HealingWell
Search Close Search
☰

Capsule endoscopies: talk to me, guys

Support Forums
>
Crohn's Disease
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/4/2016 2:33 PM (GMT 0)
Because I'm gonna be having my first one.

Had a hospital appointment this morning. My heart sank when the nurse announced a 45-minute delay because that means you can immediately double the waiting time. And so, 90 minutes later, I saw my GI.

Fairly short and sweet appointment. The only unexpected thing was when he said he wanted to do a capsule endoscopy. Definitely wasn't expecting that, but he said he wanted to see inside the small bowel before I started vedolizumab (Entyvio). Got a bit nervous at that point and asked if it would disqualify me from the vedolizumab if it was clear: the answer was no, fortunately. I don't actually think it's going to find a lot. As far as I know I've always had the vast majority of my disease in the colon, with only the very end of the small bowel being affected. But I think my consistently high faecal calprotectin results has my GI wondering if there's something else going on.

After the appointment I then had another 90 minute wait for a blood test - the blood clinic was ridiculously crowded. Then a 15-20 minute walk back to Tesco car park because I'm too mean to pay hospital parking fees.

I could google capsule endoscopy, but why would I do a thing like that when I can just ask HW? ;p What have your pillcam experiences been, folks? I know you swallow a miniature camera, but that's about it...
Posted 10/4/2016 8:56 PM (GMT 0)
I had one a couple years ago. Not much to it. I think it was more the thought of the camera in me that freaked me out a little.

No prep I just couldn't eat after dinner the night before. I went to the doctor in the am and a nurse got me all hooked up with the sensor and transmitter, I swallowed the pill and they sent me on my way. I could start eating a few hours after I swallowed the pill. They did tell me to keep up right and moving not to lay down and sleep which is what I wanted to do. Something to do with making sure it keeps moving through in the right amount of time.

It's not that big, like a large vitamin. I never saw mine come out which worried me for a bit but they are easy to miss.

Mine showed nothing, which I kind of already knew.
Posted 10/4/2016 8:59 PM (GMT 0)
Although knowing you don't have a colon it will come out a lot sooner so you might see it.
Posted 10/5/2016 12:41 AM (GMT 0)

cupcakespinkgal said...
Although knowing you don't have a colon it will come out a lot sooner so you might see it.

Doh! I never thought of that.

I did end up googling it. Looks a right to-do, but I'd still rather that than have another flex sig ever again.
Posted 10/5/2016 12:53 AM (GMT 0)
I had it done twice in late 2006, and it was pretty easy. Of course that's not always the case, but overall it's one of the easier tests we have to go through.

My doc made me do a semi-prep the night before (that didn't do much), but some docs require full prep while others no prep at all.

The morning of, you go in, they gave me a drink of something that probably had glycerin or something in it - it was like a lubricant for my throat. Small amount, easy to drink.

Then the pill. It looks pretty big but it's nice and rounded, no edges, so it went down surprisingly easy.

Wore a belt with the hard-drive recorder on it and several small antenna probes stuck to my belly.

Didn't feel a thing after that. Was allowed to start eating a few hours after. Never noticed it come out either time (but you probably will).

Unless you have a narrowing/stricture, or an unusual difficulty swallowing it, this is a pretty easy test.

The pill usually sits in your empty stomach for anywhere from a few minutes to 30-60 minutes, then goes into the small bowel, where it takes 4-8 hours (usually around 6) to go through. So it records for around that amount of time - something like 6-8 hours.

It will take your doctor a long time to watch the video, so don't expect results immediately. My first one, I was hospitalized and they checked it that night. The second one, it took a month before the doctor found time to watch the video.
Posted 10/5/2016 1:24 AM (GMT 0)
Cheers for that, beave. As with most tests, it's the not being able to drink anything for hours which gets to me :-/ Wouldn't be so bad if I could just have endless cups of tea.

And I don't envy the doctor who has to sit through 6-8 hours of footage. I mean, I'm interested in the inside of my bowels but not to that extent.
Posted 10/5/2016 2:13 AM (GMT 0)
Yeah, that would be one long boring movie! :-) By hour 6, I wonder how many glasses of wine and/or bags of popcorn the doctor has consumed?!?

I'm not sure how long it actually takes to "watch" the video, though. If I remember correctly, the system only takes 2 or 3 pictures per second (that may have changed in the last ten years). Actual film movies are 24 frames per second. Video is 25 or 30 frames/second, or sometimes even 60 frames/second in some situations.

So a doctor might be able to speed through parts of it at a higher frame rate than 2-3 frames/second. 20-30 frames second would be ten times faster, meaning the 6-8 hours would be cut down to 36-48 minutes. If they see anything that catches their attention, they can slow it down and look at it frame-by-frame.

I would imagine some doctors take lots of time looking at individual images, while others speed through them. And that opens up the potential for small things to get missed. I would imagine as time goes on the software will have some built-in image processing that can flag any images it sees as unusual or noteworthy. That may already be part of the system, I don't know. I always found it a fascinating test.
Posted 10/5/2016 7:02 AM (GMT 0)
ncot, I would LOVE to have one but I am too narrow in lots of places.. :O(
Posted 10/5/2016 10:44 AM (GMT 0)
Beave - Yeah, that makes sense. Even the most conscientious doctor in the world would start nodding off after a couple of hours, I reckon. There has to be some way of speeding up the viewing, otherwise stuff is bound to be missed. It is an interesting test; I hope I get a chance to see some images of my small bowel, but I probably won't :-(

Randy - Yours would be the shortest test of all: probably no more than 15 minutes :p (Well, unless you got a blockage, but that's another issue...)
Posted 10/5/2016 2:57 PM (GMT 0)
Hi NCOT,
As medical tests go, this one isn't bad. The first time in 2007, I felt like the uni-bomber because there were so many leads on me, but the last time I did it was a few years ago and the technology has gotten much better,so the equipment isn't so heavy and annoying. I still stayed home from work though because I didn't want to be seen with the transmitter and all. As long as they are sure you don't have a stricture in your small intestine, then you should be fine. The pill isn't at all hard to swallow, at least for me that was the case. I honestly can't remember the prep, but I do remember being able to eat and drink after a certain time period.

Nowawadays, a computer analyzes the film footage and alerts the doc for troubled areas. The doc can then go to that section of the film and watch what he wants. So they don't actually sit there watching a movie for 6 hours of your intestines. The last time I had the test, I was severely anemic and the pill cam didn't pick up any bleeding. It was very frustrating. It was a few months later that I had my first obstruction, so obviously something was going on. So it's not a perfect test. But I was originally diagnosed from the first pill cam which detected bleeding ulcers in my small intestine. I think your doc is being thorough and that's a good thing.
BTW, I never saw the camera in my poop either time.....the docs don't worry about that too much.
Posted 10/6/2016 9:00 PM (GMT 0)
Hi Gumby.

Cheers for the feedback. Interesting to hear how the technology has improved. Video resolution is another thing that's probably got better as well.

I never fail to be suprised by people who have strictures without any symptoms. I'd be even more surprised if I turned out to have a small bowel stricture. You never know I suppose, but my GI told me the MRI scan hadn't shown anything.
Posted 10/6/2016 9:19 PM (GMT 0)
I hope You have a good experience with it, NCOT!
Curious, does anyone know what the difference in detection capabilities is between MRE and capsule endoscopy? Could you have a clear MRE and have a stricture or inflammation show up with the capsule?
Posted 10/7/2016 4:33 AM (GMT 0)
^MRE can see most strictures, but occasionally they are missed - because of poor distention of the bowel (not enough contrast or contrast not distributed evenly); or because the stricture is so short that it doesn't show up in the images, or the radiologist just misses it. Occasionally strictures can be only a couple millimeters long, in which case they could be missed by a scan.

MRE also can see most ulcers but sometimes misses them, especially if they are small and/or shallow.

MRE is obviously better at seeing thickening of the bowel wall and issues external to the bowel such as enlarged lymph nodes, fat creeping, fistulae, etc.
Posted 10/18/2016 5:36 PM (GMT 0)
I just had one today! The worst part was no fluids past 10pm. Especially as I have had a sore throat for a few days. Well, swollen - not sore inside but from a swollen lymph node in my neck.

Anyway, it went down easily even with that, and I was allowed 2 whole glasses of water with it. She said in an hour I could have coffee/tea and my morning meds and at 11:30 I could have a normal lunch. My only prep was clear fluids only beginning at noon the day before.

I passed mine at 12:35 - I saw it blinking in the toilet. I called the office and they were surprised but said to just bring the sensor belt back as planned.
Posted 10/18/2016 7:42 PM (GMT 0)
I'm slightly dreading the no fluids part, as I get thirsty more often than I used to - one of the perks of not having a colon, I guess. Not looking forward to driving to the hospital without my morning cup of tea.

Still don't have a date for my test yet, which I'm getting slightly miffed about. I accept I'm not a priority case, but just an actual date would be nice.

Anyway, good luck with your test.
Posted 10/18/2016 9:35 PM (GMT 0)
I made my appt Aug 26 for Oct 11 - a day I had off from work and school, and they waited until the Friday before to do my insurance authorization! So it didn't come through in time and I had to reschedule for today.

The worst part truly was no water, but she let me have two glasses right then when I took it.

I just dropped off the equipment and the guy told me it shouldn't be a problem that mine was 4 hours but usually it takes 4 hours just to get out of the stomach.

Oops! Not sure what that means. Hope I don't have to repeat. You'll do ok. I admit I cheated and took tiny sips of water to wet my mouth & throat until I fell asleep and on the bus. With my throat as sore as it is from allergies it was hard to breath otherwise. But not enough water to even make it to my stomach frankly.
Posted 10/18/2016 9:39 PM (GMT 0)
Also: they've progressed - at least at my hospital - to a sensor belt, not ones stuck on my belly. Also there was nothing but a glass of water (it was smart water actually - probably for the electrolytes) waiting for me. I think the tech has advanced quite a bit. They said I'll have results tomorrow - or my doctor will anyway.
Posted 10/21/2016 1:11 AM (GMT 0)
Yeah, 4 hours does sound like a very fast transit time. It'll probably be about 4 hours for me, but that's 'cos I don't have a colon.

Have you got the results yet?

Meanwhile I finally have a date at long last for my pillcam: 5th December. I don't mind that.... but it's for a dummy pillcam ;_; Means I almost certainly won't get the real test until next year now, which is getting a bit ridiculous. My GI also never said anything about doing a patency capsule (as it's called) first. Think I'll chase this one up with my IBD nurse and make sure I haven't been sent the wrong sheets, or something - it's the sort of thing which happens on the NHS.
Posted 10/22/2016 12:58 PM (GMT 0)
If there is any worry that you have a stricture then the potency capsule is the right thing to do. But I still think you should call. It seems like they should be able to give you dates for both tests immediately and they shouldn't need to be scheduled far apart from each other. Sorry for all the waiting!
Posted 10/23/2016 1:31 PM (GMT 0)
Thanks gumby!

I do think my chances of having a stricture are very low. Low enough I would be willing to skip the patency capsule and go straight into the real thing. Hey, you only live once. #yolo

But I'll send an email to my IBD nurse and see what she says. Can't get in touch with her over the weekend, but hopefully she'll reply tomorrow.
Posted 10/31/2016 6:35 PM (GMT 0)
I got my results of my VCE and posted. Sadly, nothing remarkable and apparently 4 hours is instead a sign of good health.
✚ New Topic ✚ Reply