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Wireless Capsule Endoscopy

Wireless Capsule Endoscopy is a procedure where a video capsule is swallowed to take photographs of the inside of the esophagus, stomach and small intestine. This device helps visualize the entire small bowel.

BRIEF ABOUT THE PROCEDURE

The intestines are first cleared of residual food and bacterial debris with the use of laxatives. A capsule that contains video cameras, a light emitting device, battery and a transmitter is then swallowed. AsWireless Capsule Endoscopy the capsule travels through the esophagus, stomach and small intestine, it takes photographs rapidly at the rate of 2 per second. The photographs are captured by a small receiver that is worn on the waist of the patient who is undergoing the capsule endoscopy. These data are transferred to a computer for interpretation by a physician. The capsule normally passes out of the body along with stools.

This procedure can help locate and understand small intestinal bleeding could result from a number of conditions, including vascular lesions (angiodysplasia), small bowel tumors, coeliac disease and Crohn’s disease.

Limitations

  • Though the capsule provides the best means of viewing the inside of the small intestine, the most important limitation of which is that the capsule does not allow for therapy
  • The camera movement cannot be controlled and hence abnormalities in some areas of the intestine are missed because of rapid movement of the capsule and blurred, uninterruptible photographs. The movement at times is so slow that part examination is possible before the battery fails
  • This procedure does not assist in pin pointing the exact location of abnormality that requires surgical resection or further investigation. Hence, it may be difficult to determine where in the intestine the abnormality is and thereby help in direct therapy
  • If there are narrow areas due to scarring (strictures) or tumors in the small intestine, the capsule can get stuck in the narrow area and cause an obstruction of the intestine that requires surgical removal of the capsule. (For this reason, in patients who are suspected of having a stricture, a self-dissolving, dummy capsule is swallowed first. If the dummy capsule sticks, it can be seen on an x-ray of the abdomen and the location of the stricture determined. Because it dissolves with time, however, the obstruction will resolve without surgery and the real capsule will not be swallowed)
  • Tens of thousands of photographs are to be reviewed before a final assessment and is very time consuming for the physician

Some common examples of small intestine diseases diagnosed by capsule endoscopy include:

  • Angiodysplasias (collections of small blood vessels located just beneath the inner intestinal lining that can bleed intermittently and cause anemia)
  • Small intestinal tumors such as lymphoma, carcinoid tumor and small intestinal cancer
  • Crohn's disease of the small intestine

This procedure can help locate and understand small intestinal bleeding could result from a number of conditions, including vascular lesions (angiodysplasia), small bowel tumors, coeliac disease and Crohn’s disease.

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