Capsule endoscopy
Standard endoscopic procedures, using a camera on the end of a flexible tube, are limited in the distance they can access the gastro-intestinal tract. Gastroscopy will usually only be able to access up to the third part of the duodenum. Colonoscopy will usually only be able to access up to 10cm into the ileum. The leaves around 3-4 metres of small bowel that cannot be visualized using standard endoscopy techniques. Capsule endoscopy provides means of examining this area of small bowel.
The small bowel can be assessed using:
- Radiological techniques e.g. computer tomography (CT) or magnetic resonance imaging (MRI)
- Small bowel capsule endoscopy (SBCE)
- Double balloon endoscopy (See Double balloon endoscopy)
SBCE is useful as it visualizes the inside of the small bowel. It can find conditions such as:
- Small bowel tumours including cancers and benign polyps
- Inflammation and ulcers in the small bowel e.g. Crohn’s disease and coeliac disease
The main drawback of SBCE is that you cannot take biopsy samples for examination by a histologist. Because of this, the findings need to be interpreted in the correct clinical context.
The decision to perform capsule endoscopy and its interpretation should be undertaken by a gastroenterologist. Because diseases of the small bowel are rare when compared to the rest of the gastro-intestinal tract, appropriate investigations for an individual's symptoms should be performed before proceeding with SBCE.