Capsule endoscopy (or capsular endoscopy) is a procedure that seeks a new way to diagnose digestive problems, without the discomfort of a traditional endoscopy.
Traditional endoscopy uses a long tube that is inserted from the patient’s throat to the rectum, which has a camera in which the digestive tract can be seen. Let’s see what capsule endoscopy consists of.
Capsule endoscopy, what is it?
Capsule endoscopy is, as its name implies, a capsule that has a wireless camera and gets its name because it resembles any pill. During its journey, it takes images of the digestive tract that are transmitted to a recorder that the patient has on his chest.
How does capsule endoscopy work?
The patient swallows the capsule as if it were a pill. The camera inside the capsule takes thousands of color photos. The recorder transforms the images into a video, which will be easier for the treating physician to view.
To take the images, the capsule has its own light and has up to two cameras, depending on the study being carried out. The capsule is capable of taking two to six images per second. As for the results, they can be delivered up to a week later.
A case study in Alivio shows how a Latino patient agreed to capsule endoscopy after failing to improve gastric reflux. Thanks to this procedure, a gastric polyp and erythema were detected.
Benefits of Capsule Endoscopy
One of the benefits of capsule endoscopy is comfort. Unlike a traditional endoscopy, the capsule is shaped like a pill, making it easy to swallow.
Also, no special preparation is required: a liquid diet the day before and fasting for at least six hours are enough to get you ready. You do not require sedation for the procedure.
Capsule endoscopy allows detecting a gastric injury no matter how small it may be; including lesions found in the small intestine.
The procedure is outpatient, which means that hospitalization is not necessary because it does not have serious complications.
Caso of study:
Magnetically Controlled Capsule Endoscopy (MCCE) Case Study
This is a case study of a 54 years of age Hispanic male with a body mass index of 28.4 presenting to a primary care healthcare provider for abdominal and gastro-esophageal reflux symptoms relative to spicy food.
These symptoms abdominal discomfort persist for days following ingesting this cuisine. The patient’s medical history consists of no chronic diseases/disorders. Previous medical surgeries/procedures pertain to an appendectomy at 19 and a negative H. pylori test in 2021.
The physical examination revealed no gastro-intestinal bleeding alarm features or weight loss. The patient did not present with complaints of dysphagia or known or suspected gastrointestinal obstruction, stenosis, or fistulas. Additionally, the patient did not have any implantable electronic devices.
Following a discussion with their primary care healthcare provider in which the option of an esophagogastroduodenoscopy (EGD) or an MCCE examination was selected by the patient to evaluate for stomach lesions (to determine if further endoscopic assessment was warranted) before undergoing further endoscopic assessment. Justification for this evaluation strategy was that MCCE excluded anesthesia and reduced potential additional healthcare costs.
The MCCE was performed at the primary care provider’s medical center. The patient completed the MCCE pre-test preparation protocol by withholding food ingestion post 8 P.M. the day before the procedure. The patient was instructed that a small amount of water post 8 P.M. would not interfere with the MCCE procedure.
On the day of the examination, the MCCE preparation was performed at 0800: 100 ml of Simethicone diluted in 100 ml of water following 10-minute latency period two additional water volumes were ingested 100 ml and ≥ 500 ml prior to MCCE administration. Total water consumption was 1200 ml of water. A vest was positioned on the patient covering their chest region and abdominal cavity.
The magnetically controlled capsule (27.8 mm x 11.8 mm) was ingested in the left lateral decubitus position with a small volume of water, approximately 20 ml. (Figure 1) The images were transmitted and collected inside a protective jacket by a data recorder. (Figure 2) The MCCE identified eight anatomical regions inside the stomach: Cardia, Fundus, Anterior Wall, Posterior Wall, Incisura Angularis, Greater and Lower Curvatures, Antrum, and Pylorus.
The software automatically traversed from one anatomical region to the next by magnetically controlling the capsule orientation and location prompted by the MCCE operator. During the MCCE procedure, the patient was in three different positions: left lateral decubitus, supine, and right lateral decubitus.
Figure 1: Magnetically Controlled Capsule
Figure 2: Portable data recording unit with rechargeable lithium battery unit.
The duration of the MCCE procedure was 25 minutes excluding the pre-test preparation (35 minutes). No significant stomach lesions were identified in seven of the anatomical regions. A gastric polyp and erythema were discovered in the gastric body and antrum. (Figure 4) Following the MCCE procedure, the primary care provider and the patient discussed the MCCE results.
The patient was grateful for receiving the results immediately following the MCCE procedure. After discussing a medical strategy plan, the patient agreed to undergo an esophagogastroduodenoscopy (EGD) to further evaluate the stomach polyp and erythema.
Moreover, the patient was appreciative of evidence justifying the economic cost for an EGD.
Figure 4: Magnetically Controlled Capsule Endoscopy: Gastric Polyp and Erythema Images
