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Benefits, Risks, and Alternatives

Benefits
Capsule endoscopy is the only procedure in which clear, detailed images of the inner lining of the entire small intestine can be taken. Traditional upper GI endoscopy and colonoscopy cannot reach the vast majority of the small intestine, and radiologic tests, such as x-ray, CT scan, or MRI, cannot capture the same clarity or detail of the small intestine's inner lining. Deep endoscopy, or enteroscopy, often done with the help of balloons, can allow for deeper endoluminal examination from above and below, but has higher risks, is more time intensive, and still may not reach the entire small intestine.

Risks
Complications are rare, but there is potential for the capsule to get stuck within the small intestine, often at a narrowed spot in the digestive tract. This could result in bowel obstruction. Narrowing in the digestive tract may be due to inflammation, prior surgery, or a tumor. A bowel obstruction can cause unusual bloating, abdominal pain, nausea, or vomiting, and result in perforation, or tearing, of the intestines, which may then require surgery. Magnetic resonance imaging, or MRI, MUST be avoided while the capsule is inside a patient.

Alternatives
Radiologic tests, though not as clear or detailed, can also be helpful in diagnosing conditions of the small intestine. Radiologic alternatives to capsule endoscopy include:

  • Upper GI series, or barium swallow, with small bowel follow-through x-ray, which uses x-rays and swallowed barium to act as a contrast medium. In order to capture x-rays of the barium-coated small intestine, additional time is required as compared with a traditional upper GI series. This shows contours and shapes of the inside of the intestine, like a topographic map.
  • Computed tomography, or CT, enterography, which uses a combination of x-rays and computer technology, with large volumes of oral contrast, to evaluate the small intestine. This provides information about the small intestinal lumen as well as whether there is inflammation on the mucosal, or inner, surface of the intestines.
  • Magnetic resonance, or MR, enterography, which uses a combination of radio waves and magnets, with large volumes of oral contrast, to evaluate the small intestine. This provides information about the small intestinal lumen as well as whether there is inflammation on the mucosal, or inner, surface of the intestines.