Capsule endoscopy is a procedure that uses a pill-sized camera to check the midsection of the gastrointestinal (GI) tract for any abnormalities.

An endoscopy is a minimally invasive procedure in which a doctor inserts an endoscope into the body. This device can help with the imaging of organs and tissues in areas such as the GI tract.

One type of endoscopy is capsule endoscopy. It involves swallowing a tiny camera that takes pictures of the digestive tract as it moves through the body. Doctors use this procedure to diagnose conditions in the GI tract.

After passing through the digestive tract, the camera exits the body in a bowel movement. The camera sends the pictures wirelessly to a belt the person wears. The belt has a screen that displays the images.

Healthcare professionals can then examine the images to see whether there is any problem with the GI tract.

This article discusses capsule endoscopy, including its uses and what to expect during the procedure.

A small camera that medical professionals use for a capsule endoscopy procedure.Share on Pinterest
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With capsule endoscopy, a person swallows a pill containing a camera.

As the camera travels through the digestive tract, it takes numerous pictures that a doctor uses for further analysis.

Unlike traditional endoscopy procedures, capsule endoscopy helps doctors view the small intestine and check for abnormalities. The capsule leaves the body through the anus within a day.

Generally, capsule endoscopy is a safe, minimally invasive procedure. It can play an important role in diagnosing conditions in the small intestine.

The two main reasons for capsule endoscopy are to determine the cause of unexplained GI bleeding or diagnose inflammatory bowel diseases, such as Crohn’s disease.

A doctor can also use capsule endoscopy to:

  • find tumors in the digestive tract, including the small intestine
  • diagnose celiac disease, which is an inflammatory reaction to gluten
  • examine the esophagus from the mouth to the stomach to look for abnormalities such as swollen blood vessels
  • do additional tests after X-rays or other imaging tests for confirmation
  • screen for polyps that may grow in the colon

Capsule endoscopy uses a wireless camera encased in a pill capsule to take pictures of the GI tract.

The size of the capsules varies, but they are approximately 1.1 centimeters (cm) by 1.6 cm. Hence, a person can easily swallow it and pass it through their digestive tract.

There are several types of capsule cameras, which offer different functionality. These include:

  • PillCam ESO: Doctors use this to examine the esophagus. There is a camera at both ends of the pill, and its battery lasts for 20 minutes. It activates immediately and can take 18 images per second.
  • PillCam COLON: This camera activates 2 hours after ingestion to examine the colon. This capsule may be larger than the standard capsules at 1.1 cm by 3.2 cm.
  • Video capsules: These take live videos of the inside of the GI tract. The capsules transmit video signals to a recording device that the patient wears, and a doctor can examine the footage.

A person may have to take some steps to prepare for a capsule endoscopy. The preparation and procedure may vary among different clinical practices, so a person should talk with their healthcare team about how to prepare.

Doctors can perform a capsule endoscopy as an outpatient procedure, so there is no need to stay overnight. However, a person should clarify this with a doctor.

A person should review any regular medication with their doctor, as they may need to stop taking it in the days leading up to the procedure.

Some actions a doctor may request include:

  • following a clear liquid diet the day before the procedure, drinking only water
  • avoiding eating for at least 10–12 hours before the procedure
  • taking 3 liters of a solution called polyethylene glycol the night before the procedure, as this will help clear the digestive tract of food and stool and allow the camera to take clearer images

During a capsule endoscopy, a doctor will give a person a small capsule camera to swallow. They may also give them a recording device to wear on the waist.

This device receives the pictures from the camera and allows a doctor to view them afterward.

Before

A healthcare professional may recommend removing the shirt so the adhesive patches of the recording device can stick to the stomach.

Each of these patches contains an antenna with wires that connect to the recording device. This makes it possible to receive pictures from the camera.

During

For most types of capsule endoscopy, a person will swallow the capsule with water while in an upright position.

The doctor will advise against certain activities that may affect the recording equipment, such as jumping and running.

If the person needs an esophageal capsule endoscopy, they must drink 100 milliliters (mL) of water just before they take the capsule.

They must also swallow the capsule while lying down and slowly move upright over the next 5 minutes.

After

After swallowing the pill, the person should wait at least 2 hours before drinking water again. After 4 hours, they can have a small meal.

The capsule takes about 8 hours to pass through the digestive tract and exit through the anus, although this varies depending on the individual.

After the capsule exits the body, the person may be able to flush it down the toilet. They may not need to retain it for healthcare professionals. However, they should discuss this with their healthcare team beforehand.

After the capsule exits, the person can remove the recording equipment from their body and arrange to return it to the doctor for review.

A person should contact a doctor if the capsule does not exit the body within two weeks. They may order an X-ray to see if the capsule is still inside.

‌The cost of a capsule endoscopy depends on many factors, such as an individual’s location and insurance plan.

A capsule endoscopy procedure may cost around $826, according to the American medical device company Medtronic.

The price of the procedure may vary depending on the purpose, equipment, and whether it is an inpatient procedure.

Does Medicare cover a capsule endoscopy?

Medicare may cover outpatient endoscopy under Medicare Part B, if a doctor deems it medically necessary. If Medicare approves the procedure, it will cover 80% of the cost.

Remember that not all insurance companies cover capsule endoscopy. Hence, it is important that a person checks with their insurance company beforehand.

Capsule endoscopy is a relatively safe procedure that does not require any form of anesthesia.

The main risk is capsule retention — when the capsule gets stuck in the GI tract. This can happen in 1.3% to 1.4% of people undergoing the procedure. People with Crohn’s disease may also have a higher risk of a stuck capsule, at 2.6%.

In such cases, a doctor may need to perform surgery or another endoscopy to remove the capsule. They may be able to prescribe medication to help expel the device.

Other conditions that can put people at high risk of capsule retention include the following:

There is also a risk that an electromagnetic field can erase the data from the capsule and cause internal injury. Hence, a person should avoid any source of an electromagnetic field, such as an MRI scan.

After the procedure, the doctor will take the recording device and move the images to a computer.

A specialized computer software compiles the images and turns them into a video. Then the doctor watches this video to analyze the capsule’s trip through the digestive tract, looking for any anomalies.

After the doctor studies video, they will contact the individual to discuss their results. This may happen about 2–3 weeks after the procedure, but the timeline may vary among different clinical practices.

After reviewing the results, a healthcare professional may be able to diagnose a condition.

Some of the conditions capsule endoscopy can help diagnose include:

After receiving a diagnosis, a person can work with their healthcare team to determine the best treatment plan for them.

If a doctor diagnoses a person with a chronic condition such as inflammatory bowel disease or cancer, they may need to start treatment. Doctors may also suggest lifestyle changes and advise on how to live with the condition.

A doctor will explain everything a person needs to know about their outlook and treatment.

If the results show nothing abnormal in the GI tract, a doctor may recommend other procedures to find out what is causing a person’s symptoms.

Sometimes, the results of a capsule endoscopy may be inconclusive. This can happen for a few reasons:

  • The camera takes pictures intermittently, and it may miss important parts of the GI tract.
  • Some parts of the GI tract may stop the camera from seeing certain areas.
  • The camera cannot view folds or hidden areas.
  • The battery may expire during the procedure.

In these cases, a doctor may suggest another capsule endoscopy or another procedure, such as a colonoscopy, biopsy, or surgery.

This section answers some frequently asked questions about capsule endoscopy.

What is a capsule endoscopy looking for?

Most commonly, capsule endoscopy is looking for the cause of GI bleeding in the small bowel.

However, a healthcare professional can use capsule endoscopy to help diagnose other conditions, such as colon polyps, celiac disease, Crohn’s disease, ulcerative colitis, and more.

How long does it take to pass an endoscopy capsule?

The capsule takes approximately 8 hours to pass through a person’s digestive tract and exit when a person goes to the toilet. However, this time can vary depending on the individual and may take longer.

If the capsule does not pass within 2 weeks, the capsule may be stuck. A person should contact a healthcare professional if this is the case.

Is a capsule endoscopy better than a normal endoscopy?

Most endoscopies involve inserting a long, flexible tube with a camera at the end into the body. Doctors can insert this tube through the rectum or esophagus.

Capsule endoscopy can help doctors see parts of the GI tract that are harder to reach with a tube endoscopy. It is useful in finding the source of GI bleeding when other endoscopies and procedures could not find a cause.

Capsule endoscopy may also be less uncomfortable than a tube endoscopy, as the person only has to swallow a small pill-like camera.

However, there are drawbacks to capsule endoscopy. The camera can get stuck in the GI tract, and the doctor cannot control the movement of the device or decide when it takes pictures.

Capsule endoscopy uses a small camera encased in a capsule to take pictures of the digestive tract. It helps detect bleeding, tumors, and other issues in the GI tract.

The pill takes about 8 hours to move through the body and exits via bowel movement. After the procedure, the doctor goes through the recording device to analyze the pictures.

Overall, capsule endoscopy is a safe procedure with little risk. There is a slight chance that the pill may get stuck in the GI tract.

If this happens, a doctor can surgically remove the pill or prescribe medication to help expel it.