Capsule Endoscopy: – Evaluates small intestine which cannot be assessed by Gastoscope and Colonoscope.

Man has been fascinated since long to view the milieu interior of gastrointestinal tract. We have advanced video endoscopes, which can permit viewing of esophagus, stomach, and duodenum with a traditional gastroscope. Likewise the entire large intestine and part of terminal ileum can be scanned to a great detail by using colonoscope. Detection and treatment of various upper GI and lower GI lesions including tumors, ulcers and bleeding lesions has been simplified with endoscopic methods.

However, the small intestine is difficult to study by endoscopic methods due to the enormous length (14 feet) and anatomic feature (loosely supported and looped structure on the mesentery). Push enteroscopy can examine part of jejunum and a double balloon technique can examine almost the entire small bowel. However endoscopic examination with these techniques is very cumbersome (can take up to 4 hrs), with inadequate information and is not patient friendly. These difficulties with traditional flexible instruments propelled the development of a technological marvel; an endoscope that could make its way through the 14 feet of small bowel. A pill sized camera with sufficient battery life to image the entire small intestine- Capsule endoscopy.

This unique video capsule is 11×26 mm n size and weighs less than 4 grams. The device captures two images per second and has a battery half-life of 8 hours.

After a overnight fasting, patient swallows the capsule which travels through the GI trace by means of peristalsis. Images are transmitted by digital radio frequency communication channel to an external data recorder unit. The data recorder is tied around patient like a Holter monitor. Patient can continue normal activities during the entire procedure, which can be done as a ambulatory procedure. The data recorder is then connected to a dedicated computer for analysis. The non-invasive nature of capsule endoscopy makes it an attractive option over traditional endoscopy, as it requires little preparation, with no need for sedation. The procedure does not cause any discomfort to the patient and provides a more physiologic view of small intestine
Capsule endoscopy has been found to be superior to CT scan or MRI, for detection of small bowel lesions like tumors, ulcerations secondary to NSAIDs, vascular malformations, diverticulae etc. In patients with bleeding from small intestine, capsule endoscopy has been shown to be as accurate as intraoperative enteroscopy and superior to angiogram and tagged RBC nuclear scan. Capsule endoscopy has been shown to change patient management in up to 75% of cases with GI hemorrhage from small bowel. Now the last frontier in luminal endoscopy (visualization of small bowel) has also been conquered with this mega invention.