Capsule Endoscopy
INDICATIONS:
Obscure GI bleeding
Signs of GI bleeding: Melena, Hematochezia, Iron deficient anemia
Abnormal GI X-ray
Crohn’s disease
Unexplained abdominal pain
AdvanCE:
Endoscopic device to deliver the capsule to the stomach or duodenum
Useful for patients with oropharyngeal or mechanical dysphagia, gastroparesis, and known or suspected anatomical abnormalities
Helps minimize loss of battery life spent in the esophagus or stomach
PATENCY CAPSULE:
A capsule that degrades within 30 hours of being in the gut; Given prior to real capsule in some patients to rule out obstruction
KUB is taken at 24 hrs after administration and if still in the small bowel the Pillcam is not administered due to high risk of not passing/obstructing
COMPLICATIONS/RISK:
Caution but not contraindicated
Dysphagia or Zenker’s diverticulum-can use AdvanCE
Surgery of abdomen, bowel or pelvis in the preceding 12 months due to risk of obstruction due to adhesions
Crohn’s due to risk of obstruction-can use Patency capsule first
Abdominal radiation due to risk of obstruction-can use Patency capsule first
Mentally or developmentally uncooperative-can use AdvanCE
Use of iron supplements: light from capsule is absorbed rendering poor quality images
Diabetics or chronic narcotic use have poor gastric emptying and capsule may stay in stomach – can use AdvanCE
If performing EGD and Biopsy, there can be a confused bleeding source
Relative contraindications
Electromedical device (i.e. pacemaker or defibrillators): Not FDA approved, but substantial evidence suggest there is no deviation of function with an implanted device and concurrent capsule use; Some centers have done >150 studies without any problemsRelated posts:
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