown origin.
- Chronic iron deficiency anaemia with normal prior endoscopic studies.
- Recurrent episodes of digestive bleeding in the form of melenas or haematochezia, without aetiology after normal endoscopic studies.
- Crohn’s Disease: diagnosis, extension, and monitoring.
- Small intestine malignancies.
- Hereditary polyposis syndromes.
- Celiac Disease: diagnosis, extension, and monitoring.
- Intestinal mal-absorption síndromes.
- Unexplained chronic abdominal pain, with or without diarrhoea, and with an organic origin suspected.