Instructions for Small Bowel Capsule Endoscopy

Your physician has determined that as part of your medical evaluation you should undergo an examination known as an SB Capsule Endoscopy. This procedure involves ingesting a small (about the size of a large vitamin pill) Pill Cam capsule which will naturally pass through your digestive system while taking pictures of your intestine. The images are transmitted wirelessly to a small recording device that is secured to your abdomen with an adhesive patch. This device will collect and store the images throughout the study. You will be wearing the equipment for 15 hours, so you may be sleeping with it on. You will be instructed at the time of your appointment on how to remove the equipment when the study has completed, and when to return the equipment back to the office. The Pill Cam capsule is disposable and will be excreted naturally in a bowel movement. In the rare case that it is not excreted naturally, it will need to be removed either endoscopically or surgically.

Please Note: Small Bowel Capsule Endoscopy is relatively contraindicated for patients with a swallowing disorder, a known small bowel disorder, and a pacemaker or other implanted electro-medical device. In these circumstances, you will need to consult your physician to make a decision as to whether the benefit of the procedure outweighs the risk. Additionally, if you think you may be pregnant, please discuss this with your physician before undergoing this procedure.

The Day Before the Capsule Endoscopy

1. 1. Follow a low-fat diet for the entire day prior to your procedure
   2. Abstain from smoking 24 hours prior to undergoing SB Capsule Endoscopy.
   3. Twelve (12) hours before PillCam ingestion, switch to a clear liquid diet only.
      • Do not consume any red-colored liquids.
        Bowel Preparation
   4. Take Simethicone 180 mg capsules (over-the-counter anti-gas medication)
      • Take 2 capsules total just prior to starting your bowel prep.
   5. Bowel prep solution:

• GoLYTELY®, PEG with electrolytes, or similar preparation will be sent to your pharmacy.
• Drink half of the prescribed prep (2 liters) starting 6 hours before Pill Cam appointment.
• Drink 8 ounces of the bowel preparation every 15 minutes until completed.

The Day of the Capsule Endoscopy

1. Do not eat or drink anything (fast) for 2 hours before your arrival time for PillCam ingestion.
2. Arrive at the Middletown office at the scheduled time for your SB Capsule Endoscopy dressed in loose fitting, two-piece clothing. Please remember that you may be sleeping with the equipment on, so where it is placed is where it will stay for the next 15 hours.
3. The recording device will be placed on your abdomen using an adhesive patch. After that, you will be instructed to ingest the SB Capsule/Pill Cam with a glass of water.

After Ingesting the SB Capsule/Pill Cam

1. You may resume clear liquids 2 hours after PillCam ingestion.
2. You may resume solid foods 4 hours after PillCam ingestion.
3. Contact the office immediately if you suffer from abdominal pain, nausea, or vomiting during the SB Capsule Endoscopy.
4. After ingesting the SB Capsule and until it is excreted, you should not be near any source of powerful electromagnetic fields such as one created by an MRI device or amateur (HAM) radio.
5. The SB Capsule Endoscopy lasts approximately 15 hours. Do not disconnect or remove the equipment at any time during the active testing process. Since the recorder is actually a small computer, it should be treated with the utmost care and protection. Avoid sudden movement or banging the data recorder.
6. During the testing, it is important to verify every 15 minutes that the small light on the data recorder is blinking green. If for some reason it stops blinking green before the allotted end time of your test, please contact our office.
7. You should record the time and nature of any events such as eating, drinking, activity, and unusual sensations. Return the Event Form with these notes to the office at the end of your test.
8. Avoid any strenuous physical activity, especially if it involves sweating. Do not bend over or stoop down during the SB Capsule Endoscopy.

After Completing the SB Capsule Endoscopy

1. Please remove the recording device as instructed by the office and return the data recorder to the Middletown office as instructed.
2. You may or may not be able to visually verify that the SB Capsule as passed. If you develop unexplained post-procedure abdominal pain, nausea, or vomiting, please contact the office for evaluation and a possible examination by abdominal X-ray.
3. Undergoing an MRI while the capsule is inside your body may result in serious damage to your intestinal tract or abdominal cavity. If you did not positively verify the excretion of the SB Capsule from your body, you should contact the office for evaluation before undergoing an MRI examination.