Capsule endoscopy: screening the bowel

The capsule endoscopy is an example of what wireless technology can achieve. With a simple capsule, some water and a monitor, you can have all 26 feet of your digestive tract screened. Professor Owen Epstein explains how this miniature technological marvel has altered the scope of colonoscopy screening.

The importance of colonoscopies

Patients opting for a screening of the digestive tract are usually referred to have a colonoscopy, which is a type of endoscopy. Colonoscopy screening programs are used to detect cancer, which is uncommon, and polyps. Most polyps that are discovered are small, benign and unlikely to progress. Nevertheless, the detection of these is one of the few ways colon cancer can be prevented.

“Issues” with traditional colonoscopies

Whilst a traditional colonoscopy is an excellent screening test of the 5 feet of the large intestine and offers the opportunity to remove suspect polyps, the procedure does contain some shortcomings due to its long tube and connectivity to a monitor

• The procedure is invasive
• It can be uncomfortable
• It requires a day case admission into hospital
• It can require intravenous analgia (pain medication that is inserted into a vein), sedation (or anaesthesia)
• It is occasionally complicated by perforation (1 in every 1000).
• The test does not provide images of the oesophagus, stomach, or small intestine, all of which are subject to disease.

Despite these, it is important to remember that traditional colonoscopies do have their benefits, particularly regarding the ability to remove polyps upon diagnosis and treat other conditions.

What is a capsule colonoscopy

A capsule colonoscopy is an alternative screening test for healthy individuals considering colon screening. The capsule endoscope is a TV studio in a “pill” that is swallowed by a patient and their natural bowel movements power the pill’s passage through 26 feet of the digestive tract (mouth to rectum). The pill will travel in the exact same way as food or drink. Whilst the capsule travels through the digestive tract, it relays a wireless video feed of the surface of the oesophagus, stomach, small and large intestine (colon). This minimally invasive scouting test screens for abnormalities throughout the entire 26 feet of the digestive organ.

But how can a specialist see the results?

After the disposable capsule is passed through the body naturally, the images are downloaded from a small receiver that is worn by the patient. They are then reviewed on a computer screen. No need for wires or a physical connection to a computer while the digestive tract is surveyed.

Benefits of a capsule colonoscopy

• There is no need for hospital admission, sedation or pain relief medication
• There is no risk of perforation
• The test is completed at home

What if something is discovered?

In a small minority of patients, the screening test will discover a significant abnormality requiring further intervention to address it. A traditional endoscope can be used to perform a biopsy, remove polyps and/or to treat bleeding.

When the specialist considers it appropriate, the minimally invasive wireless capsule can be used to first look at the abnormality and, if necessary, a traditional endoscope is then used to address the issue. In short, both can be used in harmony to treat a patient.

Get in touch with Professor Epstein by booking an appointment via his profile.