Video Capsule Endoscopy

 

Video capsule

Dr McLaughlin undertook specialist training in video capsule endoscopy at St. Thomas’ Hospital London. He leads the video capsule endoscopy service at both the Royal Bournemouth hospital and the Nuffield hospital Bournemouth. He is happy to accept referrals for patients living outside Bournemouth and currently provides the NHS service for Salisbury patients.

Background to the test

Video capsule endoscopy or the “pill cam” is a relatively new technique which was introduced into clinical practice in 2000 and has revolutionised small bowel imaging. The test involves swallowing a single use capsule containing a battery and a video camera which transmits pictures to a small video recorder worn on a belt. Video capsule endoscopy is the most sensitive test for identifying abnormalities of the small bowel. Its advantages are that unlike X-ray and CT tests it involves no ionising radiation, is non-invasive and it is able to identify subtle mucosal abnormalities that may be missed with these tests.

To see images obtained by Dr McLaughlin during this procedure click here

Indications for video capsule endoscopy

Assessment of small bowel disease activity in patients with known Crohn’s disease

  • Suspected small bowel Crohn’s disease
  • Unexplained iron deficiency anaemia
  • Continuing symptoms in patients with coeliac disease (non-responsive coeliac disease)
  • Suspected small bowel tumours
  • Surveillance in patients with Familial adenomatous polyposis and known duodenal polyps
  • Surveillance in patientswith Peutz Jegher’s syndrome

 

Contraindications

Known small bowel strictures (significant narrowings) are a relative contraindication to video capsule endoscopy. In such circumstances other investigations such as conventional small bowel imaging (X-ray tests) and/or a ‘patency capsule` may be performed first to reduce this risk.

Risks

Capsule endoscopy is a very safe test. Unlike other endoscopy tests an instrument is not inserted into your bowel and sedating drugs are not needed.

There is a small risk (about 1%) of ‘capsule retention` with the higher risk (of about 3%) in those patients with suspected or known Crohn’s disease. In the majority of patients where the capsule is retained (defined as the capsule remaining within the body for more than two weeks after the test) the patient will not develop any symptoms and the capsule will eventually be passed. A small proportion of patients will develop symptoms of intestinal obstruction and require admission to hospital for medical treatment.

Outline of the test

Video capsule endoscopy is a painless non-invasive outpatient procedure which is performed without the need to take any drugs. The patient is required to follow a liquid diet regime (see instructions for patients undergoing video capsule endoscopy) before the test and must take laxatives to clean the bowel in order that good pictures can be obtained.

Patients undergoing video-capsule endoscopy are usually asked to attend the hospital in the morning (8-9am is preferable). The data (video) recorder will be attached to your waist with a belt and small sticky plasters with electrodes will be applied to your abdomen. You will then be asked to swallow the video capsule with a cupful of water. After a short period of observation (to ensure everything is working and you are OK) patients are discharged home. Patients can then perform most activities (bathing and showering must obviously be avoided). The equipment undertakes a 12 hour video which is later downloaded at the hospital, watched and reported by Dr McLaughlin.

 

Bowel preparation instructions for patients undergoing video capsule endoscopy

Four days before the video capsule endoscopy test

  • Stop taking any iron tablets

The day before your video capsule endoscopy test

  • It is recommended that you take the day off work and stay at home near the toilet, as the bowel preparation will produce diarrhoea.
  • On the day before your video capsule endoscopy test you should start a liquid diet (black coffee, black tea, squash, lemonade or sports drinks) after your lunch.
  • Dissolve one sachets of moviprep at 1pm in 500ml of water and a second sachet at 6pm in 500ml of water and drink a glassful every 15 minutes until it is all finished. Many patients find it is easier to drink if the solution is cold (this can be achieved by making it up and cooling it in the fridge).
  • If you experience severe stomach pains or vomiting, take the preparation more slowly (one glass every 30 minutes) until these feelings stop. If they continue seek medical advice from your GP or contact the Endoscopy Unit.
  • From 10pm do not eat or drink anything except for necessary medications with a SIP of water.
  • Do not take any medications in the 2 hours before the video capsule endoscopy

 

Eating and drinking after the test

  • Patients can start drinking 2 hours after swallowing the capsule and can resume eating after 4 hours.

Private video capsule endoscopy Bournemouth, Dorset

To arrange a private video capsule endoscopy at the Nuffield hospital Bournemouth please contact Dr McLaughlin’s private secretary;

01202 237993

simon.mclaughlin@doctors.org.uk

melanie.boucher@ntlworld.com

 

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