Capsule endoscopy has been used for almost 20 years now. It has been CE-certified and FDA-approved since 2001.
The procedure provides over 50,000 high-quality photos directly from the intestine in a gentle, non-invasive way. The photos are later combined into a video.
A gastroenterology specialist can then evaluate the video and use it to accurately diagnose the symptoms. Live evaluation of the images sent is now also possible.
Capsule endoscopy is much more comfortable for the patient than a colonoscopy © Kzenon | AdobeStock
Especially
the capsule is used.
Diseases of the small intestine can be examined more thoroughly with capsule endoscopy than with a conventional magnetic resonance imaging(MRI). An MRI often does not have sufficient resolution. Capsule endoscopy, on the other hand, can also visualize smaller lesions.
The camera capsule passes through all sections of the intestine on its way through the gastrointestinal system. It can therefore also be used to screen for bowel cancer.
There are special small intestine and large intestine capsules. The colon capsule has two cameras, one at each end. This allows photos to be taken on both sides. The small intestine capsule, on the other hand, is equipped with only one camera.
Capsule endoscopy is much less uncomfortable than a colonoscopy. The camera capsule is taken like a normal vitamin capsule with a little water. Neither a hospital stay nor a sedative is necessary.
The capsule endoscopic examination is completely automatic. Nevertheless, some preparations are necessary in advance in order to obtain high-quality images of the intestine:
- Clarification with the doctor as to whether the swallowing reflex is working or whether there are already known constrictions in the bowel. A self-dissolving preliminary examination capsule can be used for this purpose.
- To ensure that the intestinal mucosa can be easily seen, the patient should fast 12 hours before taking the capsule, i.e. abstain from food and drink.
- The doctor may prescribe a laxative to be used before the examination.
- Two hours after the capsule has been swallowed, patients may consume drinks again. Red-colored drinks or drinks containing milk should be avoided so as not to affect the photographs. Light meals are permitted again after around four hours.
Before the camera capsule is swallowed, the patient is given a recording device to wear on their belt. They usually take the recording device home with them and bring it back the next day.
During the intestinal passage, the camera capsule continuously transmits images from the digestive tract. The recording device records the transmitted photos for later analysis. In this way, up to 60,000 photos are collected.
The capsule is now moved by the natural intestinal movements (peristalsis). Its position can be checked via the recording device.
The camera capsule traverses the entire digestive tract. Here you can see the large and small intestine © Sebastian Kaulitzki / Fotolia
During the recording phase of the capsule endoscopy, there are no special rules to follow apart from a slightly reduced diet. The patient can behave and move naturally.
After the camera capsule has passed through the gastrointestinal tract, it is excreted naturally in the toilet. This is usually the case after around 9-14 hours, but can also take several days in individual cases.
In the practice or clinic, a video is created on the computer from the thousands of individual photos. This video is then analyzed by the specialist.
If there is bleeding, the image can show the location of the bleeding. Capsule endoscopy can be a valuable tool for diagnosing Crohn's disease or tumors and polyps.
Capsule endoscopy is a diagnostic procedure that has many advantages for the patient. The only prerequisites for a successful examination are
- a functioning swallowing reflex and
- passable sections of the intestine without constrictions in which the capsule could get stuck.
However, these conditions are thoroughly clarified before the capsule endoscopy.
The risk factors that rule out capsule endoscopy therefore include
- pronounced swallowing disorders,
- severe intestinal inertia (for example due to certain medications or diabetes),
- Intestinal obstruction (mechanical ileus),
- adhesions (brides) of the intestine that constrict the bowel,
- deep diverticula in the small intestine.
Capsule endoscopy is a very gentle procedure. It benefits patients who have unclear abdominal complaints or are reluctant to undergo a conventional colonoscopy.
As a precise diagnostic tool, capsule endoscopy provides very good indications of the individual disease process. The advantages of capsule endoscopy at a glance:
- Non-invasive, painless and gentle examination procedure,
- no radiation exposure,
- no hospitalization necessary,
- no tranquilizers or sedatives,
- no contrast agents,
- examination of the entire small intestine is only possible with capsule endoscopy,
- Cancer screening with a low inhibition threshold.
Capsule endoscopy is an innovative diagnostic tool for the digestive tract that has been tried and tested. It can uniquely visualize the small intestine and is comparable to colonoscopy in the examination of the large intestine.
One disadvantage of capsule endoscopy is its purely diagnostic function. In contrast to colonoscopy, doctors cannot perform any procedures on suspicious tissue changes during the examination.
During a colonoscopy, on the other hand, doctors can, for example, remove intestinal polyps and take tissue samples during the examination. Capsule endoscopy can detect suspicious areas, but a conventional colonoscopy is then necessary for an intervention.
The question of cost coverage by health insurance companies has not yet been clearly resolved.
In the case of unexplained bleeding in the bowel ("unexplained moderate intestinal bleeding"), the costs may be covered by health insurance companies. However, certain criteria must be met if the capsule endoscopy is performed on an outpatient basis.
Patients should therefore talk to their doctor about reimbursement before undergoing a capsule endoscopy. In individual cases, reimbursement can be obtained from the insurance provider after prior application.
Capsule endoscopies as part of a hospital stay are billed by the hospital on a per-case basis.
In summary, capsule endoscopy is an excellent way of thoroughly examining the entire intestinal tract, especially the small intestine. Inflammatory bowel diseases or causes of bleeding in the small intestine can be clarified almost imperceptibly.
Capsule endoscopy is also a milestone in medical technology for bowel cancer screening.
Read our exciting expert interview with Prof. Dr. med. Robert Ehehalt on the Leading Medicine Guide blog!
