Why PillCam COLON
How it works
About the capsule
About the procedure
Comparing colon exam procedures
Why PillCam COLON
A: PillCam COLON is the only minimally invasive tool that offers direct visualization of the colon while providing an optimal balance of low risk and high accuracy*. It allows your doctor to see your entire colon and assess its health—including the occurrence of polyps—in a way that is more convenient and less risky than other procedures.
A: PillCam COLON is a safe and accurate alternative to other colon exams, especially for those who refuse other invasive colon exams, and for some patients who are at higher risk for complications from colonoscopy. As a diagnostic tool, it helps your doctor determine the cause of many unresolved symptoms such as, abdominal pain, changes in bowel habits, unexplained weight loss, and rectal bleeding. It’s also an effective tool for colorectal cancer screening for those who do not have symptoms but may prefer a minimally invasive test or for those who have risk factors, such as being on a blood-thinning medication or with respiratory conditions.
How it works
A: A tiny, wireless camera—contained in an easy-to-swallow and disposable capsule about the size of a vitamin pill—transmits images as it travels naturally through your gastrointestinal tract. The images are transmitted to a data recorder that you wear on a belt, allowing the doctor to remotely view the images to make a diagnosis. During the procedure, you are fully awake with no need for sedation and can leave the doctor’s office to go about your normal day.
A: More than 1.6 million patients worldwide have used this safe and convenient PillCam technology for the small bowel, esophagus, and colon. Of these procedures 1.5 million used the small bowel PillCam which has been available since 2001 and over 10,000 have used PillCam COLON.
About the capsule
A: The disposable capsule, which contains a miniature camera, is the size of a vitamin pill—specifically, it measures 11 mm x 32 mm and weighs less than 4 grams. Its small size and smooth surface help to make it easy to swallow.
A: During the course of the procedure, the capsule captures approximately 30,000 pictures that are made into a video for your doctor to review.
Q: What happens to the capsule after the images have been collected and the procedure is complete? (Click to view answer)
A: The capsule passes naturally with a bowel movement, usually within 24 hours and without any discomfort. The capsule is disposable and does not need to be retrieved to collect the images from the procedure.If you are concerned that the capsule has not passed out of your body, please consult your doctor.
About the procedure
A: To cleanse your bowel, your doctor may have you follow a liquid diet the day before your PillCam COLON procedure and take laxatives the night before and morning of the procedure (similar to the preparation for colonoscopy but the PillCam COLON procedure may require up to 3 cups more of bowel prep solution). Be sure to follow the doctor’s instructions so that the camera can capture the best quality images.
A: In the doctor’s office, the nurse or doctor will place sensors in a belt or directly on your abdomen that allow the video capsule to wirelessly transmit images to a data recorder you’ll wear around your waist. First you will swallow the vitamin-sized video capsule with a glass of water. Shortly after, you will drink about 2 cups of the additional bowel prep solution and at this point, you’ll be able to leave the doctor’s office for the remainder of the day. There’s no need for sedation or supervision. You’ll return approximately 10 hours later to return the data recorder and sensor belt or have the sensors removed.
A: It can take up to approximately 10 hours from the time you swallow the capsule until all of the necessary images are captured and transmitted. During this time, you can go about your regular daily routine as the capsule naturally moves through your digestive system.
A: No. The video capsule has a smooth texture similar to over-the-counter capsules for pain relief. You should not feel any pain or discomfort when swallowing the capsule, while it moves through your colon, or as it is naturally eliminated during a bowel movement. Though you could feel discomfort associated during the colon cleansing from the bowel preparation.
A: Recovery is immediate because PillCam COLON requires no sedation. While the capsule transmits images, you will be able to follow a normal routine and perform daily tasks such as driving to and from the doctor’s office.
A: The PillCam COLON also has some risks. Please discuss these risks with your doctor, who can determine whether you are a suitable candidate for the PillCam COLON procedure.
- PillCam COLON capsule cannot remove polyps if any are detected. Colonoscopy may later be recommended to remove and treat the findings from a PillCam COLON procedure. For the majority of patients, it is unlikely that there will be findings requiring a follow-up colonoscopy, but a second round of bowel preparation would be necessary if a follow-up colonoscopy is recommended by your physician
- Both colonoscopy and PillCam COLON procedures require bowel preparation, but the PillCam COLON procedure requires up to 3 cups more of bowel preparation solution than colonoscopy requires.
Procedure Risk Information
- The risks of PillCam capsule endoscopy include capsule retention, aspiration and skin irritation
- The risks associated with colon preparation are as follows: allergies or other known contraindication to any preparation agents or medications used for the PillCam COLON regimen, according to laxative medication labeling and per physician discretion
- Medical, endoscopic or surgical intervention may be necessary to address any of these complications, should they occur
- After ingesting the PillCam COLON capsule and until it is excreted, the patient should not be near any source of powerful electromagnetic fields such as one created near an MRI device
Indications for Use
- PillCam COLON is intended for visualization of the colon mucosa
Contraindications for PillCam COLON include:
- Patients with known or suspected GI obstruction, strictures or fistulas based on the clinical picture or pre-procedure testing and profile
- Patients with cardiac pacemakers or other implanted electro-medical devices
- Patients with swallowing disorders
Comparing colon exam procedures
A: PillCam COLON does not require sedation. It can be administered in a doctor’s office, and recovery is immediate. In addition, it does not require patients on blood thinning drugs to stop taking their prescribed medications. Compared to a colonoscopy, it provides greater convenience while minimizing risks, including bowel perforation. PillCam COLON is the only highly accurate* minimally invasive tool offering direct visualization, so it allows your doctor to see pictures of the inside lining of your digestive tract and detect polyps that could be present.
Both colonoscopy and PillCam COLON procedures require bowel preparation, but the PillCam COLON procedure may require up to 3 cups more of bowel preparation solution than colonoscopy requires. Colonoscopy may later be recommended to remove and treat the findings from a PillCam COLON procedure. For the majority of patients, there is unlikely to be findings requiring a follow-up colonoscopy, but a second round of bowel preparation would be necessary if a follow-up colonoscopy is recommended by your physician.
A: PillCam COLON does not require x-rays, so does not expose you to radiation as CT colonography does. It’s minimally invasive, so it minimizes the risk of bowel perforation. PillCam COLON also provides direction visualization of the colon, enhancing the doctor’s ability to detect smaller polyps. Both CT colonography and PillCam COLON procedures require bowel preparation, but the PillCam COLON procedure may require up to 3 cups more of bowel preparation solution than CT colonography requires.
Q: What is the difference between PillCam COLON and flexible sigmoidoscopy (flex sig)? (Click to view answer)
A: PillCam COLON provides images of the entire colon, while flex sig only examines the lower one-third. During a PillCam COLON procedure, you won’t even feel the capsule as it moves naturally through your digestive tract. Flex sig, on the other hand, requires air to be pumped into the colon, which can cause discomfort and the risk of perforation. Flex sig does not require bowel preparation unlike PillCam COLON.
Q: What is the difference between PillCam COLON and double-contrast barium enema? (Click to view answer)
A: PillCam COLON does not require x-rays, so does not expose you to radiation as a double contrast barium enema does. It’s minimally invasive, so it minimizes the risk of bowel perforation. PillCam COLON also provides direct visualization of the colon, enhancing the doctor’s ability to detect smaller polyps. Both double-contrast barium enema and PillCam COLON procedures require bowel preparation, but the PillCam COLON procedure may require up to 3 cups more of bowel preparation solution than double-contrast barium enema requires.
A: PillCam COLON provides direction visualization of the colon, enhancing the doctor’s ability to detect polyps of all sizes. Stool tests (such as FOBT, FIT, and sDNA) only detect colon cancer and have not consistently demonstrated high accuracy* of the detection of polyps or pre-cancer. Stool tests do not require bowel preparation unlike PillCam COLON.
*"High accuracy" means more than 50% likely to detect large polyps as defined by Levin B, et al. Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 2008;58:00-00.
Lieberman D. Screening for Colorectal Cancer. New England Journal of Medicine. 2009: 361; 12.
Spada C et al, Second Generation PillCam COLON Capsule Compared with Colonoscopy. Gastrointest Endosc. 2011;74(3):581-589.
Eliakim R et al, Prospective Multicenter Performance evaluation of the Second Generation Capsule Compared with Colonoscopy. Endoscopy 2009; 41:1026-1031.
Berrington de Gonzalez D, Kim K, Yee J. CT colonography: perforation rates and potential radiation risks. Gastrointest Endosc Clin N Am. 2010 April; 20(2): 279–291.