By Victor Adar
Dr Christopher Opio, section head, gastroenterology and consultant gastroenterologist at Aga Khan University Hospital, Nairobi, says capsule endoscopy helps doctors see inside small intestine, an area that isn’t easily reached with traditional procedures, which involves passing a long, flexible tube equipped with a video camera down your throat or through your rectum.
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Patients suffering from intestinal diseases can now swallow a capsule for an endoscopy and colonoscopy, a medical procedure that rides on a tiny wireless camera to take pictures of a digestive tract.
“Your doctor might recommend a capsule endoscopy procedure to find out the cause for gastrointestinal bleeding, diagnose inflammatory bowel diseases, such as crohn’s disease, diagnose gastrointestinal cancers by showing tumors in the small intestine or other parts of the digestive tract,” says Opio.
He adds that capsule endoscopy evaluates the muscular tube that connects a patient’s mouth and stomach (oesophagus) to look for abnormal, enlarged veins. People who have inherited syndromes that can cause polyps in the small intestine can also undergo the procedure.
A capsule endoscopy spots bleeding and other problems in your digestive tract, one of the tests that currently helps doctors examine small and large intestines in a ‘good way’ – other diagnostic procedures (such as an endoscopic ultrasound) use a thin, flexible tube with a camera, but the tube can only reach the first six feet of your small intestine.
“If the results of an imaging test are unclear or inconclusive, your doctor might recommend a capsule endoscopy to get more information,” says Opio, adding that the procedure is “very safe and non-intrusive” – unlike the traditional endoscopy, which involves the insertion of a whole tube through the mouth and a patient put on anaesthesia.
He says that patients should choose a capsule endoscopy because the capsule travels through the entire digestive system, and covers more distance than a tube. The capsule also takes pictures of the whole digestive tract, including the hard-to-reach small intestine.
Inside the capsule, which is swallowed with water just like one would take a pill, is a light, a transmitter and two tiny cameras. Digestive system moves the capsule through the throat and stomach, and into the intestines.
It is sealed, so acids in the stomach can’t break it down like they break down food, thus the capsule stays intact while it travels through the body as its cameras take picture and transmits them to the recording device, usually left with the doctor.
A patient may also be given a mobile phone size transmitting device to wear, or a medical worker may opt for a wireless device that attaches to a belt. The device receives pictures from the capsule’s transmitter and stores them so a healthcare worker can review them later.
“The capsule leaves your body naturally when you have a bowel movement (poop). This usually happens within 24 hours, but may take a few days for you to pass the capsule. You may see the capsule in the toilet, although some people don’t realize they’ve passed it. You can flush the capsule when you go to the bathroom,” he says.
Complications from a capsule endoscopy are rare. Sometimes, the capsule gets stuck in a part of your intestine that’s narrower than the rest of your intestines (stricture). This complication can happen in people who’ve had bowel surgery, inflammation or a tumor in the past. If you aren’t sure if the capsule has passed, you may need an X-ray or CT scan to see if the capsule is still in your body.
However, the doctor normally assesses your gastrointestinal tract in advance to determine your suitability for the procedure. In most cases, patients with narrowed gastrointestinal tract may not qualify for the procedure because this limits the movement of the capsule.