|
What is a
Capsule Endoscopy?
Video capsule
endoscopy is a new noninvasive technology designed for visualization of the
small intestine. The small intestine is approximately 18 feet long. The first
one to two feet (duodenum) can be visualized by upper endoscopy and the last
several inches (terminal ileum) sometimes is seen on colonoscopy. The
remainder of the small intestine is usually not seen during conventional.
Capsule endoscopy allows photographic visualization of the entire small
intestine.
Reasons to have a
Capsule Study
The full
range of indications has yet to be defined since it is a new technology and
there have been no large studies of its effectiveness. However, the main
indications for the study will probably be those listed below:
The majority of bleeding from the GI tract occurs from the
esophagus, stomach, duodenum, or colon. These sites are visualized by
conventional upper endoscopy and colonoscopy. In those cases where the site
has not been found after upper endoscopy and colonoscopy, video endoscopy can
be done to locate a small bowel source.
Crohn's Disease: In a select group of patients with this disorder, the capsule
endoscopy may be utilized to determine the extent and location of disease.
Small
bowel tumors and surveillance: It may be useful in the detection of small
bowel tumors.
Other
potential indications: It may be useful in evaluation of malabsorptive conditions
such as celiac sprue and chronic diarrhea
Abnormal
small bowel x-rays: Abnormalities identified on a small bowel series can sometimes be
better characterized by a capsule study.
What Risks are
involved?
The most
common complication is retention of the capsule above a stricture (narrowed
area) in the small intestine. This usually requires surgery for removal of the
capsule. However, the stricture is then usually treated and corrected at the
time of surgery. While the capsule is in your body you are not allowed to be
in close proximity to an MRI machine.
What can you expect
during the capsule endoscopy?
Patients come
to the Erie Office in the morning usually at 8:30AM. They are fitted with the
leads, which appear similar to that of an EKG. A vest with the data recorder
is then fitted to the individual patient. After drinking a glass of water, the
patient removes the capsule from the protective covering and swallows it with
another glass of water. Nothing is taken orally for two hours; then liquids
are permitted. Four hours after capsule ingestion, solid food is permitted.
The capsule takes two images a second and transmits these images in a wireless
fashion to the data recorder fastened in the vest. The recorder acquires up to
50,000 images over a 7 hour period. The patient then returns in the afternoon
where the vest, data recorder, and leads are removed. The images are
downloaded to a computer. The capsule is passed on its own and not
retrieved.
How do I prepare
for the procedure?
THE DOCTORS MEDICAL ASSISTANT WILL BE PUTTING ON THE CAPSULE
EQUIPMENT.
You
will be given prep instructions in advance that will outline what you should
and should not do in preparation for the capsule endoscopy. Be sure to read and follow these
instructions. One very critical step is to thoroughly clean out the small
intestine and colon so the capsule can pass through and take clear pictures. It is essential that you complete this step carefully, because how ell
the bowel is emptied determines the success of the procedure.
Have nothing to eat or drink after midnight. 2 hours before the test you may take blood pressure or heart medication
with a small sip of water. You
are allowed to take the rest of your medications following your test.
If you have any questions regarding this procedure,
please contact our office.
What are the limitations
and alternative testing?
Capsule
endoscopy does not permit tissue sampling. The exact location of abnormalities
found may not be apparent. If the capsule moves too slowly through the
intestine, it may not reach the area of abnormality before the seven hour time
period for recording expires. If there is a known small intestine stricture,
it should not be used unless there is a plan in place for possible surgery. In
addition, the accuracy of the results has not been adequately verified by
large studies.
Alternative
testing
Barium studies of the small
intestine (small bowel follow through) may identify strictures and evidence of
Crohn's disease. They rarely identify a bleeding source. Small bowel
enteroclysis (a barium study of the small bowel in which a tube is passed
through the nose, esophagus, stomach, and into the small intestine) may be as
accurate as the capsule endoscopy in finding polyps and tumors but is more
uncomfortable. Push enteroscopy (an upper endoscopy with a longer endoscope)
may enable direct visualization of the first half of the small bowel.
BACK
|
