You likely know that a colonoscopy is performed to evaluate the large intestine for possible cancer. You may even be familiar with upper endoscopy, which involves inserting a similar type of lighted scope to evaluate the esophagus, stomach, and first part of the small intestine. But what about the parts of the digestive tract in the middle that can’t be reached by either method? For that, all you have to do is swallow a pill.
Capsule endoscopy, informally called a “pill cam,” is a noninvasive technology that examines the lining of the middle part of your gastrointestinal tract, which includes the three portions of the small intestine (duodenum, jejunum, ileum). The examination is performed by applying a sensor device to your abdomen with adhesive sleeves (similar to tape), or a sensor belt.
A pill- sized video capsule, containing a camera and light source, is swallowed and passes naturally through your digestive tract while transmitting up to 55,000 video images to a data recorder worn on your belt for approximately eight hours. At the end of the procedure the data recorder is removed so that images of your small bowel can be downloaded onto a computer for physician review.
Prior to capsule endoscopy, there were limited means to evaluate the small intestine, such as imaging studies which are unable to video survey the area of interest. According to the American College of Gastrointestinal Endoscopy (ASGE), capsule endoscopy achieves superior results versus standard radiographic studies for diagnosing obscure intestinal bleeding.
The most common reason for having capsule endoscopy is to search for a cause of anemia and bleeding from the small intestine. It may also be useful for detecting polyps, inflammatory bowel disease (Crohn's disease), ulcers, tumors of the small intestine, and to evaluate abdominal pain of unknown cause.
According to the ASGE, capsule endoscopy is generally a safe procedure. The most common complication is capsule retention which usually relates to a stricture (narrowing) of the intestine from inflammation, prior surgery, or tumor.
Dr. David Chaletsky is board certified in both gastroenterology and internal medicine. He is a gastroenterologist with Connecticut GI and performs a wide variety of GI procedures, including pill cam endoscopy, at Day Kimball Hospital in Putnam.