Capsule endoscopy of the small intestine is an imaging technique used primarily for clinical examination of the small intestine, which, unlike the stomach (gastroscopy; gastroscopy) and colon (colonoscopy; colonoscopy), is relatively difficult to reach with externally guided endoscopes.
Indications (areas of application)
- Bleeding from the intestine that cannot be localized by endoscopy
- Polyposis syndromes – such as Peutz-Jeghers syndrome.
- Chronic inflammatory bowel diseases such as Crohn’s disease (here: for the diagnosis of the sometimes difficult to distinguish isolated small intestinal infestation) or ulcerative colitis.
- Lymphomas in the small intestine – malignant diseases of the lymphatic system.
- Celiac disease (gluten-induced enteropathy; chronic disease of the mucosa of the small intestine (small intestinal mucosa), which is due to hypersensitivity to the cereal protein gluten), which does not respond to therapy.
- Incomplete colonoscopy (colonoscopy), which is not due to high-grade stenosis (narrowing), but due to other problems.
Contraindications
- Possible existing or present stenoses in the gastrointestinal tract (GI tract).
The procedure
In video capsule endoscopy, the patient is given a video capsule, which is about 2.5 x 1 cm. He is asked to swallow this with some liquid. The camera built into the capsule sends two images per second, which are stored on a receiver worn on the body. After the examination is completed, the data is read into a computer where it is analyzed by a gastroenterologist. Before the examination, the intestine must be cleaned by drinking a special solution. The examination can be performed on an outpatient basis. It is not yet paid for by the statutory health insurance funds in Germany.
The disadvantage of video capsule endoscopy is that in the event of pathological findings, a biopsy cannot be taken at the same time as in gastro- or colonoscopy.
Further notes
- Meanwhile, capsule endoscopy has been made more effective. Fluorescent light could expand the diagnostic capabilities of the colon capsule.