Capsule Endoscopy

Capsule endoscopy is a non-invasive, ingestible-camera technology that visualizes the small bowel — territory beyond the reach of conventional endoscopes. The standard application is investigation of obscure GI bleeding, but capsule endoscopy also evaluates suspected Crohn's disease, small-bowel tumors, and surveillance in polyposis syndromes. Newer indications include capsule colonoscopy in selected patients who cannot tolerate conventional colonoscopy, and a recent generation of capsules dedicated to upper GI bleeding detection.

Deployment is straightforward in most patients — the capsule is swallowed, transit takes roughly 8 hours, and images are reviewed with computer-assisted reading software. Patency is the main technical concern: known or suspected strictures should be evaluated with a patency capsule (which dissolves in 30 hours if retained) before deploying a non-dissolving imaging capsule, since retention can require enteroscopy or surgery.

Endoscopic capsule deployment during EGD is useful for patients unable to swallow the capsule or with delayed gastric emptying — the capsule is delivered into the duodenum using a dedicated delivery device or net, accelerating small-bowel transit and improving completion rates. The PillSense capsule is a newer point-of-care device that detects active upper GI bleeding within minutes, useful in triage of emergency department patients.