Leaflet Details
| Title | Having a Colon Capsule Endoscopy |
| Department | Endoscopy |
| Author(s) | Jean Asare |
| Review Date | August 2025 |
| Next Review | August 2027 |
| Download | A5 Booklet PDF and A4 Handout PDF |
| Accessibility Options | Click on the Recite Me button to show our accessibility resources |
Patient Information
Introduction
This information leaflet contains information about your procedure including the risks, benefits, alternatives to the test and what you might expect when you come to the hospital. If, after you have read it, you have any queries or concerns; please talk to us about any worries and ask any questions you may have.
The aim of this booklet is to enable you to make an informed decision when you come for your procedure. It is important to us that you have understood the procedure, and its risks and benefits, before we ask you to sign your consent form. We will need to have your formal written consent before we can perform your procedure, which will be done either by an experienced Registered Nurse or your Endoscopist.
Your appointment time is approximate, as some procedures may take longer than expected. You should expect to be in the department for approximately most of the morning or afternoon.
Preparation for the procedure
The success of your procedure depends on how clean your colon (bowel) is. To achieve this, we will provide you with a diet regime which you will need to follow, and you will have to take some laxatives the day before you come for your procedure. This usually results in diarrhoea which can be unpleasant.
Bowel preparation
You will need to take a special laxative which will be supplied to you (Picolax®, Citrafleet®, Moviprep®, Klean Prep® or Plenvu®).
Please ignore the instructions on the sachets and follow those set out on the separate sheet of paper in this envelope, entitled “Bowel Preparation Instructions”.
These instructions will tell you what you need to do for the week running up to your colonoscopy, and particularly how to prepare the day before the procedure. Depending what time your procedure is booked for, you will need to follow a special checklist of instructions.
If you do not understand the instructions or need any advice, please call the Endoscopy Unit on 01932 722747
Medicines
Unless you have been advised otherwise, you should take your usual medicine normally with few sips of water. Please do remember to bring in the list of your medications.
Patients taking blood thinners (antiplatelet or DOAC) should continue their medicines.
- Iron tablets - stop taking your iron tablets at least one week prior to your appointment
- Diabetes: If you are diabetic, please inform the Endoscopy department so that we can schedule your appointment appropriately. Also do let us know about the medications you are on. You will also be given specific instructions on managing your diabetes while you are having your bowel preparation. For example, if you are a diabetic you should find an advice sheet along with this leaflet. If you do not have the advice sheet, or you do not understand the instructions, please call the Endoscopy nurses on 01932 722747.
What is Colon Capsule Endsocopy?
A capsule endoscope is a miniature video camera (containing 2 tiny video cameras powered by a tiny batteries) placed inside a small pill like device, often called a Pillcam®. On swallowing the capsule, it travels through your digestive tract on its own, aided by the natural movement of the bowel. During its passage it takes pictures of your colon and transmits those images to a data recorder worn on a belt. These are downloaded onto a computer allowing the doctor to examine for any disease or abnormalities in the small bowel. Eventually the capsule is eliminated with the stool.
Why do I need a Colon Capsule Endoscopy?
Your doctor has referred you for this investigation for either of the following reasons:
- Unexplained anaemia, where other endoscopic examinations have not identified a cause
- To investigate the bowel following a positive stool test called FIT Test.
- Assessment following removal of polyp
- Assessment following an operation to remove a cancer in the bowel
Where will the test be performed?
The test will be initiated at Woking Community Diagnostic Centre (CDC). You will then be able to leave CDC for 24 hours, returning when the test is complete to return the equipment. Please note you will need to return the equipment to the Endoscopy unit at St Peter’s hospital.
What are the possible risks / complications of Colon Capsule Endoscopy?
- Pill capsule retention happens when the capsule is retained somewhere in the bowel. Even if the capsule is retained in the gut, it is unlikely to lead to the capsule being damaged or causing a blockage in your gut. Occasionally, we may need to perform additional X-rays, a limited CT scan or an endoscopy procedure to retrieve the capsule.
Prior to having the examination, we will assess you using a questionnaire to identify any risks of capsule retention. If we identify any such risks we will undertake a patency capsule examination. This involves swallowing a dissolvable ‘dummy pill’ with a special detector, which helps to identify any potential sites of narrowing in the small bowel / colon. In that case you will have alternative examinations of the colon
- Rarely the capsule can inadvertently enter the lungs while attempting to swallow capsule it, causing choking.
- Missed lesions or incomplete examination of the bowel if the colon is not clean enough because the bowel preparation did not work or equipment failure.
Is the procedure painful?
A capsule endoscopy is a painless procedure. However, in the event of the capsule causing a blockage of the bowel, you might experience abdominal pain and/or sickness. If this happens, please contact the endoscopy unit straightaway. Outside normal working hours, please contact the A&E department or your emergency GP.
Will I need to be sedated?
No, this procedure does not require any sedation.
Are there any alternatives to capsule endoscopy?
Yes, there are alternative tests available. However, these tests might not always be right one in your case. Please speak to your doctor about the alternatives.
- Colonoscopy - is a test that allows the Endoscopist to directly inspect the inner lining of the colon (large intestine). This is done using an instrument called a colonoscope, which is carefully passed through the anus into the large intestine. The colonoscope is a long flexible tube, about the thickness of your index finger, with a bright light at its tip. The video camera on the colonoscope transmits images of the inside of the colon to a monitor allowing the Endoscopist to examine the lining of the colon for any disease or abnormalities.
- Flexible Sigmoidoscopy - This is similar to a colonoscopy but only looks at the lower part of the bowel. If your doctor or nurse cannot diagnose your symptoms after this test, you may still need a colonoscopy.
- CT (computerised tomography) scan - This is a special type of X-ray machine that can give more details than normal X-rays. However, it cannot be used to take biopsies or remove polyps, so you may still need a colonoscopy.
Preparing for the procedure
Prior to your appointment, please check the following and inform us if
- there is a possibility that you might be pregnant
- you have a cardiac pacemaker / defibrillator. These devices will not prevent you from having the test. However, we may perform an ECG to check there are no problems before we undertake the test.
- you have had previous abdominal surgery involving the stomach/bowel, any narrowing or obstruction in your bowel or have intra-abdominal adhesions
- you have swallowing problems
- you are taking iron supplements. Please do not take any iron tablets (e.g. ferrous sulphate, ferrous fumarate etc.) for 7 days prior to the test
- you are taking anti-inflammatory tablets (like ibuprofen, diclofenac, naproxen etc.).
Before you arrive at the CDC
- Do not eat or drink anything, except essential medication with a sip of water.
- Wear loose fitting two-piece clothing.
- Because the sensor belt must not be worn over synthetic fabric, you will need to wear an upper garment of thin, natural fibre cloth (cotton) that is long enough to reach at least to hip level.
- Another layer of clothing such as sweatshirt, sweater, or jacket may be worn over the sensor belt.
What will happen during the procedure?
When you arrive at the CDC please report to the reception desk.
A doctor or nurse will explain the procedure to you and get you to sign a consent form for the procedure. Please feel free to ask questions or voice any concerns you may have regarding your test.
A sensor belt (a comfortable belt worn around your waist and over your clothing) with the recorder box will be placed around your waist
You will be asked to swallow the Capsule camera with a small amount of water and a tablet to allow the camera to leave your stomach quicker. Your nurse will check the video recorder to check the capsule progress. If the nurse is satisfied that the equipment is functioning and recording as expected, you can be discharged home.
You will be sent home with some further advice relevant to this test and a pack of ‘booster medications’. These booster medications are additional laxatives which can help the camera pill move through your bowels before the battery runs out.
To enable us to obtain clear images of your gastrointestinal tract, you will be unable to eat for the rest of the day. You will also be encouraged to move about and remain active while the capsule is inside your body, to encourage the natural passage into your bowels. Once you have passed the capsule in your faeces, it can be flushed away and there is no need to recover it.
We will ask you to return the recorder and belt between 08.00am - 10.00 am the following day. Once we receive the recorder, we will be able to upload the images into our computer to allow us to review it and write your report.
Procedure Alert on the recording device
The data recorder will send various alerts as the pill camera progresses in the bowel. We will give you a separate information leaflet to follow and a bag containing three different medications (laxatives) which you might need to use for this procedure.
What happens if the pill camera does not pass through?
The capsule endoscope is a ‘single use’ disposable device. This will be passed out naturally with a bowel movement in 24 to 72 hours. As it is a small device, it might have passed unnoticed. However, if you have not passed the capsule camera in 2 weeks, please contact endoscopy unit. We can organise X-RAY of the abdomen to look for a retained capsule.
If the pill camera reveals Crohn's disease, treatment with anti-inflammatory medications may allow the narrowed part of the bowel to heal so that the pill passes by itself. If the pill camera is at the extreme upper or lower end of the small bowel, it may be possible to retrieve it using an endoscope (gastroscope or colonoscope). If the bowel is severely ulcerated, scarred or blocked by a tumour, an operation might be needed, not only to remove the pill camera, but also to treat the disease
When will I know the results?
After the examination, images are downloaded from the recording device to a computer. It will be a few weeks before the test results are sent to your referring doctor and general practitioner who should contact you regarding further management.
Can I seek a second opinion?
Yes, if you are not happy with the results, treatment or advice, you have the right to seek a second opinion, and your doctor can advise you on that.
Will there be any restrictions following the Capsule Endoscopy?
After you have removed the recorder belt, you can continue with normal activities. You must NOT have a MRI scan until you are sure that the capsule has passed. Please make sure that you have NO FLIGHTS booked within 2 weeks after having the Capsule Endoscopy.
Further Information
Additional useful information may be obtained by logging on to the following websites:
- British Society of Gastroenterology
https://www.bsg.org.uk
- Cancer Research UK
https://news.cancerresearchuk.org/2021/04/14/colon-capsule-endoscopy-reshaping-bowel-cancer-diagnosis
- Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
https://www.esge.com/colon-capsule-endoscopy
