Capsule endoscopy is a modern diagnostic method that allows you to assess the condition of the intestinal mucosa during the passage of a video capsule through the gastrointestinal tract, which the patient swallows. In the process of moving through the gastrointestinal tract, the capsule captures images, and then is excreted from the body naturally. The resulting images are transmitted to the monitor screen and studied by a specialist. With the help of capsule endoscopy, it is possible to detect inflammatory processes of the mucous membrane of the digestive canal, hidden internal bleeding, benign and malignant neoplasms. The technique is absolutely non-invasive, performed without the use of contrast agents.
Capsule endoscopy is an innovative method of diagnosing gastrointestinal diseases. For the first time, American scientists began using the procedure in 2001. The essence of the manipulation consists in the patient swallowing a special capsule equipped with a video camera. The size of the capsule reaches about 1×2.5 cm, which does not cause difficulties when swallowing. The tablet also has a backlight module, a radio frequency sensor and a battery that ensures continuous operation of the device for 8-10 hours. Additionally, the patient puts on a special recording device on which the received images are stored. The design features of the capsule allow you to get high-quality images even at low light levels.
Taking pictures and transferring them to a recording device takes place at a frequency of 2 photos per second. Thus, about 80,000 images are taken during the study. The received data placed on the carrier is processed by the diagnostician using a special computer program. On their basis, an accurate diagnosis is established. Capsule endoscopy is considered a modern informative diagnostic method, but the high cost of the procedure does not allow it to be prescribed to all patients suffering from gastrointestinal pathologies, in particular, the small intestine. The procedure is especially popular in gastroenterology. It is also in demand in oncology, as it allows you to identify tumors even of small sizes.
Another advantage of the study is the possibility of multiple viewing of saved images, if necessary, consulting related specialists without repeated manipulation. In comparison with a conventional endoscopic examination, the capsule technique does not require swallowing the endoscope tube, which often presents difficulties for the patient. During the passage of the device through the departments of the digestive canal, the patient does not feel any discomfort and can freely go about his business. After reaching the lower gastrointestinal tract, the capsule leaves the intestine naturally. The disadvantage of this technique is the impossibility of carrying out therapeutic manipulations, in particular, when detecting gastrointestinal bleeding. If we compare capsule endoscopy with classical colonoscopy, the latter remains more informative at the moment. It is also not always possible to identify pathologies of the upper gastrointestinal tract in this way, for this purpose it is better to use esophagogastroduodenoscopy.
This diagnostic method is used as an additional to the main studies. Manipulation is prescribed if it is impossible or uninformative to perform esophagogastroduodenoscopy, irrigoscopy, OBP survey radiography, colonoscopy. Capsule endoscopy can be performed in various public and private clinics. The technique is used in cases of suspected development of gastrointestinal pathologies, as well as in the presence of symptoms of disorders of the digestive canal. With the help of endoscopic examination, it is possible to thoroughly examine the intestinal mucosa and identify inflammatory changes. Diagnosis of enteritis, enterocolitis, duodenitis is possible. The technique is also prescribed if the development of duodenal ulcer is suspected. During the procedure, you can determine the degree of progression of the disease, determine the localization of mucosal lesions and determine their size.
Capsule endoscopy is also used in cases of suspected hidden gastrointestinal bleeding. When passing the “pill” through the digestive canal, you can see the localization of the pathological focus. Iron deficiency anemia is also an indication for the study, since it can develop against the background of hidden blood loss from the gastrointestinal tract. Recently, manipulation has been widely used in oncology, as it makes it possible to diagnose a tumor at an early stage of development, to establish the size and location of the neoplasm. This is how it is possible to diagnose cancer of the small intestine and duodenum, to confirm the presence of metastases resulting from the growth of malignant tumors of other internal organs.
The technique is also valuable in the detection of intestinal polyps, since this pathology is often characterized by a latent course. Endoscopic scanning is also used for Crohn’s disease, celiac disease. Indications for examination may be a violation of nutrient absorption, irritable bowel syndrome, a tendency to develop constipation, diarrhea, which does not respond to standard treatment. Capsule endoscopy is recommended for patients with abdominal pain of unclear etiology, in case of increased gas formation, fermentation. The procedure is also used for rapid weight loss of the patient and the absence of obvious reasons.
Despite its safety and non-invasiveness, capsule endoscopy is not performed in some conditions. A contraindication to the study is the presence of a pacemaker or any other electronic implants in the patient. Manipulation should not be used for intestinal diverticulosis, in the presence of fistulas, strictures. The device may get stuck between the folds of the intestine, in which case the extraction is performed by classical endoscopy. A contraindication to the study is also dysphagia (impaired swallowing function), epilepsy, suspected intestinal obstruction. There are restrictions to the use of the technique in children and women during gestation.
Preparation for endoscopy
In order for the study to show maximum information, it is necessary to properly prepare the digestive canal. He should be freed from food, and care should also be taken to remove excess gases. Preparation begins 1.5 weeks in advance, during this period, iron-containing medications, smoking, and alcohol consumption should be excluded. 5-7 days before the scheduled procedure, it is important to adjust the diet. The patient is prescribed a diet that involves the rejection of heavy food: fatty dishes, foods with a high starch content, pastries, muffins, carbonated drinks. 2 days before capsule endoscopy, it is necessary to exclude from the diet everything that can lead to increased gas formation: fresh vegetables and fruits, black bread, kefir, legumes.
24 hours before the manipulation, the patient is recommended to use simetikon-based drugs. This substance destroys gas bubbles and promotes its excretion. Sometimes, on the eve of the study, patients are prescribed drugs to help cleanse the intestines. Capsule endoscopy is performed on an empty stomach, so the last meal should be no later than 12 hours before it begins. From now on, only the use of still water is allowed. For the duration of the study, it is better to wear loose clothes without belts, belts, tight fasteners and other accessories.
Methodology of conducting
The study is carried out both in the hospital and on an outpatient basis. The patient puts on a special cuff, vest or belt where the recording device is located. It receives signals from the capsule’s video camera and saves the resulting images. Then the patient swallows the capsule, which, under the influence of peristalsis, begins to move along the digestive canal. The whole process of passing the device through the gastrointestinal tract takes about 8 hours, after which it is excreted from the body in a natural way. If there are doubts about the capsule’s output, radiography may be prescribed for monitoring. After 4 hours after swallowing the device, a light snack is allowed. A full meal is possible after 8 hours from the beginning of the manipulation. All this time, the subject can do the usual things.
At the time when the camera is in the body, MRI is prohibited. At the end of the scan, you must give the recording device to the doctor. The received data is processed on a computer using special software. On their basis, the diagnostician makes a conclusion and issues it to the patient. The duration of decoding the results is several hours. The obtained images of the gastrointestinal tract are preserved, in the future they can be used if there are doubts about the correctness of the established diagnosis, in order to monitor the effectiveness of the therapy. Capsule endoscopy is well tolerated by patients and is not accompanied by adverse reactions.