Capsule endoscopy is a new non-invasive form of endoscopy that is easy to have, comfortable and convenient. No sedation or analgesia are necessary. A pill-sized, video-imaging, wireless capsule is simply swallowed with water. The capsule contains a camera, light source, batteries and transmitter. During the test more than 100,000 colour images are recorded.

These images are then downloaded for analysis later. 3 types of capsule are available: the oesophageal capsule, the small bowel capsule and the colon capsule.

Oesophageal capsule endoscopy

The oesophageal capsule is indicated for the investigation of gastro-oesophageal reflux disease (GORD) and liver disease usually when patients are unwilling or unable to undergo gastroscopy and other invasive procedures.

The oesophageal capsule can screen for and detect:

• reflux oesophagitis
• Barrett’s oesophagus
• oesophageal varices

Small bowel capsule endoscopy

The small bowel capsule is indicated for:

• investigation of iron deficiency anaemia
• obscure gastrointestinal bleeding
• known or suspected small bowel Crohn’s disease
• refractory Coeliac disease (or where there is doubt about the diagnosis) and other disorders that lead to chronic diarrhoea and weight loss
• detection and surveillance of small bowel tumours (e.g. polyps, GISTs, carcinoids, lymphoma)
• identification of medication related small bowel injury (e.g. NSAID-induced enteropathy)
• as an additional diagnostic modality when small bowel abnormalities have been identified by other investigations (such as CT, MRI or barium X-rays)

Colon capsule endoscopy (capsule colonoscopy)

Colon capsule endoscopy is a safe, reliable and effective method for imaging the colon and has a high sensitivity and specificity for detection of bowel polyps. While conventional colonoscopy remains the gold standard, the colon capsule may be considered as an alternative procedure in certain situations. Indications for capsule colonoscopy include:

• incomplete (failed) conventional colonoscopy when complete examination of the colon is necessary
• patients at average risk of colonic neoplasia without alarm symptoms (who are unwilling to undergo conventional colonoscopy)
• patients who are unable to undergo conventional colonoscopy
• monitoring of mucosal healing in response to medical treatment in patients with known and uncomplicated IBD (e.g. ulcerative colitis)