Video capsule endoscopy (VCE)

A video capsule endoscopy (VCE) is a relatively newer tool used to look inside your gastrointestinal tract. During this noninvasive procedure, you swallow a capsule that has a small high-resolution camera inside it. As the capsule makes its way through your digestive tract, the camera takes photographs that are transmitted wirelessly to a data recorder attached to your waist. It allows your doctors to see the lining of your small intestine up close, and aids in the detection of abnormalities that may be present, including cancer.

Why your doctor may order a video capsule endoscopy

A VCE allows your care team to see parts of your bowel that aren’t as easily seen on other imaging tests, such as a regular endoscopy or colonoscopy.

A VCE also may be ordered to look inside your large bowel if you have symptoms of colon cancer.

Other reasons for this test include:

• You have small bowel cancer or polyposis syndrome, and your doctors want to keep you under surveillance.
• Other imaging tests of your gastrointestinal tract were negative or inconclusive.
• You have bleeding from your small bowel with an unknown cause.

You may not be able to undergo a VCE if you:

• Have a cardiac pacemaker or implantable defibrillator
• Have a GI tract obstruction, fistula or stricture that is benign or malignant
• Have a swallowing disorder
• Are pregnant

How to prepare for your video capsule endoscopy

• Don’t wear body lotions or sprays on the day of your exam, especially on your chest or stomach areas.
• You need to empty your bowels. Your doctor will give you instructions for cleaning your bowels using laxatives.
• Stop eating and drinking before your test, per your doctor’s instructions. If your test is in the morning, you should stop at lunchtime the day before. Some tests may require you to stop eating up to 24 hours before your test. You may consume broth or plain Jell-O and drink only clear fluids, such as water, hot tea, black coffee, soda, apple or white grape juice. 
• Speak with your doctor about the medications you take and which you must stop before your test. If you take blood thinners, iron supplements or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, you may need to stop them as much as a week before your test.

What happens during a video capsule endoscopy

You will visit the outpatient department of a hospital or an endoscopy center for d your VCE.

To start, you will be given a belt with sensors inside it to wear around your waist. In some cases, a nurse may attach the sensors directly to your skin. Once you have the belt on, you will be given a capsule to swallow. The capsule is about the size of a large pill.

Once you’ve swallowed the capsule, you can go home while fasting. You’ll likely be asked not to eat for about eight hours after the procedure. Your care team will provide specifics about when you’re able to resume eating and what you may drink. Also, you’ll want to avoid strenuous activities such as running or jumping that could cause the sensors to detach or not work properly.

You may need to keep the sensors and data recorder on longer if the capsule hasn’t passed into your large bowel. The data recorder will last as long as the battery—about 12 to 14 hours from the start. The camera, which is disposable, should pass through your digestive tract the next time you have a bowel movement.

The next day, you must return the data recorder to the hospital or office. Once you return the belt, a technician will download the images the data recorder has taken for the doctor to see and to analyze.

Benefits and risks of video capsule endoscopy

A video capsule endoscopy is a noninvasive tool for seeing abnormalities in the small bowel. However, there are potential risks, including:

• Lesions may be missed
• The camera may fail to work
• The capsule may not be expelled from your intestines (though this doesn’t happen often)

Results

It can take a few days to more than a week for your doctor to hear from the radiologist who reads the images and writes a report. Your doctor will then share the results with you.

The report will indicate any abnormalities that the capsule endoscopy possibly uncovered, including:

• Small intestinal tumors
• The cause of obscure GI bleeding
• The cause of iron deficiency anemia
• Changes in small bowel cancers

Your doctors can discuss the findings with you and work together to determine a course of action: surveillance or treatment. Your doctor also will recommend any follow-up tests and procedures that may be necessary.