Capsule Endoscopy is a remarkable, state-of-the-art diagnostic procedure that allows your gastroenterologist to visualize the entire length of your small intestine, an area of the digestive tract that is largely inaccessible to traditional endoscopic procedures. The technology involves swallowing a small, disposable capsule, about the size of a large vitamin pill, which contains a miniature wireless camera, a light source, a battery, and a transmitter. As this capsule travels naturally through your digestive system, propelled by normal muscular contractions, it captures thousands of high-resolution images, providing an unprecedented, detailed view of the inner lining of your small intestine. This procedure is painless, requires no sedation, and allows you to go about most of your light daily activities while the examination is underway.

The primary and most important use of capsule endoscopy is to investigate the cause of bleeding from the small intestine, a condition known as obscure gastrointestinal bleeding. It is also an invaluable tool for diagnosing Crohn's disease of the small bowel, detecting tumors, and evaluating other abnormalities that cannot be reached by a standard upper endoscopy or a colonoscopy. By providing a direct look at this hard-to-reach area, capsule endoscopy can solve complex diagnostic mysteries, leading to an accurate diagnosis and a targeted treatment plan. At Fortis Healthcare, we utilize the latest in capsule technology, interpreted by expert gastroenterologists, to provide definitive answers for your digestive health.

The Science: How Capsule Endoscopy Works

Capsule endoscopy is a feat of medical engineering, packing sophisticated imaging technology into a tiny, swallowable device. The system consists of three main components that work together to create a detailed video of your small intestine.

1. The Endoscopic Capsule

The single-use, disposable capsule is the heart of the technology. Despite its small size, it contains several key components:

• A Miniature Color Camera: Positioned at one end, this camera is designed to capture high-quality images of the intestinal lining.
• LED Light Sources: Four tiny, powerful light-emitting diodes illuminate the dark environment of the small intestine, ensuring the images are bright and clear.
• A Battery: A tiny, silver-oxide battery powers the capsule for its entire journey, which is typically 8 to 12 hours.
• A Radio Transmitter: This component wirelessly transmits the captured images to a data recorder worn by the patient.

2. The Data Recorder and Sensor Array

Before you swallow the capsule, a sensor array, which consists of several adhesive sensor pads, will be applied to your abdomen. These sensors are connected by wires to a small data recorder, about the size of a portable music player, which you will wear on a belt around your waist. The sensors on your abdomen pick up the radio signals transmitted by the capsule, and the data recorder stores the thousands of images it sends.

3. The Workstation and Software

After the examination is complete, you will return the data recorder to the hospital. The gastroenterologist then downloads the images to a powerful computer workstation equipped with specialized software. This software compiles the thousands of individual pictures into a fluid video format. The doctor can then meticulously review this video, speeding it up, slowing it down, and pausing at any point to closely examine areas of concern. The software also helps to estimate the location of any abnormalities found within the small intestine.

The capsule itself is not retrieved. It travels through your entire digestive tract and is naturally passed out of your body in a bowel movement, typically within one to three days.

When is Capsule Endoscopy Recommended?

Capsule endoscopy is a specialized diagnostic tool, not a first-line procedure. It is recommended when a comprehensive evaluation of the small intestine is needed, and other tests have not provided a diagnosis.

The Primary Indication: Obscure Gastrointestinal Bleeding

This is the most common and important reason for performing a capsule endoscopy. Obscure GI bleeding refers to a situation where a patient has persistent or recurrent signs of bleeding, such as iron deficiency anemia, black stools (melena), or visible blood in the stool, but both a standard upper endoscopy (which examines the esophagus, stomach, and first part of the small intestine) and a colonoscopy (which examines the large intestine) have failed to find the source of the bleeding.

This strongly suggests the problem lies within the approximately 20 feet of the small intestine that is situated between these two areas. Capsule endoscopy is the gold standard for finding the source of this bleeding, which can be caused by:

• Angiodysplasias: Small, abnormal blood vessels in the intestinal wall that are prone to bleeding.
• Ulcers: Sores in the lining of the small intestine.
• Tumors: Both benign and malignant tumors can cause bleeding.
• Crohn's Disease.

Diagnosing and Monitoring Crohn's Disease

Crohn's disease is a type of inflammatory bowel disease that can affect any part of the digestive tract, but it most commonly affects the end of the small intestine (the ileum) and the colon. When Crohn's disease is suspected but a colonoscopy is inconclusive, a capsule endoscopy can be invaluable for visualizing the characteristic inflammation and ulcers of the disease within the small intestine.

Detecting Small Bowel Tumors and Polyps

While tumors of the small intestine are rare, capsule endoscopy is a highly sensitive tool for detecting them. It is also used as a screening tool for patients with certain inherited genetic syndromes, like Peutz-Jeghers syndrome, who are at a high risk of developing polyps in their small intestine.

Diagnosing Celiac Disease

For patients with suspected celiac disease who cannot undergo an upper endoscopy, or for those with a confirmed diagnosis who are not responding to a gluten-free diet, a capsule can be used to assess the extent of the damage to the small intestinal lining.

Capsule Endoscopy vs. Traditional Endoscopy

Our Specialists

The capsule endoscopy procedure is prescribed and interpreted by a gastroenterologist, a medical doctor who specializes in the diagnosis and treatment of diseases of the digestive system.

Dr. Ajay Kumar Kriplani

PRINCIPAL DIRECTOR & HOD LAP GI, GI ONCO, BARIATRIC & MIS SURGERY | Fortis Gurgaon

Dr. Gourdas Choudhuri

CHAIRMAN-GASTROENTEROLOGY | Fortis Gurgaon

Dr. (Prof.) Amit Javed

SENIOR DIRECTOR - GI, GI ONCOLOGY, MINIMAL ACCESS & BARIATRIC SURGERY | Fortis Gurgaon

Patient Stories

"For over a year, I had been struggling with severe, unexplained anemia. I was constantly tired and weak. I had an upper endoscopy and a colonoscopy, but both came back completely normal, which was so frustrating. My gastroenterologist at Fortis then recommended a capsule endoscopy. The prep was similar to a colonoscopy, but the procedure day was so easy. I just swallowed the capsule and went home. When the results came back, the video showed a small, bleeding lesion in the middle of my small intestine that was the source of my anemia. Finally having a diagnosis after all that time was an incredible relief." - Rohan Mehra, 52, Delhi

"My doctor suspected I might have Crohn's disease based on my symptoms, but my colonoscopy was not definitive. He suggested a capsule endoscopy to get a look at my small bowel. It was amazing to think a tiny camera was travelling through my intestines. The test confirmed the diagnosis, showing clear areas of inflammation and ulceration in my ileum. This clear evidence allowed my doctor to start me on the right specific medication, and my symptoms have improved dramatically since." - Anika Sharma, 29, Gurugram

The Capsule Endoscopy Procedure: A Detailed Walkthrough

The Bowel Preparation: A Critical Step

For the capsule's camera to get clear, unobstructed images, your small intestine must be completely clean. You will be given very specific bowel preparation instructions, which you must follow precisely for the test to be successful.

• Dietary Restrictions: You will need to be on a clear liquid diet for the entire day before your procedure. This means no solid food, milk, or dairy. You can have water, clear broth, black tea or coffee, and clear juices.
• Fasting: You must stop drinking any liquids, including water, for about 10 to 12 hours before your scheduled appointment time.
• Laxatives: You will be prescribed a laxative solution to drink the evening before your procedure. This is designed to flush out the contents of your digestive tract.
• Medication Review: Inform your doctor of all your medications. You may need to adjust the timing of your doses, especially for diabetes medication.

The Day of the Procedure

• Arrival and Setup: You will arrive at the gastroenterology department. A nurse will have you sign a consent form and will then apply the sensor array to your abdomen and connect it to the data recorder, which you will wear on a belt.
• Swallowing the Capsule: You will be given a glass of water and the video capsule. You will swallow it just like you would a pill. It is coated to make it easy to swallow.
• Post-Swallowing Instructions: You can then leave the hospital. You will be given a detailed timeline of when you can start drinking clear liquids again (usually 2 hours after swallowing the capsule) and when you can have a light meal (usually 4 hours after). You should avoid strenuous physical activity, bending, or stooping for the rest of the day.
• The Monitoring Period: For the next 8 to 12 hours, the data recorder will collect the images. A small light on the recorder will blink to show it is working correctly. You must not remove or disconnect the equipment during this time.
• Returning the Equipment: At the end of the monitoring period, you will return to the hospital as instructed to have the sensor array removed and to return the data recorder.

After the Procedure

You can resume your normal diet and medications after the examination is complete. The video capsule is single-use and disposable. It will pass naturally out of your body in your stool, usually within one to three days. You will not feel it pass, and you do not need to retrieve it. It is safe to flush down the toilet.

Myths vs Facts

Take the Next Step

For patients struggling with complex and undiagnosed digestive issues, particularly those originating from the small intestine, capsule endoscopy can feel like a breakthrough. This safe, painless, and non-invasive technology provides a view of the digestive tract that was once impossible without major surgery, offering the potential for a definitive diagnosis that can pave the way for effective treatment.

If you have been dealing with unexplained symptoms like chronic anemia or have a suspected case of Crohn's disease, a consultation with a gastroenterology specialist can help determine if this advanced procedure is the right next step for you. Our team is dedicated to using the best in medical technology to provide you with the answers and the care you deserve.

CTA: Book a Gastroenterology Consultation / Get a Second Opinion

Frequently Asked Questions

Q1. How long does the capsule endoscopy procedure take?

Ans. The monitoring period, during which the capsule is actively taking pictures, lasts for about 8 to 12 hours. You will wear the data recorder for this entire duration.

Q2. Is the capsule endoscopy procedure safe?

Ans. Yes, it is a very safe procedure. The capsule is made of biocompatible material. The most significant, though rare, risk is capsule retention, where the capsule gets stuck in a narrowed part of the intestine.

Q3. When will I get the results?

Ans. After you return the data recorder, your gastroenterologist needs to meticulously review the 8 to 12 hours of video footage, which contains over 50,000 images. This is a time-consuming process. A formal report is typically available and will be discussed with you within one to two weeks.

Q4. Can the capsule take a biopsy?

Ans. No, this is a key limitation. The current capsule technology is for diagnostic imaging only. It cannot take tissue samples (biopsies) or perform any therapy, like stopping bleeding. If a serious abnormality is found that requires a biopsy, a different procedure, like a deep enteroscopy, may be necessary.

Q5. What happens if I have trouble swallowing the capsule?

Ans. The capsule is about the size of a large vitamin pill and is coated to make it easy to swallow for most people. If a patient is unable to swallow it, it can be placed in the small intestine endoscopically during a standard upper endoscopy procedure.

Q6. Can I have an MRI scan while the capsule is inside me?

Ans. No. You must not go near any powerful magnetic fields, such as an MRI machine, until you have confirmed that the capsule has passed out of your body. The strong magnet can cause serious internal injury.

Q7. How will I know when the capsule has passed?

Ans. Most people do not see the capsule in their stool. If your doctor needs to confirm its passage, they may order an abdominal X-ray a week or two after the procedure, as the capsule is visible on an X-ray.

Q8. What is a "patency capsule"?

Ans. If your doctor suspects you might have a narrowing (stricture) in your small intestine, they may have you swallow a patency capsule first. This is a dissolvable "dummy" capsule of the same size. If it passes through your system without issue, it is safe to proceed with the real video capsule. If it gets stuck, it will dissolve on its own after a day or two.