In order to image the interior of the whole gastrointestinal tract, a procedure can be used that involves swallowing a camera pill. This is ordered by a gastroenterologist if there are various gut-related symptoms which cannot be pinned down using a colonoscopy or upper endoscopy. The typical issues that might be found by using a pill camera are Crohn’s disease, growths, strictures, or structural abnormalities that impede the normal flow of food though the gut.
Before the pill camera can be swallowed it is necessary to prepare the bowel. This requires that the patient stop eating for a number of hours prior to the procedure and to drink a large quantity of polyethylene glycol laxative solution. This causes multiple bowel movements which clear out all the material from the gut, allowing the interior wall to be easily visible.
The patient must wear a special vest with a radio receiver for a number of hours. The pill is typically activated and swallowed with a dose of simethicone, a surfactant that helps to prevent foaming that would otherwise block the camera’s view. The patient must drink only clear liquids for the first part of the procedure and must avoid strenuous exercise or sleeping which would alter the normal peristalsis motions of the gut.
The pill camera procedure is intended to image the middle part of the gut which cannot be reached using upper or lower endoscopies. The patient is typically free to go about their business for a number of hours until the radio vest is returned and the operator can download the imagery that has been transmitted from the pill to the receiver. The system can track the location of the pill as it moves and can receive an image about twice per second. The operator carefully examines all the imagery and looks for any problems in the gut. They hope to see that the pill has made its way through the ileocecal valve and has ended up in the colon.
Typically the pill will exit the anus at the first bowel movement once the patient returns to normal eating. It is then discarded.
The main risk factor for this procedure is that the pill will become stuck at some abnormally narrow section of the gut. This is not a common occurrence and is a medical emergency that will require an operation.