Dr Amit Bhasin MBBS, MD(Med), DM(Gastro) Senior Consultant Gastroenterologist, Gold Medal
Capsule Endoscopy | Dr Amit Bhasin | Gastroenterologist
In 2000, a group of doctors from England reported the use of a new instrument for determining the causes of small bowel bleeding. The device, the capsule endoscope, is 1-1/8 inches long and 3/8 inches wide (26 mm x 11 mm), the size of a large pill. It is composed of a battery with an 8-hour lifespan, a strong light source, a camera, and a small transmitter. Once swallowed, the capsule begins transmitting images of the inside of the esophagus, stomach and small bowel to a receiver worn by the patient. The capsule takes two pictures per second, for a total of approximately 55,000 images. After 8 hours, the patient returns the receiver to the doctor who downloads the information to a computer and then can review in detail the 8 hours of pictures of the capsule passing through the intestine, looking for abnormalities that are possible sources of bleeding. The patient passes the capsule through the colon and it is eliminated in the stool and discarded. The capsule is generally safe and easy to take, however, the capsule can get stuck in the small intestine if there has been prior abdominal surgery causing scarring or other conditions that cause narrowing of the small intestine. If the capsule becomes stuck, endoscopic or surgical removal is necessary. In about 15% of exams, the capsule does not view the entire small bowel prior to the battery running out and may need to be repeated. Like x-rays, the capsule is purely diagnostic and cannot be used to take biopsies, apply therapy, or mark abnormalities for surgery. Moreover, the capsule cannot be controlled once it has been ingested, so that once it has passed as suspicious abnormality, its progress cannot be slowed to better visualize the area. Despite these limitations, capsule endoscopy is frequently the test of choice bowel bleeding if standard endoscopy has failed to do so.