Capsule Endoscopy

Before your capsule endoscopy

Be sure your healthcare team knows if you:

• Take any medicines. This includes vitamins, herbs, and supplements. You may be asked to hold some of these before your test.
• Are allergic to any medicines.
• Have an implanted or wearable medical device. They will let you know if you need special instructions during the test.

If you smoke, you may be asked not to smoke starting the day before the test. Smoking could interfere with test preparation and how the capsule travels through your digestive tract.

Tell your healthcare team if you have trouble swallowing, or if you’ve had:

• A bowel blockage
• Narrowing of the digestive tract
• Crohn’s disease
• Surgery on your digestive tract
• Radiation treatment to your belly or pelvis

Your care team may order an imaging test or have you swallow a dissolvable test capsule, called a patency capsule, to make sure the camera capsule can pass safely.

Preparing for the test

Your care team will tell you how to prepare. You may need to follow a clear liquid diet, take a laxative, and stop eating or drinking for several hours before the test. Be sure to follow their instructions. Ask questions if there is anything you don’t understand.

During your capsule endoscopy

Capsule endoscopy is done as an outpatient, meaning you do not need to stay overnight in a hospital. You will swallow the capsule in a doctor’s office or clinic, then return home while the camera takes pictures for about 8 hours.

Your doctor will review the procedure with you and ask you to sign a consent form.

Placing the sensors

At the doctor’s office or clinic, the care team will place sticky patches (sensors) on your belly or give you a sensor belt to wear around your waist. The sensors send pictures from the capsule’s camera to a small recorder that you wear during the test.

Swallowing the capsule

You will swallow the capsule with a few sips of water. You will do this while sitting upright. Most people do not feel the capsule as it moves through the digestive tract.

If you cannot swallow the capsule or your stomach empties slowly (gastroparesis), your care team might recommend having the capsule placed with an upper endoscopy, which involves sedation. You can learn more about it in Tests: Upper Endoscopy.

During the test

Your care team will tell you when you can drink and eat after swallowing the capsule. Follow their instructions because the timing can vary.

You can usually walk around and do most of your normal activities during the test. However, you may need to avoid running, strenuous exercise, bending over, or other activities that could loosen or damage the equipment.

You will usually wear the recorder or sensor belt for about 8 hours. Your care team will tell you when the test is finished and when to remove or return the equipment. Do not remove or disconnect the equipment unless your care team tells you to do so.

After your capsule endoscopy

After the test, you will pass the capsule out of your body with a bowel movement (poop).

In most cases, you can flush the capsule down the toilet. This may happen within a few hours or take several days. If you do not see the capsule in the toilet after about 2 weeks, contact your healthcare team. They may order an x-ray to check whether it’s still in your digestive tract.

Do not have a magnetic resonance imaging (MRI) test until you know the capsule has left your body. The capsule has metal parts and may not be safe in an MRI machine. Tell the MRI care team that you recently had a capsule endoscopy.

Follow your healthcare team’s instructions about when you can return to your usual diet.

The doctor will review the pictures taken by the camera. You will need to follow up with them after the procedure to get your results.

Possible risks of capsule endoscopy

Capsule endoscopy is usually safe, but there is a small risk of certain complications.

Capsule retention: The capsule may get stuck in your intestine and not leave your body through a bowel movement. This is more likely if part of your digestive tract is narrow. This may happen in people with Crohn’s disease or those who’ve had surgery on the digestive tract. If the capsule gets stuck, it may need to be removed with an endoscopic procedure.

Perforation (puncture) of the intestine wall: Very rarely, a hole can form in the wall of the intestine when a capsule gets stuck in a narrowed or diseased area. This is a serious problem that may require surgery.

Bowel blockage: Very rarely, the capsule may block the intestine. This can cause severe pain, bloating, and vomiting. Surgery may be needed to remove the blockage.

Aspiration: In rare cases, the capsule may go into your windpipe instead of your esophagus. This can cause coughing, choking, or trouble breathing. A doctor may need to remove it using a procedure called a bronchoscopy. If the capsule is not removed, it could block your airway or cause an infection.

When to call your care team

Before you go home, your doctor or nurse should give you specific instructions on when to call about problems.

In general, call your care team if you have:

• Severe pain in your belly, throat, or chest
• Swelling or bloating in your belly
• Vomiting
• Fever
• Constipation (cannot pass stool or gas)
• Signs of bleeding, including dark or black stools
• Trouble swallowing

Also call your care team if you do not see the capsule in your bowel movement or toilet after 2 weeks.

Be sure you understand what you should watch out for, when to call for problems, and the possible timing of when these problems might happen.