In 2012, my mother experienced a sudden drop in her hemoglobin resulting in life threatening anemia. In an attempt to diagnosis what caused this, her doctors wanted to examine her small bowel more closely. One of the procedures that presented the least risk was a capsule endoscopy or pill camera. Find out more about what it is like to have this affordable procedure which provides a view of the GI tract, primarily the small intestine.
Capsule Endoscopy: A Personal Experience
If a physician wants to examine your GI tract, particularly the small bowel, they may order capsule endoscopy or a pill camera. Learn more about this procedure from my experience.
What is Capsule Endoscopy?
For three or four years my mother had struggled to maintain her weight as she found it difficult to eat more than a several bites of food at meal times. Earlier in the year, my mother had undergone an EGD or esophagogastroduodenoscopy. The EGD examined the esophagus and stomach primarily while a traditional colonoscopy examined her large bowel . Both procedures used a flexible endoscope and fiberoptic camera to view portions of her digestive tract.
Although she had some diverticulum (pockets within the walls of her intestines) and a hiatal hernia, no other issues were revealed. But 6 months later, a sudden drop in her hemoglobin to life threatening levels prompted her physicians to want to examine the only remaining portion of her digestive tract; the small intestine.
To our relief, the test the doctor ordered was a capsule endoscopy which employs a pill camera.
With capsule endoscopy, patients swallow a "pill" which includes a tiny camera and light source. After being swallowed, this device will take approximately 55,000 images as it travels through the digestive tract. The images are wirelessly transferred to a small recorder that the patient wears strapped to their body via a velcro belt.
Eight or nine hours later, the recorder is returned, and the images are downloaded and reviewed to identify any issues.
What Does the Camera See?
Obviously, a pill camera can view the walls of the digestive tract. It can see any bleeding, tumors, narrowings, ulcerations, polyps, and so forth. Certainly it could assist in diagnosing cancer, Crohn's disease, and much more.
Preparing For Capsule Endoscopy
Preparation for the test was minimal. My mother went on a liquid diet at noon on Tuesday and then stopped eating, drinking, and taking medications by early Wednesday morning.
We went to the outpatient clinic at 7:30 a.m. on Wednesday. We were there only 20 minutes. During that time, the nurse applied a few sensors to her body, strapped a light weight belt around her waist and attached a small recorder to it. She was then asked to swallow the pill camera which was the size of a large vitamin pill.
Once this was done, we were free to go. We were to check to make sure the recorder was still operating periodically by checking the light on it. After waiting a couple of hours, my mother was able to return to a normal diet.
The capsule endoscopy procedure was non-invasive and required less preparation than the EGD or colonoscopy which my mother had completed previously. Unlike these other tests, no anesthesia was required and in fact, aside from going into the outpatient clinic briefly in the early morning to be fitted with the recorder and swallow the pill camera, no hospital time was required. My mother was able to go about her normal routine without interruption.
In addition, preparation was minimal as well. With the colonoscopy, a complete clearing of the intestines via laxatives and massive amounts of clear liquids can be an intimidating prospect, but with capsule endoscopy, she only had to discontinue solid foods at noon the day before the test and forgo any medications a couple of hours before she was to swallow the pill camera.
Once the pill was swallowed, she had to wait only a few hours before she could have a meal.
Eight hours after swallowing the pill camera, we merely returned the recorder to the clinic and the pill passed in her stool sometime thereafter.
In addition to the ease and convenience of this test, certainly the cost was another benefit. Without time in the hospital, any anesthesia, and so forth, the total cost of the procedure was significantly less than for the typical colonoscopy. Insurance covered the cost, but even out of pocket I believe it was well under $1,000 (US).
Finally, of course is the clinical advantage that capsule endoscopy offers. While traditional endscopes examine the upper and lower portions of the digestive tract, little else offers this first hand view of the small intestine in the middle.
The Limitations of Capsule Endoscopy
While the pill camera offered a good way for the physician to view the small bowel, it did have some limitations. When completing endoscopic examinations via a flexible endoscope, apparently physicians can biopsy any tissue they suspect as cancerous at the time of the examination. In fact, they can remove polyps as well during the procedure. These endoscopic exams can not only evaluate but allow the physcian to intervene as well.
The same is apparently not true when using capsule endoscopy. The pill camera procedure is purely a visual diagnostic procedure. Additional, more invasive procedures would need to be conducted in order to sample or remove questionable tissue discovered by the camera.
Reviewing the images captured via capsule endoscopy took little time. My mother and I received the results of her test within a day.
In my mother's case, nothing abnormal was seen and the source of her blood loss was later found to be related to some of her medication.