Capsule endoscopy

A capsule endoscopy is a test that looks at the inside of your bowel. This is also called a video capsule endoscopy.   

You might have a capsule endoscopy if you have symptoms of bowel cancer.

About capsule endoscopy 

You swallow a capsule that contains a small disposable camera. The capsule is the size of a vitamin pill. The camera takes lots of pictures as it travels along your gut. The camera sends the pictures wirelessly to a data recorder that you wear on your waist. You might also hear this called Pillcam or Scotcap. 

The test is complete once the capsule has passed through your bowel and out into the toilet. A doctor or specialist nurse looks at the pictures from the data recorder to help find out the cause of your symptoms. 

Types of capsule endoscopy

There are 2 types of capsule endoscopy:

• a capsule endoscopy that looks at your small bowel

• a colon capsule endoscopy that looks inside your large bowel

Small bowel capsule endoscopy

You might have this test if your doctor needs to look closely at the inside of your small bowel. The small bowel is made up of 3 parts:

• duodenum

• jejunum

• ileum

A small bowel capsule endoscopy can examine the part of the bowel that other tests such as endoscopy or colonoscopy might not always reach.

Colon capsule endoscopy

A colon capsule endoscopy can look at the inside of your large bowel. Your large bowel is made up of 2 parts:

• colon
• rectum (back passage)

Why you might have a capsule endoscopy

You might have a capsule endoscopy if you have symptoms of bowel cancer. This includes having blood picked up in your poo on a Faecal Immunochemical Test (FIT).

You usually have a colonoscopy if you have symptoms of bowel cancer. During a colonoscopy, your doctor uses a flexible tube with a small camera to look inside your large bowel (colon). In some hospitals, people with symptoms of bowel cancer may have a capsule endoscopy instead of having a colonoscopy straight away.

The capsule endoscopy can help to rule out bowel cancer. And many people do not need to have further tests. The capsule endoscopy is a less invasive test than colonoscopy, which people may prefer.

You still need to have a colonoscopy if your doctor sees any abnormal areas on the capsule endoscopy. This is so they can take biopsies or remove growths (polyps ) if necessary.

Preparing for your capsule endoscopy

Your nurse will explain what you can eat and drink, and what medications you can take before the test. These instructions are usually in an information leaflet or your hospital appointment letter.

Instructions vary slightly between hospitals, the following is general guidance.

Your bowel needs to be clear for the camera to get the best pictures. To do this, you will usually have to change your diet a few days before your test. This helps to reduce the amount of poo in your bowel. You also need to take laxatives to empty your bowels. This is called bowel preparation or bowel prep. It’s important to follow the instructions carefully so that you have a clean bowel for the test.

Let your nurse know if you are on any regular medication. They will tell you if you need to stop any medication beforehand and when to stop them. If you take iron tablets, you will be asked to stop taking them about one week before the test.

Your hospital letter will also tell you what you should do in the days before your test and on the day of the test.

This includes:

• when to start reducing the amount of food you have and when you should stop eating

• what fluids you can drink and how much you should drink

• when to take your bowel prep

You must let your nurse or doctor know if you are diabetic and if you are allergic to anything.

You can’t have this test if you are pregnant. Phone your nurse before your appointment if you are pregnant or think you might be. 

What happens?

You usually go to the outpatient department or the endoscopy unit on the morning of the test. You are at the hospital for about an hour. The test itself can take around 6 to 10 hours.

Your doctor or nurse will check that you are ready for the test and will explain the procedure to you. They will then ask you to sign a consent form. This is a good time to ask any questions you may have.

There are two ways you may have the test.

The most common way is to wear a belt with built in sensors inside it. You will be fitted with a special belt and shoulder bag that holds the recorder. Some people might find these feel little heavy.

Or the nurse or technician may put some sticky pads (sensors) on your chest and stomach area. They then attach a data recorder to a belt that you wear around your waist.

Once this is in place, your nurse, doctor or technician will ask you to swallow a capsule that has the camera inside. You swallow it whole with some water.

At home

Once you have swallowed the capsule and your nurse has given you all the instructions, you can leave the hospital.

They will give you instructions about taking more laxatives for your bowel. This is to keep your bowel moving which helps the capsule pass through the bowel. They will also tell you when you can drink again and when you can have a light snack.

You may go back to hospital later that afternoon to check if the capsule has passed into the large bowel. 

The camera takes pictures as it passes through your bowel. It sends all the photos that it takes to the data recorder. 

You can remove the sensors or belt once the test has finished. You return the data recorder to the department later that day or the next day. 

After your capsule endoscopy

A technician downloads the pictures from the data recorder to a computer. A doctor or specialist nurse then looks at the pictures.

The capsule is disposable. You pass it naturally in your poo when you go to the toilet.

Possible risks

The team caring for you will give you phone numbers to contact if you have any questions or problems after your test. 

A capsule endoscopy is usually a safe procedure. Your doctors make sure the benefits of having a capsule endoscopy outweigh any possible risks.

Very rarely, the capsule might get stuck inside your body. Tell your doctor or nurse if you are worried that you have not passed out the capsule. You might need an x-ray to check if it is still in your bowel.

Getting your results

It may take some days or weeks for the medical team to look at all the pictures. They send the results to the doctor who arranged the test. 

Waiting for results can make you anxious. You might have contact details for a specialist nurse who you can speak to for information and support if you need to. It may help to talk to a close friend or relative about how you feel.