Pillcam
A capsule endoscopy (also called a pillcam endoscopy) is a non-invasive, pain-free procedure that is used to take pictures of your small bowel. Dr Dunkley may perform this procedure to identify the cause and location of suspected blood loss in your digestive tract if these cannot be identified during gastroscopy or colonoscopy.
What is pillcam technology?
A pillcam is a tiny capsule that contains a camera that takes photos as it travels along your digestive tract. Despite its small size (similar to a jelly bean) it is a powerful medical device that is used to reach areas that are difficult to see using traditional endoscopy.
The procedure involves swallowing the pillcam capsule with water and wearing small sensors and a recorder on your body while you go about your day as normal. The test takes about eight hours to complete.
Why do I need a capsule endoscopy?
The most common reason for having a capsule endoscopy is for Dr Dunkley to gather information about unexplained iron deficiency (anaemia) which indicates loss of blood from the digestive tract where other diagnostic tests (gastroscopy or colonoscopy) have not revealed the cause.
Capsule endoscopy can also reveal areas of inflammation in the small intestine and help diagnose inflammatory bowel conditions such as Crohn’s disease. It can also reveal small tumours in the small intestine and may be used to examine the oesophagus.
Preparing for your pillcam procedure
A capsule endoscopy is a procedure that is completed over the course of a day while you go about your normal activities. You will visit the clinic in the morning to set up the procedure and come back at the end of the day to return the sensors and recorder.
There is no anaesthetic or sedation required but you will need to follow a special diet and complete a bowel prep the day before to allow a clear view of your bowels.
We will explain the procedure to you in more detail, with instructions on how to prepare and what to wear, when you make your appointment. After taking the capsule, you will be able to go about your day as normal while avoiding exercise or heavy lifting.
What to expect during your pillcam procedure
The procedure to set up the pillcam will take around 1 hour.
You will arrive at the clinic in the morning to have the sensors attached to your abdomen using adhesive patches. These will be attached to a small recorder that you will wear on a special belt around your waist.
You will be given the pillcam to swallow with water.
It is fine to drive and go to work as long as you can avoid strenuous activity and environments that may interfere with the sensor (eg shopping centres, areas with radio transmitters and MRI machines).
It is fine to use a mobile phone, computer and listen to a stereo.
You will be wearing a battery pack and data recorder so it may be a good idea to avoid public places where security is being monitored.
You will be given instructions about when you can start drinking and eating again (clear liquids only 2 hours after swallowing the capsule and certain foods only 4 hours after swallowing the capsule).
It’s important to follow these instructions carefully for the pillcam to work effectively.
After your pillcam procedure
The pillcam procedure is complete after eight hours or when you see the camera capsule appear in the toilet, whichever comes first. There is no need to retrieve the capsule because the images have been stored on the recorder. It is safe to flush it away.
You will return to the clinic to remove the sensors and return the recorder. The recording is sent to another laboratory to extract the images and provide a report. Dr Dunkley will discuss the results as soon as they become available.
Are there any risks or side effects?
Capsule endoscopy is a very safe procedure. The capsule has a special coating to make it easier to swallow and most people experience no side effects.
In a small number of people (estimated 1 in 200) the pillcam may get stuck in the small bowel, usually due to an abnormal narrowing or blockage that needs to be treated. If this happens, it is likely that Dr Dunkley will schedule a separate endoscopic procedure to remove the pillcam and treat any blockage. The risk might be higher in people who have an inflammatory condition such as Crohn's disease or previous surgery in the area.
As with any procedure, Dr Dunkley will discuss your medical history and explain any risks beforehand.
If the pillcam images do not clearly show the capsule passing through the large bowel, an x-ray may be arranged to check that you have passed the capsule successfully.