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Capsule Endoscopy

The capsule is the latest and the best technology for viewing the small intestine.
A new era of endoscopy was introduced in the 2001 when the FDA approved the M2A wireless video capsule endoscopy after a single clinical trial of 20 patients. This device is designed for the examination of the small intestinal mucosa for the first time. Until recently, the examination of the small intestines is done by barium small bowel series, a contrast X-ray study by indirect means, like the negative of a photo. Other methods, including push enteroscopy, Sonde enteroscopy, and intraoperative enteroscopy, are rather invasive.

How it works

The capsule is 11mm by 26mm. The outside coating is slippery when wet, so that it is easy to swallow. The lens allows 140-degree view, similar to most endoscopes. The magnification allows great resolution of the small bowel mucosal surface. The capsule takes 2 images per second. During the examination, about 50,000 images are transmitted to a recorder worn on a belt. There is no sedation involved.
The patient comes to doctor’s office after 6 hours of fasting (no food or medication). Adhesive leads (like those used in EKG) are placed on patient’s abdominal wall attached to a recorder (the size of handheld palm PDA) which is fixed on a belt. To initiate the video capsule endoscopy, the patient then swallows the capsule which is slightly smaller than a candy. Patient then leaves the doctor’s office and returns after 7-8 hours for the removal of the recorder. The information from the recorder is downloaded onto the computer so that a video will be produced of the entire small intestine. The capsule has battery power that lasts only 7-8 hrs. after which it is automatically turned off. It is disposable and will come out with bowel movement. Patient is allowed to have clear liquids (water/ juice) after two hours; food and medications are allowed 4 hrs. after swallowing the capsule. The current capsule technology does not allow for adequate visualization for the stomach and the colon (large intestine).

Who should have the capsule endoscopy?

  • Patients with history of obscure gastrointestinal bleeding or abnormal small intestine found on small bowel series.
  • Patients with chronic abdominal pain and their doctor suspects organic / anatomic cause in the small intestine.
  • Chronic diarrhea.
  • Evaluation of the extent of Crohn
  • ’s disease and celiac disease; visualization of surgical anastomosis. Surveillance of polyposis syndrome of the small bowel.

For more information about the manufacturer of the M2A capsule, please visit webpage http://www.givenimaging.com.