Video Capsule Endoscopy

Why it is needed?

It helps to visualise the lining of the small bowel, It is useful to detect ulcers, polyps, haemangioma in the small bowel. It is a valuable tool for patients who has suspected small bowel Crohn’s disease who has normal or relatively normal endoscopic, histological and MRI small bowel finding. It is also used to detect haemangioma, angiectasia, lymphagiectasia, obscured gastrointestinal bleeding and unexplained anaemia.

What preparation do I need?

Patient will need to follow a low residual diet a day before the procedure. The procedure is performed either in the out-patient setting or in the theatre. In the out-patient setting, patient will be asked to swallow the video capsule as instructed by the out-patient nurse. In theatre setting, the video capsule is introduced into the small bowel via a gastroscope with the capsule delivery device. A belt is attached to the patient’s waist. The patient is asked to drink a glass of water containing infacol which reduces the bubbles in the small bowel and allows better visualisation of the small bowel. After the belt is fitted and the study is activated, patient will be allowed home. No food or drink is allowed within 2 hours of the study. Patient can have clear fluid including black teas or squash. Patient can have light meal such as sandwich or clear soup 4 hours after the study begins. Patient is allowed to have normal diet 8 hours after the study begins.

How long does it take?

The procedure will take up to 4-8 hours.

Is there any risk?

There is a small risk of capsule retention. It occurs in 1% of the cases. This means the capsule does not pass after 2 weeks of capsule introduction. This is usually caused by the small bowel stricture in patients with Crohn’s disease. A trial of laxative may help to propel the exit of the capsule. Double balloon enteroscopy may be required to remove the capsule. Occasionally, a surgical removal of capsule is required. Patient may undergo surgery to remove the stricture at the same procedure. A dummy capsule can be useful if patients who have high risk of capsule retention.