Oleh: Thalia Kaylyn Averil
Capsule endoscopy is an innovative examination technique that utilizes a small, wireless camera to record images from inside the digestive tract. This method is specifically designed to explore the esophagus, stomach, small intestine and large intestine, to detect any lesions or abnormalities. Capsule endoscopy is often used to view the small intestine because this area is not easily accessible with other endoscopic procedures. Although effective in mapping and eliminating problems, capsule endoscopes do not have the ability to take tissue samples or biopsies.
In capsule endoscopy, the camera used to capture images is inside a capsule that is approximately the size of a vitamin. The patient will wear a sensor belt which functions to collect images sent by the capsule. Patients are advised to refrain from engaging in any activities that may potentially cause the sensor belt to detach during the procedure, such as running, jumping, heavy exercise, or lifting weights. Then, the patient swallows the camera capsule with water once the recorder is connected and operating. The capsule is easy to swallow because of its smooth coating and should not be felt after the capsule swallowed. Capsules can be introduced into the body by swallowing or inserted into the upper small intestine or stomach with an endoscope. Once swallowed, the capsule will move through the digestive tract and the camera will take thousands of images which are then sent to the recorder. Two hours after swallowing the capsule, the patient can drink clear liquids and can eat small portions four hours later. After eight hours or when the capsule is visible in the toilet after defecation, the capsule endoscopy procedure is complete. However, each person has a different digestive system so the camera capsule can be excreted in a matter of hours or days. After that, the capsule can be thrown into the toilet, then the patient can go to the hospital so the nurse can remove the tools used and the doctor can diagnose the patient based on the video results.
Figure 1. Capsule endoscopy.
The preparations that must be made before undergoing a capsule endoscopy procedure are similar to endoscopy in general. Patients will be asked to fast for at least 12 hours before the procedure so that the camera can capture clear images of the digestive tract. In addition, the patient may also be asked to take laxatives to clean the small intestine so that the image captured by the camera capsule can be clearer. Patients may also be asked not to take certain medications before the capsule endoscopy procedure is performed. The health worker on duty will explain the things that need to be done before the procedure, make sure to follow the instructions given because the capsule endoscopy may need to be rescheduled if the patient fails to prepare as instructed.
Capsule endoscopy can be used for many indications, namely:
- The source of bleeding that remains unidentified when using upper and lower endoscopy most commonly originates from the small intestine
- Patients who are intolerant of sedation, have a high risk of colonoscopy, or have had an incomplete endoscopy
- Diagnosis and evaluation of Crohn’s disease
- Diagnosis of celiac disease and evaluation of refractory celiac disease
- Diagnosis of small bowel tumors, such as neuroendocrine tumors or carcinoid tumors
- Surveillance of patients with polyposis syndrome
- Evaluation of the esophagus to screen for esophageal varices, esophagitis and Barrett’s esophagus
Capsule endoscopy can be useful in detecting certain digestive disorders, although it is still not commonly chosen as the first-line test for now. Capsule endoscopy offers a comprehensive and minimally invasive test that is highly helpful in identifying hidden or shallow lesions missed by other tests. Before undergoing the procedure, healthcare providers will be informed about the indications, contraindications, and limitations of the procedure, thus reviewing the patient’s past medical history.
Abdi Waluyo Hospital offers capsule endoscopy services as part of its commitment to providing high-quality healthcare. Patients with medical indications requiring thorough examination can benefit from this technology for accurate and precise diagnosis.
Capsule endoscopy technology represents a significant advancement in the medical field, offering minimally invasive diagnostic methods with great potential in detecting and managing various gastrointestinal conditions. With these advantages, capsule endoscopy not only reduces discomfort and risks for patients but also opens new avenues in research and treatment of digestive tract diseases.
Resources
- Mayo Clinic. Capsule endoscopy – overview [Internet]. Rochester: Mayo Clinic; date of publication unknown [cited 2024 Feb 7]. Available from: https://www.mayoclinic.org/tests-procedures/capsule-endoscopy/about/pac-20393366
- Robertson KD, Singh R. Capsule Endoscopy. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482306/
- Manhattan Gastroenterology. Top small bowel capsule endoscopy doctor upper east side, NYC [Internet]. Manhattan: Manhattan Gastroenterology; date of publication unknown [updated 2023 Nov 16] [cited 2024 Feb 7]. Available from: https://www.manhattangastroenterology.com/procedures/small-bowel-capsule/
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