Gastroenterology Professional Association is proud to be able to offer Video Capsule Endoscopy. Capsule Endoscopy is the latest in cutting-edge technology allowing direct visualization of the small bowel previously only seen via surgical techniques. The Capsule is a small camera about the size of a vitamin capsule. It emits a light and takes two (2) pictures per second as it traverses the gastrointestinal tract. The pill is easily swallowed and transmits the images to a recording device worn around the waist. These images are then downloaded to a computer where they are reviewed by a physician.
The clinical utility of the capsule in its current form is limited to the study of the small intestine. It does NOT replace Colonoscopy or Upper Endoscopy. The capsule contains no steering mechanism or ability to wash the surface it’s viewing, nor does it provide the ability to take tissue samples unlike standard endoscopy which does provide all of these options. The Capsule does provide the unique ability to film the lining of the small intestine well beyond the reach of the standard endoscope or enteroscope which at best may only examine the first three (3) to six (6) feet of the small intestine. The Capsule will examine the entire length, (approximately 20 feet) of the small bowel. Early studies have shown a 60 – 70% success rate in identifying the source of bleeding in the intestinal tract where standard diagnostic tests had failed. Often, individuals were subjected to multiple colonoscopies, upper endoscopies, small bowel x-rays, bleeding scans and arteriography and ultimately intraoperative endoscopy before we were able to locate difficult small bowel bleeding sites. By introducing capsule endoscopy we have a new diagnostic tool that may allow us to hone in on a site much more quickly and with more certainty than ever before. The Capsule may also be able to locate suspected Small Bowel Tumors, suspected Crohn’s Disease as well as other diseases of the small intestine. At this time, the Capsule has no indication for diseases of the colon.
The Capsule is swallowed after a modified diet on the previous day and an overnight fast. Receiving sensors are taped to the abdomen and the receiver and battery pack are worn around the waist. Once the setup is confirmed to be functional, the individual is free to leave the office and participate in most of their usual activities. After two (2) hours, clear liquids may be taken. A light snack may be taken four (4) hours after ingestion of the Capsule. Detailed diet instructions will be provided prior to your procedure. After eight (8) hours, the individual returns to the office to have the receiver and battery pack removed. The Capsule will only transmit data for approximately eight (8) hours, but this is usually well beyond the time required to traverse the small intestine. The capsule will eventually be excreted in the stool. It is not reusable and does not need to be retrieved. It is important to avoid any areas with strong magnetic fields while the capsule is transmitting, as a magnetic field will shut it off. One also must refrain from going into an MRI machine until the capsule passes into the toilet, otherwise serious injury to the GI tract may occur.
There is very little risk with this exam; however if a blockage or narrowing of the small bowel is suspected, there is a concern that the capsule could become lodged at that site and require surgical removal.
Since this is brand new technology, your insurance company may not be willing to provide reimbursement for this procedure. The Capsule is expensive and disposable. Our office will attempt to pre-authorize this procedure with your insurance company, however, this is not a guarantee of payment and payment in advance will be required.
Guidelines for Video Capsule Endoscopy
Video Capsule Endoscopy is a disposable, ingestible capsule that captures video images as it is naturally propelled through the digestive system. Patients fast overnight and report to the physician office in the AM to take the capsule.
An external wireless recorder is fitted at the office and worn by the patient on a belt around the waist. The recorder receives signals transmitted by the capsule through a series of antennas placed on the patient’s abdomen. Patients may go about most of their daily activities during the procedure.
Approximately eight (8) hours after ingestion of the capsule, the patient returns to the physician’s office for removal of the recording device. The information received through the wireless recorder is than downloaded to a computer where the physician views and captures pertinent data images.
Video Capsule Endoscopy does not replace colonoscopy or upper endoscopy
Purpose: Study the small intestine only
Ingestion of the capsule and fitting of the device requires a 15-20 minute office visit in the early AM Gastroenterology Professional Association will perform Video Capsule Endoscopy studies for other gastroenterologists outside of our practice with a prior consult with our physicians.
Referring physicians must have a conversation with our physicians regarding their patient prior to scheduling a consult and/or the Video Capsule Endoscopy procedure.
Reimbursement by insurance companies is still in review.
(Please contact your insurance company for your plan’s coverage)
The capsule must be obtained through our office.
A consult visit must be scheduled for all patients not previously seen by a Gastroenterology Professional Association physician.