Will Pill Cam still show if symptoms are mild?

Hello all, I’m new here.

I’ve been dealing with IBS type since I was about 10yrs old on and off (I’m now 29). I’m also a RN so, I tend to not take great care of myself.....I know I know, that’s changing this year.

I went to a GI in 2015 with these symptoms: pain and diarrhea with mucous and food after eating most times but not all the time. There are some days, weeks, I can eat whatever I want and just feel bloated and slight cramping around my bellybutton. Then other days, I can eat the same exact thing I had before and was fine, except I’m deathly ill and in the bathroom multiple times. Nausea and I bloat so bad it looked like I was 9mos pregnant. It’s SO inconsistent. So that GI thought it was my gallbladder, had a HIDA scan, EF was 9% so the gallbladder was removed in Jan 2015. Since then, I’ve had the same symptoms except worse. Now my shoulder joints burn at random times, my hair has been thinning so badly and I CANNOT lose weight since the surgery. Yes I’ve tried all the diets, I use to be a runner and weight lifted with a trainer 2x a week. Since August 2018, any kind of exercise makes me so nauseated.

Nov 2018 finally had an EGD/colonoscopy. Showed possible Gastroparesis (liquified food in stomach from 32hrs prior), gastritis, duodenitis, and inflammation throughout my colon. Biopsies were negative. The doctor said I was inflamed from the bowel prep. I called BS because my CRP was elevated months before my scopes (my symptoms were pretty good at the time of the scopes).

So now I have a new GI doctor and a PCP. New GI doctor wants to do a pill cam (I’ve been asking for this for a while but, denied by old GI). I’ve always thought I have Crohns in the small intestine. My question is, if my symptoms are pretty mild at the time of the pill cam, will anything still show? Does it have to be active and flared for it to show?

Thank you everyone!

Have you had a CT scan or MRI of your small bowel (with oral and IV contrast)?

If not, that should happen before you do the capsule endoscopy.

You symptoms indicate there is *possibly* a stricture or narrowing in your small intestine. *If* that is true, and you took the pillcam, it could get stuck at a narrowing and require surgical removal. The odds of this are pretty low, but it's a *possibility.*

The MRI or CT scan would show any narrowings, can find *most* abnormalities that a pillcam can find, and can find lots more things outside the inner wall of the small bowel.

The pillcam is typically the *last* test done, when other tests are normal but you and your doctor are pretty sure there is *something* wrong. In that case, it can find shallow ulcers that can be missed by other tests.

So I strongly recommend a CT enterography or MR enterography before you consider the pillcam.