Capsule Endoscopy

A capsule endoscopy (CAP-sool en-DOSS-co-pee) is a safe, painless way for doctors to look inside the small intestine. Your child’s doctor will discuss with you how the test might help your child, what it can and cannot show, and the small risks involved.

In order to have a capsule endoscopy, your child must be able to swallow a large pill. Most children ages 10 and up, and some children who are younger, are able to have a capsule endoscopy. Nurses will screen all children who are scheduled for a capsule endoscopy to be sure they can swallow a pill.

If your child is unable to swallow a pill, the capsule must be placed through a traditional endoscopy or EGD, which requires general anesthesia to make your child sleep.

A capsule endoscopy may be prescribed to diagnose a range of problems in the digestive tract, including Crohn’s disease, Celiac disease and other absorption disorders; tumors of the small intestine; bleeding problems; injuries to or disorders of the bowels; or to rule out the small intestine as the source of problems.

• A capsule endoscopy uses a tiny, single-use camera called a PillCam^TM, which is about the size of a large vitamin. The PillCam is swallowed like a pill and glides naturally through the digestive system, taking pictures along the way. 
• As the PillCam moves through the digestive system, it takes color pictures and short video clips of the insides of the small intestine and transmits them to a recorder worn on a belt. 
• These photos and video clips let the doctor see what is ­happening inside your child’s small intestine. 
• Once the PillCam has passed from the small intestine to the colon, the test is over. 
• The PillCam will come out of your child’s body through the anus when he or she has a bowel movement, usually within about 72 hours. The PillCam can be flushed.
• Your child’s doctor will look at the pictures and video clips to make a diagnosis. 

On the day before and day of your child’s capsule endoscopy, there will be special instructions for what he or she should eat and drink.  

On the day before the capsule endoscopy:

• Your child should have only clear liquids once he or she wakes up. Any kind of clear liquid is fine — including apple, cranberry, cranapple and grape juices; fruit-flavored drinks, such as Kool-Aid^®; sports drinks, such as Gatorade^®; clear tea; carbonated beverages (soda or pop); Popsicles^®; plain Jello^® or gelatins; and fat-free broth or bouillon.
• You will need to buy a bottle of magnesium citrate at a drug store for your child to drink. Magnesium citrate comes in flavors, such as lemon/lime and cherry, that may make it easier for your child to drink than the unflavored type.
• At lunchtime or as soon as he or she gets home from school, your child should drink one ounce of magnesium citrate for each year in age, up to a maximum of 10 ounces. For example, if your child is 7 years old, he or she should drink 7 ounces of magnesium citrate; if your child is 12 years old, he or she should only drink the maximum of 10 ounces. 
• Your child should have nothing to eat or drink after 10 p.m. 
• Do not be alarmed if your child has diarrhea. Diarrhea is normal with a clear liquid diet and magnesium citrate and is necessary to clean out the bowels in order for the PillCam to get the clearest pictures and video clips. 

On the day of the capsule endoscopy:

• Your child may take medications only if they are taken more than 2 hours before the test. Do not take any medications in the 2 hours before the test.
• If your child was scheduled to report to the Same Day Surgery Center for his or her capsule endoscopy, there may be different instructions for what your child may eat or drink on the day of the test. Please follow the specific instructions given to you by the GI or Same Day Surgery scheduling nurse, which may be different from the instructions above.
• Have your child wear comfortable, loose-fitting, two-piece clothing. 
• You may bring along a "comfort" item — such as a favorite stuffed animal or "blankie" — for your child to hold during the test.  

Your child’s capsule endoscopy will be scheduled at UPMC Children's Hospital of Pittsburgh. You and your child should report to the GI Lab at your appointment time.

If the nurses have any questions about your child’s ability to swallow a pill, you and your child may be asked to report to the Same Day Surgery Center.

You and your child will be taken to an exam room.

• The nurse will attach a set of sensors to your child’s belly using sticky patches. These sensors do not hurt.
• The nurse will attach a recorder belt around your child’s waist. The belt looks like a "fanny pack" and contains the recording equipment. The sensors attached to your child’s belly will pick up signals from the PillCam and send pictures and video clips to the recorder in the recorder belt.
• The nurse will show your child how to swallow the PillCam and give him or her a glass of water. Most children are able to swallow the PillCam in just a few tries.
• Once the recorder belt is in place, your child may leave the hospital and go to school or any other regular activities. There are no restrictions on your child’s movement during the day, but care should be taken to make sure the recorder belt does not get wet or damaged by strenuous activities.
• Your child should not eat within 2 hours of the PillCam being swallowed. After 2 hours, he or she may have clear liquids; in 4 hours, he or she may have a light lunch. When the test is completed, he or she may return to a normal diet.
• The recorder belt will stay on for the entire test. You will be asked to come back to Children’s Hospital at 3:15 p.m. to have the belt and sensors removed.
• Once the recorder belt is removed, the pictures and video clips will be transferred onto a special computer so the ­doctor can look at and save the information.  

When the test is done, your doctor will speak with you in the surgical family waiting room. You can join your child in the recovery room when he or she is awake.

Once the belt has been removed, your child may go home and resume a normal diet and normal activities.

• The PillCam will be passed from your child’s body through the anus when he or she has a bowel movement, usually within about 72 hours. You and/or your child should be on the lookout for the PillCam in the stool (bowel movement) to make sure it passes from the body.
• If you do not notice the PillCam in the stool within two weeks, your child’s doctor may prescribe an X-ray to be sure it has been passed. Your child should not have an MRI scan done until it is confirmed that the PillCam has passed from his or her body. 
• Your child’s GI doctor will look at the results of the test and contact you to discuss them, usually within 1 to 2 weeks. 

We welcome your help and support during this test. One of the most important roles of a parent or guardian is to help your child stay calm and relaxed before and after the procedure. The easiest way to do this is for you to stay calm. 

If your child has any special needs or health issues you feel the doctor performing the test needs to know about please call the GI procedure nurse at UPMC Children's Hospital of Pittsburgh before the test at 412-692-5944. It is important to notify us in advance about any special needs.