What to expect when your doctor tells you to have a “colon capsule.”
I haven’t had a colonoscopy in years. Probably since I was first diagnosed with ulcerative colitis when I was 16 years old – I’m now 33. So I’m feeling happy that I’m actually getting round to sorting this out – it’s been on my To Do list for as long as I can remember!
I have had flexible sigmoidoscopies over the years which aren’t too bad – they don’t involve any prep work and you get sedated during the procedure so you don’t really know what’s going on, but it still means getting into a hospital gown and having one of those awful cannulas stuck in your arm.
So what does a colon capsule involve?
A colon capsule is a clever little pill with a camera inside – you swallow the pill and the camera takes pictures of your stomach .
An amazing piece of technology invented by the Israelis. But of course you can’t just swallow the pill one morning without any preparation or it will be taking pictures of all the chicken/potatoes/chocolate cake you’ve consumed over the last few days! First you have to empty your bowels. I will go through the process with you.
2 days before the procedure:
Eat a low fibre diet for example: eggs, chicken, fish, chicken, potatoes, rice, bread (i.e. bland things your grandmother eats).
High Fibre foods to avoid: fruit and vegetables, red meat, nuts, anything wholegrain, fruit juices with pulp, beans and pulses.
Day before the procedure:
Clear liquid diet only. NO SOLID FOOD.
Eg: clear soups – make a big chicken soup and strain it, tea or coffee without milk, apple juice/clear fruit juice (no bits), jelly (Osem jelly definitely the best, trust me, I have tried all others and this one is by far the most edible).
Evening before the procedure (exact time will be given to you by endoscopy unit):
Moviprep or other bowel prep to be drunk over 1-2 hours. STAY NEAR A TOILET. You will be experiencing watery bowel movements.
Morning of procedure (time to be given to you by endoscopy unit):
Second dose of Moviprep or other bowel prep to be drunk over 1-2 hours
Try and do this at home so you have the comfort of your own bathroom – I can’t imagine anything worse than using a hospital toilet and worse still, possibly having to wait for an available toilet when there is a volcano erupting in your stomach!
When you get to hospital (time to be given to you by the endoscopy unit), the nurse will attach sensors to your abdomen that allow the video capsule to transmit images of your colon to a little monitor that you wear around your neck. You may also wear a small data recorder attached to a belt around your waist.
You will then swallow the capsule which is flashing blue! You will then need to walk around the hospital for an hour so the capsule will make its way through the bowel. Best not to venture too far – and stay near the loos. You may get a few funny looks – you could be mistaken for a suicide bomber with all the wires hanging out of your jumper, but please bear in mind this is a hospital – people are (surely) walking around with weirder things.
The nurse will then check on the monitor if the capsule has passed through to the small bowel. If it has, good news, you are free to go home (still attached to the monitor/wires). If it hasn’t, you will be given some medication called Metoclopramide to help the capsule move more quickly into the small bowel. Once this has happened you can go home.
When you get home you will need to take Gastrografin and Fleet mixed together with water. This is truly revolting but you must take it – these are laxatives that propel the capsule through your bowel and out the other end. You will take two doses about 2 hours apart. Stay near a toilet and don’t invite guests for tea. You will have watery diarrhoea.
You may be allowed to eat a light lunch at about 3pm.
Keep checking if the capsule has come out into the toilet. Eventually this will happen! If it hasn’t happened after the two doses of Gastrografin and Fleet you will need to take a suppository.
Once the capsule comes out the blue light will turn off – job DONE!!! Don’t be alarmed if your toilet is flashing blue inside – it is the capsule and it is disposable – just flush it down! Do not fish it out the toilet!!!
You will need to return the monitor and paraphernalia to the endoscopy unit.
Overall process was very manageable – The prep/laxatives are hard to down but it’s definitely not as bad as having a full blown colonoscopy!
Please note: If you are having a capsule endoscopy, please follow the specific instructions provided to you by your endoscopy department which may vary from those above.