Thomas Lyles, MD
As a leading GI doctor in Bedford and the surrounding Fort Worth, TX areas, Dr. Yepuri is an expert in performing upper endoscopic (EGD) examinations. In addition, Dr. Yepuri is one of a few gastroenterologists in the Fort Worth area that has been trained in advanced endoscopic procedures.
What is capsule endoscopy?
Wireless capsule endoscopy is a tool that gastroenterologists use to visualize the small bowel. While the esophagus, stomach and first portion of the small intestine (the duodenum) are easily accessible using an upper endoscopy, and the colon and last portion of the small intestine (the terminal ileum) can be examined via a colonoscopy, it is relatively difficult to examine for disease of the small bowel. The capsule endoscopy allows for a gastroenterologist to obtain sequential pictures of the entirety of your small intestine. The capsule itself is made up of a camera, a lens, light emitting diodes, and an antenna.
How does it work?
After consuming a mild bowel prep the night before, the patient is ready for a capsule endoscopy. On the day of the exam, a mobile data recorder is worn by the patient and then the capsule (also known as a pill camera) is swallowed by the patient. After the capsule is swallowed, it begins its journey through the esophagus, stomach and then small intestine. Over the course of the next 8 hours, the capsule will take 50,000 – 60,000 images which are transmitted to the data recorder, where they are stored until they are downloaded by your gastroenterologist.
After the capsule stops taking pictures, the capsule then proceeds throughout the rest of your GI tract, including the colon, until it is painlessly passed through your stool. At the end of the day, the data recorder is returned to your physician’s office, where the images are then downloaded and reviewed.
Do I really need to take a bowel prep before a capsule endoscopy?
Yes. Although we typically think of bowel preps for cleansing the colon prior to a colonoscopy, the bowel prep before a capsule endoscopy helps to effectively clear out the small intestine in order to get the best pictures possible.
Why do patients undergo capsule endoscopy?
The most common reason that a patient undergoes a capsule endoscopy is for further evaluation of obscure gastrointestinal bleeding. An example of obscure gastrointestinal bleeding is iron deficiency anemia. In this example, a patient is diagnosed with iron deficiency anemia and then has an unrevealing upper endoscopy and colonoscopy. A capsule endoscopy is then used to fully examine the small intestine for bleeding disorders that lead to slow, chronic blood loss, and ultimately iron deficiency anemia.
Other indications for capsule endoscopy include:
- Suspected Crohn’s disease of the small intestine
- Diagnosis of suspected small intestine tumors
- Suspected Celiac’s disease
- Undiagnosed abdominal pain
- Evaluation of malabsorption within the small intestine
Are there any risks of capsule endoscopy?
The biggest risk is that the capsule endoscopy will become stuck within the small intestine. This is approximately a 1-2% risk. Even if a capsule becomes stuck (retained), then most cases spontaneously resolve without the need for medical intervention.
If a patient has a known narrowing (stricture) within the small intestine, then they cannot undergo a capsule endoscopy. A patient cannot undergo a capsule endoscopy if they have a known small bowel obstruction