What is video capsule endoscopy (VCE)?
Invented in the 1990s, VCE has revolutionized management of disease of the small intestine (jejunum and ileum). VCE provide views of the entire 15-foot-long small intestine, much of which is beyond the reach of the traditional endoscope. During VCE, you simply swallow a pill-sized capsule equipped with a tiny light and camera. Your own digestive contractions propel the capsule tumbling through the length of the small intestine, where it captures photographs two/second, and transmits the images via radio signals to a recorder situated on your belt. Your doctor reviews these data frame-by-frame to look for pathology.
There is no need for sedation, and you go about your activities of daily living during the eight or so hours of the study. You pass the capsule in a day or two by “the normal route” and you flush it away.
The camera captures images of your esophagus, stomach, and small intestine to diagnose and monitor potential illness. It can also help determine if you need further treatment.
Unlike a traditional endoscope, the capsule can access the entire length of your small intestine. However, the capsule is not able to treat conditions it detects.
When do we recommend VCE?
Video capsule endoscopy is useful to:
- Locate and determine sources of gastrointestinal bleeding
- Diagnose digestive tract tumors
- Diagnose inflammatory bowel disease
- Detect polyps and other growths that can be precancerous
- Diagnose and monitor celiac disease
- Follow up on imaging test results
What should I expect during a video capsule endoscopy?
You will need to fast overnight before VCE and you typically take a laxative to clean out your digestive tract, ensuring the clearest possible images.
When you arrive at our office, we begin by affixing sticky leads (which resemble the familiar EKG leads) to your chest that receive signals from the capsule and transmit the data connection to a small recorder secured to your waist. You then swallow the capsule, which is about the size of a large vitamin tablet.
You don’t need to stay at New York Gastroenterology Associates during the test. As long as your job does not require strenuous physical activity, you can go to work, and you can perform other routine activities. You can drink clear liquids two hours after ingesting the capsule and eat a light lunch or snack four hours afterward.
The test is over after eight hours, or when you see you’ve passed the capsule in the toilet, whichever comes first. After the test, you can remove the patches and recorder and return them according to your doctor’s instructions. You will receive your results in about a week.
What are the risks of VCE?
VCE is extraordinarily low-risk. A tight narrowing in the small intestine may impede the passage of the capsule. This is generally not dangerous, and may in fact reveal the origin of your medical problem. Rarely, patients cannot swallow the capsule; in these instances, we can place the capsule in the stomach endoscopically, with the patient under anesthesia. It is important to confirm that you excreted the capsule, since it is metallic and could complicate MRI testing. Many people visualize the capsule in a bowel movement, but where needed we can confirm excretion with X-rays.
What happens after VCE?
Your gastroenterologist will review the results of the study with you. If your study reveals a small bowel disease (e.g. Crohn’s Disease) or lesion (e.g. a bleeding site), we will discuss the management and treatment options and guide you towards the next steps.
VCE is a safe, effective and minimally invasive test that is the gold standard for diagnosing diseases of the small intestine.
Video Capsule Endoscopy At Our Endoscopy Centers
If you need a video capsule endoscopy, you’ll be glad to know that our doctors perform these procedures at our two state-of-the-art endoscopy centers. These are:
The Endoscopy Center of New York. This advanced, 12,000 square foot facility is located on the Upper East Side of Manhattan. The center has five large, fully-equipped procedure rooms, a well-appointed, comfortable waiting room, a private registration area, and spacious pre-assessment and recovery areas. ECNY has been the site of more than 50,000 procedures.
Carnegie Hill Endoscopy is a clinical affiliate of Beth Israel Medical Center, this is an advanced, 15,000 square foot facility center located on Lexington Avenue in Manhattan.