The Pill Camera

What is it?

Capsule endoscopy refers to a relatively new technology that gastroenterologists use to examine the deepest portions of the digestive tract. In 1981, an Israeli engineer named Dr. Gavriel Iddan began work on designing a disposable pill-sized camera that could be swallowed and would pass directly through the intestine. In 2001, after twenty years of research and development, the FDA approved the Given Diagnostic Imaging System called Capsule Endoscopy. 

How does it work?

An “endocapsule” is a miniature video camera that has been incorporated into a capsule-shaped device along with a light source, transmitter and battery. It has a biocompatible coating which allows it to be safely swallowed and pass undigested through the intestinal tract. During this journey, it transmits over 50,000 color images via radio frequency to a recorder worn on a belt on a patient’s hip or waist. The pill weights only 1/7th of an ounce and is about the size of a large vitamin. Once swallowed, the capsule moves through the intestine, naturally aided by the muscular contractions of the intestine.

What does it do?

Since the advent of capsule endoscopy, gastroenterologists have been able to make diagnoses not previously made using conventional methods. For example, in disease such as Celiac Sprue and Crohn’s disease, the endocapsule has assisted in visualizing areas that were previously unreachable without major surgery. Additionally, capsule endoscopy has played a major role in advancing the diagnosis and treatment of obscure gastrointestinal bleeding. Additionally, it has been helpful in identifying tumors of the small intestine and evaluating polyposis syndromes. Subsequent development of an esophageal capsule also provides a modality to monitor GERD (gastroesophageal reflux disease) non-invasively.

What to expect?

Typically, patients undergoing an endocapsule study will have a preparation that will consist of a brief fasting period. Some physicians may also recommend a bowel prep to cleanse the small intestine before the study. This outpatient procedure will begin in your doctors office. After a brief orientation, you will swallow the endocapsule and be asked to wear a small data recorder around your waist during the test.  You will be able to drink clear liquids and eat a light meal about two hours after the pill has been swallowed. Approximately 8 hours later, you will be asked to return to your doctor’s office so the data recorder can be removed and the images downloaded to a computer for physician viewing. The capsule will then be eliminated from your body normally in your feces during a bowel movement.

To date, well over a million endocapsules have been used in clinical practice and demonstrated the overall safety of this technology. Complications are extremely rare, especially when performed by specialists who have extensive experience with the endocapsule. Wireless capsule endoscopy is a safe, reliable, and noninvasive technology that can be very useful in the diagnosis and treatment of disorders of the esophagus and small intestine. If you are interested in this exam or think that it may be beneficial to your treatment, ask your physician for more information.