Understanding the PillCam Small Bowel Capsule Endoscopy System With Sensor Belt

What is the PillCam SB System?

The small intestine (or small bowel) connects the stomach with the large intestine. It consists of three sections: the duodenum, jejunum and ileum. Its main function is to absorb nutrients and minerals from the foods that we eat. 90% of digestion and absorption occur in the small intestine with the remaining 10% occurring in the stomach and large intestine.

Crohn’s disease can affect the small intestine. The small intestine can also be a source of GI blood loss. If you suffer from GI bleeding, iron deficiency anemia, or Crohn’s disease, Dr. Sinha may need to see inside your small intestines to evaluate it for disease.

The PillCam is an ingestible capsule about the size of a vitamin that allows a trained gastroenterologist like Dr. Sinha the ability to see inside your small intestine.

While upper endoscopy is used to visualize the esophagus, stomach, and the first part of your small intestine (the duodenum), and colonoscopy is used to visualize the large intestine and rectum, the majority of the small intestine is missed during both of these procedures. PillCam is used to assess all three portions of the small bowel.

How does it work?

The PillCam SB capsule contains a tiny camera and light source that takes pictures of your small intestine as it travels naturally through your digestive tract. The images are transmitted to a recorder that you wear on a strap across your body. Sensors placed on your stomach or in a sensor belt help to transmit these images.

How should I prepare for the procedure?

An empty stomach is optimal for viewing so you will be asked to follow a clear liquid diet after lunch the day before your procedure and you will begin fasting at midnight. Specific bowel prep instructions will be given to you. Please follow them accordingly.

You will arrive at our office first thing in the morning. Sensors, or a sensor belt, will be placed on your abdomen and a recorder will be connected to these sensors. You will swallow the capsule. Then, you will leave and go about your day. There is no need for sedation for the procedure so after you swallow the PillCam SB capsule you can leave our office and go about your normal activities. You will be able to eat four hours after the capsule is ingested unless our office instructs you otherwise.

The test can last up to 12 hours. At the end of the day you will return to our office and the recorder and sensors will be removed. Please do not remove them yourself. The images captured will be downloaded to a computer and Dr. Sinha will view them in a color video. Afterwards, you will have a follow up appointment to discuss your results.

Please be sure to notify our office of all of your medical conditions and history including if you have a pacemaker or other electro-medical devices, if you have had any previous abdominal surgeries or adhesions, if you have difficulty swallowing, if you choke with eating or food routinely gets stuck, and if you have a history of bowel obstruction or blockage in the GI tract.

Are there risks associated with the procedure?

Capsule endoscopy is an endoscopic exam of the small intestine. It is not intended to examine the esophagus, stomach or colon. There are risks associated with this exam including bowel obstruction. The capsule can get stuck, and an obstruction may require immediate surgery.

Depending upon your medical and surgical history you may need to do a “retention camera” study first where you’ll swallow a dissolvable camera and then have an x-ray taken to make sure that the camera is able to pass through your digestive tract completely without getting stuck. You’ll do this study first before swallowing the actual PillCam. If the dissolvable camera does not pass through your digestive tract you will not be able to do the actual PillCam study. The dissolvable camera will dissolve on it’s own, but an alternative study like CT enterography with contrast will have to be used to look at your small intestine in lieu of the PillCam.

Is there anything I should avoid after swallowing the capsule?

During the procedure you will need to avoid MRI machines until the capsule is excreted.

Can lesions or diseases be missed?

Due to variations in intestinal motility, the capsule may only image part of the small intestine. Lesions can be missed. It is possible that due to interferences some images may be lost and this may result in the need to repeat the procedure.

For more information about the PillCam SB System please contact our office at 908-788-8200 to schedule a comprehensive, personalized medical evaluation.

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