Overview

A video capsule endoscopy (VCE) looks at the inside of your bowel. You swallow a small capsule that takes pictures as it travels along your gut. The test is simple, non-invasive and very safe.

We might ask you to have this test if you:

• have bleeding from the stomach or intestine, that cannot be reached by an endoscope tube
• are having tests for coeliac disease and inflammatory bowel diseases
• do not have enough iron in your body (iron deficiency anaemia) 
• have had a CT or MRI scan that showed small growths (polyps)

Let your doctor or nurse know as soon as possible if you think you could be pregnant, or if you have an implanted cardiac device (ICD). This does not include pacemakers. You might need a consultation before you have a VCE. 

How the video capsule works

The capsule is the size of a large vitamin capsule, or the end of your little finger. It has a camera and a light on, which work together to take images of the lining of your large bowel.  

In an appointment with us, you swallow the capsule with a glass of water that has a solution in. The solution dissolves any bubbles in the digestive juices in your large bowel to make the images clearer. 

After swallowing the capsule you will need to wear a data recorder. This records what happens when the capsule is inside your body. You will need to wear a belt which has wireless sensors on, to send the information into a data recorder box. You will need to wear this when you go home, and return it to the hospital the next day. 

The capsule travels through your gut and is passed in your poo. Usually you will not notice when you pass the capsule and it will flush away in the toilet.

The alternatives are an advanced endoscopic procedure which is invasive and difficult to do. 

Risks

A VCE is extremely safe and has few risks or complications. Your doctor will talk to you about any possible risks before your procedure. 

If you are at more risk of the capsule getting stuck because of your medical history, we will do other tests before your appointment. Some people need to swallow a dummy (patency) capsule before having a VCE, to check if the video capsule can travel through their small intestine.

Do not have an MRI scan while having a VCE. If you need an MRI after having a VCE, a doctor must check that the capsule has passed out of your body, before you have the scan.

Sometimes the capsule does not reach your large bowel within 8 hours. This will show on the video. If this happens, your medical team will arrange an X-ray to see if the capsule is still in the small bowel.

For the procedure, it is important that your bowel is empty. If the bowel preparation has not worked, or your bowel is not clean enough, the examination images may not be good enough. This may mean you need to repeat the procedure.

If the capsule does not pass through you naturally it might have got stuck in your bowel. If this happens, your medical team might need to use an endoscope tube to remove it. For some people, surgery might be needed to remove the capsule and find out the cause of it getting stuck, but this is rare. The signs of the capsule being stuck are tummy (abdominal) pain that is getting worse, tummy cramps and being sick. 

Talk to your doctor or specialist nurse if you have any questions about these. 

Pre-assessment appointment

Your medical team gives you information about how to prepare during a pre-assessment appointment, including taking a laxative medicine. This appointment might be over the phone. You can ask us any questions about the VCE and preparing for it. 

Please tell your medical team as soon as possible if you: 

• are taking any medicines to thin the blood or prevent blood from clotting (anti-coagulants) or anti-platelets, such as warfarin, rivaroxaban or clopidogrel, you do not need to call if you only take aspirin 
• have diabetes and are on insulin 
• have allergies to any medicines
• take any regular medicines, this includes medicines you buy from a pharmacy or shop, or any herbal or homeopathic medicines 

If any of the above applies to you, you might need special instructions before your VCE. 

After your pre-assessment, your medical team post the information and medicine to you, or you can collect it in the endoscopy unit at the hospital. 

If your health has got worse since seeing the doctor or nurse, please contact the endoscopy nurses.

Preparing for your VCE

For the VCE to work, it is important that your large bowel is empty. To empty your bowel, you will need to change your diet and take medicine that speeds up your bowel movement (laxative). 

Please make sure you follow these instructions carefully. If you do not, your bowel might not be clear enough to take images, and you will need to have another VCE. 

Read information on preparing for your VCE.