Capsule wireless endoscopy (WCE)

Video capsule endoscopy is a safe, painless test that can diagnose many gastrointestinal (GI) disorders. Doctors across North Texas send their patients to us because we can diagnose and treat the most complex GI disorders that affect children. Our pediatric gastroenterologists use the latest technology and tools to confirm a diagnosis and provide treatment. Our goal is to help your child get back to their healthy, active life.

What is pediatric video capsule endoscopy?

This noninvasive test uses a tiny wireless camera inside a vitamin-size capsule. Your child will swallow the capsule, and it travels through their stomach and intestines. During this time, the camera takes thousands of pictures.

A tiny transmitter inside the capsule sends the pictures to a recorder. Your child will wear the recorder around their waist for about 8 to 12 hours. The capsule leaves your child’s body in their stool (poop) within one to three days. Video capsule endoscopy is also called PillCam™ or wireless capsule endoscopy (WCE).

What are the benefits of pediatric video capsule endoscopy?

Pediatric video capsule endoscopy is one of many tools our pediatric gastroenterologists use to evaluate a child’s digestive tract. This area goes from the throat to the large intestine.

Video capsule endoscopy offers certain advantages compared with traditional endoscopy. These include:

• More detailed pictures than other imaging methods: Video capsule endoscopy provides direct photos and videos inside the digestive system. Many digestive symptoms and problems don’t show up on other imaging, such as computed tomography (CT) scans, X-rays, ultrasound and magnetic resonance imaging (MRI).

• Less invasive procedure than other types of endoscopy: Traditional endoscopic procedures involve inserting a scope (long, flexible tube equipped with a camera) inside your child’s body. In upper endoscopy, the scope goes down your child’s throat. With a colonoscopy (lower endoscopy), the scope goes through their anus (end of the large intestine). Pediatric video capsule endoscopy involves swallowing a capsule the size of a large vitamin, making the test much easier for your child. If your child is unable to swallow the capsule, we can place it in the intestine during upper endoscopy.

• Access to unreachable areas: The capsule takes pictures throughout the entire digestive tract. Many areas, especially in the small intestine, are hard to reach with traditional upper or lower endoscopy.

• No anesthesia or sedation required: With traditional endoscopy, your child will receive medication that either puts them to sleep (general anesthesia) or helps them relax (sedation). That means your child will spend some time recovering in the hospital and at home afterward. A video capsule endoscopy allows your child to go about their usual activities, except for strenuous activity.

What are the side effects of pediatric video capsule endoscopy?

A possible video capsule endoscopy side effect is constipation. To relieve constipation, your child should drink plenty of fluids. You may give your child an over-the-counter laxative or stool softener, if needed.

What are the risks of pediatric video capsule endoscopy?

Pediatric video capsule endoscopy is a safe, low-risk test. However, in very rare cases, the capsule can get stuck and cause a bowel obstruction (blockage in the intestines). Most often, the capsule will still pass naturally, but it may take several more days.

If your child develops symptoms of bowel obstruction, they may need surgery or a minimally invasive procedure to remove the capsule. Please contact the care team if your child shows signs such as:

• Abdominal (belly) pain

• Bloating

• Difficulty swallowing (dysphagia)

• Fever

• Nausea and vomiting

At Children’s Health, our care team works to minimize your child’s risks during and after a pediatric video capsule endoscopy. Your child’s health and safety are our top priorities.

What to expect with pediatric video capsule endoscopy?

Your child’s care team explains what you can expect before, during and after the video capsule endoscopy. We’ll also provide complete instructions for how to prepare your child and how to take care of them after the procedure.

What to expect before pediatric video capsule endoscopy?

The day before your child’s video capsule endoscopy procedure:

In the morning:

• They should take their medications as usual.

• Your child should only have clear liquids, such as:

  • Water

  • Pedialyte^®

  • Tea

  • Juices, such as apple, white grape and pear

  • Clear sports or electrolyte drinks such as Gatorade^®, POWERADE^® and Liquid I.V.^®

  • Lemonade without pulp

  • Broth and clear bouillon

  • Jell-O^®

  • Frozen liquids such as popsicles, ice slushes and Italian ices

• Your child should NOT have:

  • Solid food of any kind

  • Milk or milk-based products such as cheese or yogurt

  • Red, pink, blue or purple liquids, Jell-O® or popsicles

  • Juices with pulp, such as orange, pineapple or grapefruit

At 2 p.m.:

• Your child will begin a one-day laxative clean-out, similar to a colonoscopy clean-out.

  • The clean-out typically involves drinking a liquid stool softener laxative, such as MiraLAX^®.

  • Your child will drink a glass of laxative every 15 to 20 minutes until they reach a specific number of glasses.

  • Our GI procedure team will provide specific instructions for this clean-out before the procedure

The night before, around 8 p.m.:

Your child will take stimulant laxative, such as Dulcolax^® (bisacodyl) tablets or suppository or ex-lax^® (sennosides) chocolate chews. We’ll provide the specific dosing with the other clean-out instructions.

What to expect during pediatric video capsule endoscopy?

On the morning of the procedure:

• Allow enough time to get to the hospital on time. If you arrive late, we will have to cancel the procedure.

• Don’t give your child their morning medicines. However, you should bring your child’s medicines with you to the hospital.

• Do NOT allow your child to eat solid food.

• Your child may have clear liquids to drink until 3 hours before the scheduled procedure time.

• After that time, your child may NOT have anything else, not even water, chewing gum or hard candy.

During the video capsule endoscopy procedure, the care team will:

• Ask your child to remove their shirt

• Place stickers on your child’s belly

• Position a sensor belt around your child’s waist

Your child will then swallow the capsule and drink a glass of water, and then you can take them home. Our care team will provide instructions on what and how much your child can eat and drink while the capsule travels through the digestive tract.

What to expect after pediatric video capsule endoscopy?

After the video capsule endoscopy procedure, your child:

• Will not feel anything as the capsule passes through their body

• Can go to school and do their regular activities, except strenuous activities such as sports

• Will need to come back to our offices after eight hours so we can remove the sensor belt

Your child’s gastroenterologist will review the pictures from the test and call you within one to two weeks to review the results.

The capsule will exit your child’s body in the stool (poop) within one to three days.

• You should check for the capsule in your child’s stool. However, the capsule is disposable, so you do NOT need to keep it or bring it back.

• Call your child’s care team if you don’t see the capsule in the stool after several days.

• If your child develops symptoms of bowel obstruction (described above), call the care team.

What questions should I ask my child’s provider about pediatric video capsule endoscopy?

If your child’s doctor recommends a video capsule endoscopy, some questions you may want to ask include:

• Will my child need to spend the night at the hospital after a video capsule endoscopy?

• Are there other testing options for my child?

• What medications should my child stop taking before a video capsule endoscopy?

• Will my child go home with any special equipment after a video capsule endoscopy?

• How soon will I be able to see my child after a video capsule endoscopy?