Video capsule (small bowel examination)

Brugsesteenweg

Rumbeke

Torhout

Menen

The small bowel video capsule is an examination that allows you to view the inside of the small intestine. The research is done using a small camera that is built into a capsule (approximately 15 mm). You swallow the wireless video capsule just like a pill and the camera takes a photo twice a second. These images are transferred to a device that you carry in a pouch bag during the investigation. Through normal bowel movements, the capsule passes through your entire gastrointestinal tract. Usually, the video capsule leaves your body with the stool within 3 to 30 hours.

Aim of the research

With this examination, abnormalities of the small intestine can be detected.

The doctor may suggest this examination if he suspects an abnormality in the small intestine or also if there is unexplained loss of blood. We speak of unexplained blood loss when no abnormalities are found elsewhere in the gastrointestinal tract during gastrointestinal tests and if this is associated with iron deficiency anemia.
Using the video capsule, the doctor can detect, among others, the following conditions: ulcers or inflammation in the small intestine (e.g. Crohn's disease), tumors or polyps in the small intestine, bleeding in the small intestine and other disorders.

Preparation

One week before the study, the use of iron medication should be discontinued. These drugs give the intestines a black color, making the photos unclear. After the examination, you can continue taking the iron medication as before.

Medications that slow bowel function, such as Codeine or Loperamide (Imodium®), should also be temporarily stopped.

The night before the study with the video capsule, you can have another light meal, such as rusks and yoghurt.

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You are also expected to take a colon preparation. This preparation can be done with the Plenvu product.

Mix dose 2 (bag A + B) with ½ litre (500ml) of fresh water.
Drink this product alternately with 1 litre of still water.
Drink the liquids within 1h -1h15.

Medication may be taken up to 2 hours before the examination in consultation with your doctor. If you have diabetes, contact your doctor about any changes in the dose of your medication: after all, you will not eat for a while and there is a risk of low sugar levels if you do not adjust.
You must come to the investigation sober.

Execution

The research takes place via day recording.
A belt with a sensor is attached over your stomach; the images that are taken are forwarded to the recorder that you carry with you in a bag.
You swallow the video capsule with little water.
In case of known or suspected gastroparesis (delayed gastric emptying) and swallowing disorders, the capsule is inserted endoscopically. If the capsule still appears to be in the stomach after a while, a stomach exam is sometimes also performed to bring it to the small intestine.
After taking the capsule, you should only take a light meal after 4 hours.
You will be expected back at the endoscopy department at 5:30pm to remove the sensor with pouch and after removing the recorder, you can eat as usual.

Hospitalization

After the examination

Advantages and disadvantages

Disadvantage

The video capsule is expensive. It also takes a long time to view and analyse all images. The capsule is not fully reimbursed. Part of the cost is borne by the health insurance, part (200 euro) is borne by the patient. A price indication can be requested via the billing service via factuur@azdelta.be or 051 23 70 54.
Another significant disadvantage of this study is that the doctor cannot take pieces of tissue for examination. Polyps cannot also be removed immediately during the examination. If an abnormality is found in the small intestine during a video capsule examination, a small bowel endoscopy (enteroscopy) or keyhole surgery is often still necessary.

Benefit

An advantage of the video capsule is that it is a painless and not burdensome examination for the patient. This research can also provide information about disorders that would otherwise remain hidden.

Side effects

Points of interest

Risks of this study

If there is a constriction in the gastrointestinal tract, the capsule may become stuck here and cause obstruction (< 1%). You should always tell the doctor if you have had previous abdominal surgery or if you have already had an obstruction. During the examination, you should not undergo an MRI (magnetic resonance) examination and it is best to stay away from strong magnetic fields. If you have any further questions, please contact your gastrointestinal liver doctor.