GI Blog

Procedure for Performing Small Bowel Capsule Endoscopy

17 February 2023

Ⅰ. Preparation for small bowel capsule endoscopy

1. Before small bowel capsule endoscopy, it is recommended to conduct adequate bowel preparation according to the patient's condition, including appropriate dietary adjustment and drug intervention.

2. Before small bowel capsule endoscopy, it is recommended to use bowel cleansing agents and appropriate antifoaming agents to better observe the small bowel mucosa.

3. Before small bowel capsule endoscopy, an informed consent form should be signed to inform patients of possible risks, including incomplete small bowel examination, failure, and capsule retention.

4. For patients with known or suspected small bowel stenosis, if small bowel capsule endoscopy must be performed, imaging or pathfinder capsule examination can be performed according to the patient's condition to reduce the risk of small bowel capsule endoscopy retention.

Ⅱ. Theoperation process of small bowel capsule endoscopy

1. It is recommended to use real-time monitoring equipment to observe the position and status of the capsule during small bowel capsule endoscopy, especially for patients with delayed gastric emptying and previous history of capsule gastric retention. Real-time observation can guide the examining physician to implement appropriate interventions in a timely manner. Ways to optimize small bowel capsule endoscopy.

2. It is recommended to drink water 2 hours after swallowing the capsule, and eat a little light solid food after 4 hours.

3. Patients with pacemakers, implantable cardioverter-defibrillators and left ventricular assist devices can safely accept small bowel capsule endoscopy after signing the informed consent.

4. Capsule endoscopy can be safely and effectively used in children and the elderly after exclusion of contraindications.

Ⅲ. Precautions after small bowel capsule endoscopy

If capsule endoscopy has not been completed (the capsule has not reached the colon) and no expulsion has occurred after 2 weeks of swallowing, an abdominal X-ray is recommended to confirm whether the capsule is still in the body.

Ⅳ. The reading process of small bowel capsule endoscopy

1. During the reading of small intestine capsule endoscopy, nurses or trained technicians with experience in capsule endoscopy can read the images in advance, and screen out the pictures of suspicious lesions, but the final diagnosis of the lesions must be made by clinicians.

2. Adjust the appropriate reading rate according to the specific conditions of patients and readers to ensure the efficiency of lesion detection.

3. Minimize the reading rate when observing the proximal small intestinal mucosa.

4. When the small intestinal mucosal lesions are widely distributed, the automatic rapid reading software can be used, but it cannot completely replace the traditional reading mode.

5. It is not recommended to routinely use virtual staining technology when reading images, because this technology cannot improve the detection rate of lesions.