Capsule endoscopy is a revolutionary technology that allows direct visualization of the gastrointestinal (GI) tract without the need for traditional invasive endoscopy procedures. Since its introduction in 2000, capsule endoscopy has become an important and increasingly utilized tool for evaluating GI disorders.

How Capsule Endoscopy Works 

The capsule endoscopy device is a vitamin-sized pill that contains a color camera, light source, battery, and wireless transmitter. After swallowing the capsule, it travels through the GI tract propelled by natural peristalsis while continuously imaging the esophagus, stomach, and small intestine. The battery life is approximately 8 hours allowing for complete passage through the small bowel. As it travels, it captures images at a rate of 2 frames per second which are transmitted wirelessly to a recording device worn by the patient. Once complete, the recording device is downloaded to a computer workstation where the images can be reviewed. On average, a capsule endoscopy procedure captures over 50,000 images for interpretation.

Unlike traditional endoscopy which requires sedation and is limited to examining short segments, capsule endoscopy allows painless noninvasive visualization of hard to reach areas of the small intestine. It is mainly used when other diagnostic tests such as CT scan, MRI, or traditional endoscopy have failed to determine the cause of GI symptoms. Capsule endoscopy has proven valuable in evaluating various small bowel disorders including Crohn's disease, celiac disease, small bowel tumors, and sources of obscure GI bleeding. Studies have shown capsule endoscopy is superior to other modalities in detecting small bowel abnormalities and sources of occult bleeding.

The procedure is easy to tolerate for most patients. After an overnight fast, the capsule is swallowed in the morning with a glass of water. Patients are encouraged to go about normal activities during the procedure with the exception of avoiding MRI machines or other powerful electromagnetic fields which could disrupt imaging. The disposable capsules are naturally passed within 24-48 hours. While considered very safe, on rare occasions, capsules can become lodged in strictured bowel requiring retrieval or surgical intervention. Patients with known bowel strictures would not be candidates for capsule endoscopy.

Limitations of Capsule Endoscopy

While capsule endoscopy represents an exciting technology, there are some limitations to be aware of. The gastrointestinal tract is large relative to the small capsule camera, so some areas can be missed between image captures. The study is purely visual, so no biopsy specimens can be obtained. Capsule location in real-time is not possible, and intervention is not an option. Identification of tumors or sources of bleeding can be inferred but precise localization for surgical planning is not provided.

The Future of Capsule Endoscopy

Since its introduction, the technology of capsule endoscopy has rapidly evolved at Kokilaben Hospital Mumbai. Improvements in camera resolution and frame capture rate enhance the detail of mucosal visualization. New specialized capsules allow examination of the esophagus or colon in addition to the small bowel. Software algorithms and 3D modeling applied to the thousands of captured images provide automated diagnostic assessments of findings. Wireless capsule endoscopy represents one of the most significant recent breakthroughs in GI diagnostic technology with the potential for many future applications as the technology continues to advance.