Pill camera procedures at GI Care for Kids
It used to be hard to “see” what’s wrong in the small intestine. Not anymore – a pill camera can quickly and easily do that job.
The innovation of a pill camera was necessary because doctors can already easily look into the stomach or large intestine with an upper endoscopy or colonoscopy. However, getting to all of the small intestine can be tricky. Scoping the area carries risks, including the risk of acute pancreatitis. Imaging tests like X-rays, CT scans, and MRIs can tell us only that a problem exists – but don’t help us identify the cause of bleeding, the presence of Crohn’s disease, or if a suspicious polyp exists in the area.
Jelly bean-sized camera
Pill cameras are the size of a large jelly bean. A pill camera has its own light and batteries, enabling it to take more than 50,000 photos as it journeys through the intestine. These images are captured on a small monitor your child wears during the procedure. The images are then downloaded with software that combines the images into a video – which is why the procedure is also known as a capsule endoscopy or video capsule endoscopy.
What to expect: before, during, & after a capsule endoscopy
The night before, a bowel cleansing with a mild laxative is usually recommended so that the intestine can be seen clearly. Taking certain medications – such as iron and NSAIDS – are to be avoided because they can create sores that look like the ulcers associated with Crohn’s disease.
Most teens and adults can swallow these cameras like they do large vitamin pills, with a small cup of water. We’ve even had a 4-year-old swallow one easily. No sedation or X-rays are required for most patients. When younger children are unable to swallow the pill camera, we can place it in the first part of the small intestine.
Patients are asked to remain in the office for one hour after swallowing the pill to make sure the pill camera reaches the small intestine. If it does not, a medicine is provided to help the pill camera move. Either way, the patient is asked to stay upright and moderately active during the test with activities such as walking or sitting up instead of laying down.
During the test, which can last 8 hours, a specific diet is usually set out for the patient so that the food eaten does not interfere with the camera’s view of the intestine.
At the end of the procedure, the monitor your child had been wearing is removed and its images uploaded onto a computer where a doctor can interpret the findings. Meanwhile, the pill is pooped out, usually the same day.
It can sometimes take up to 2 weeks to pass the pill camera in a bowel movement. If it takes a long time to pass, it may indicate that the patient has an abnormal narrowing (stricture) within the intestine. If a brief course of steroids doesn’t allow the capsule to pass, the capsule may need to be retrieved and surgery may be required to repair the stricture. This is a rare event, however, happening less than 1% of the time in healthy patients, and up to 5% of the time in someone who has had Crohn’s disease for a while, especially if they are very thin. We can sometimes prevent the problem for children with Crohn’s disease by using a pill camera that dissolves if it can’t get through the intestine.
Most results are available within a few days, although it can take a while for a doctor to read and interpret the study.
Pediatric Gastroenterology Center in the Greater Atlanta area
If you believe your cphild may benefit from an examination of the small intestine using a pill camera, call GI Care for Kids in the Greater Atlanta area at (404) 257-0799, or request an appointment now.