A colon capsule is a painless procedure which uses a camera to examine the large bowel (colon). Your bowel takes away the waste your body does not need.
The colon capsule test is a capsule which you swallow, and it contains two tiny cameras inside. It is around the size of a large vitamin tablet. The cameras take pictures of the lining of the bowel to look for any problems or signs of disease. This test can be used instead of a colonoscopy.
Why would I have this test?
There are a number of reasons why you may need an examination of your large bowel (colon):
- you have symptoms like a change in your bowel habit or blood in your stool (poo)
- you need a test to check for bowel diseases which you may be at risk of developing
- you’ve been referred for this test because you were unable to have a colonoscopy
Patients with pacemakers or internal electro-medical devices, or pregnant women should not have this test.
Before the test
For this test to work well your bowel needs to be very clean so the cameras get the best pictures.
Please stop any iron tablets for 7 days prior to procedure.
For 3 days before your test you will be asked to change your diet, and to have only the type of food and drinks which help soften your stools (poo). Please look at the table below which has all the foods that are allowed and those that should be avoided in the three days before your test.
Please remember that if we do not get good enough views of the colon we may need to repeat the test with all the bowel preparation. Please only eat foods from the permitted side of the table.
We ask that you eat no more solid food after 10am the day before the procedure. You may continue to take clear fluids until 6am the day of the procedure.
You will need to take some strong laxatives on the day before your test and again on the morning of the test. These laxatives and instruction letter should have been sent to you along with this leaflet. Please contact the endoscopy department if you have not received them.
We will ask you to take the first dose of bowel preparation at 7pm the night before the procedure. We encourage lots of clear fluids alongside this.
On the day of the test
You will need to take the second dose of bowel preparation at 6am. Please do not drink anything further after this.
You should attend the endoscopy department at Southmead hospital - Gate 13, usually at 10am. Your appointment will last around 30 minutes. There are no effects from the test which would stop you driving to or from the clinic.
A trained nurse will check you’re ready to start the test, answer any questions you may have and go through a consent form with you. The nurse will fit you with a special belt and receiver which you can wear underneath your clothes.
You’ll be given the capsule to swallow. The receiver will capture the pictures of your bowel which are sent wirelessly from the capsule. You can then return home.
When you are back at home
You wear the belt and receiver at home during the whole test which lasts around 6 hours. It is recommended that the belt is worn until bedtime or until the battery runs out.
The capsule will work its way through your intestines but in order to get a view of all of your bowels, throughout the day of your test you’ll be asked to take more laxatives which act as a “booster” to help move the capsule through your bowel. These will be given to you to take home when you attend to swallow the capsule. You may not need to take all of them depending on when you pass the capsule out in into the toilet.
- Booster 1 – this should be taken 2 hours after swallowing the capsule. The 2 ingredients are:
- 50ml Gastrografin and
- 30ml Fleet Phospho-soda.
- Please measure out and mix both of these with 1 litre of cold water and drink. You can add some light coloured cordial or squash, if you wish, to the mixture.
- Booster 2 – This should be taken 3 hours after the first booster if the capsule has still not been excreted. The measurements are different to Booster 1. This time:
- 50ml Gastrografin and
- 15ml of Fleet Phospho-soda.
- These are mixed with 500ml of cold water (cordial can be added again as above)
- Booster 3 – if the capsule has not been excreted 2 hours after the second booster, you will need to insert a suppository in to your bottom (rectum) to help it pass. This is labelled as booster 3 and is a bisacodyl suppository.
The capsule will normally pass out of your bowel in the afternoon or evening before you go to bed, and will just be flushed safely away down the toilet. Do not take any further boosters once you have seen the capsule pass. When the capsule has been passed, you can remove the belt and receiver and get back to normal activities.
You can resume eating and drinking as normal, either once you have seen the capsule pass, or after you use the suppository (booster 3). Before then, the fluid taking with the laxatives and the boosters will keep you from getting dehydrated.
If you do not see the capsule pass, remove the belt once the battery has become exhausted.
If you have any problems on the day of the test, please contact the endoscopy department on:
- 0117 414 1264 or 0117 414 1266
- Monday to Friday between 9am to 5pm
After the test
The day after the test you’ll be asked to return the belt and receiver back to the endoscopy department. The pictures from your test are uploaded from your recorder once it is returned. These pictures are then made into a video which is looked at by a trained doctor or nurse.
Further tests
Your consultant will decide whether you need another test based on your colon capsule report. For the majority of patients who have the colon capsule test, nothing will be found which leads them to have any further tests.
For patients who do need another test, this is usually because:
- the capsule has found something that needs further investigation
- the bowel wasn’t clean enough for the camera to record clear pictures
- the capsule didn’t make it all the way around the large bowel before the battery ran out
This further test may be a colonoscopy, or a shorter camera test called a flexible sigmoidoscopy. These tests are usually needed to either treat something found by the capsule or to take a sample from the lining of the bowel to get a diagnosis.
If you have either of these tests you will have to take more laxatives before you have the test. A follow up test may be done urgently depending on what is found on the colon capsule.
Are there any risks or complications with the colon capsule test?
Most patients who decide to have a colon capsule test have no problems. If there is a problem, it’s usually because of the laxatives you take before the test. The strong laxatives can cause a few patients to be sick and become dehydrated. If this does happen, you’ll feel better once you stop taking the laxatives.
Complications related to the capsule itself are rare. A very small number of patients may have some difficulty swallowing the capsule, but you’ll be asked about any issues with swallowing before you start your test. Additionally there is a very small risk of the capsule getting stuck in your intestines.
What if the capsule doesn’t pass through the bowel at the end of the test?
It may just be delayed and this is nothing to worry about. The capsule might get stuck on a narrow section of the bowel, if this happens then that’s usually an answer for why the test was needed.
The capsule very rarely causes any blockage which needs further treatment.
Following the test, you must not have an MRI test unless the capsule has been passed. If there is any doubt about this, you might need an X-ray to show that the capsule has been passed.
Foods allowed before your test
Please follow the low residue diet above for 3 to 4 days, instead of just the day before which may be stated in the leaflet of the bowel preparation you are provided with.
| Food type | Food allowed | Food to avoid |
|---|---|---|
| Fruits / Vegetables / Nuts | Fruit juice (strained with no bits). Only one glass a day if possible. Potatoes (without skins). | All fruit and vegetables. Potato skins, potatoes cooked in fats. Crisps, nuts, chutneys, and pickles. |
| Bread and cereals | Cereals e.g. Rice crispies, cornflakes. White bread and bread products. White rice, ground rice, semolina, tapioca. White pasta and flour, corn flour. | High fibre cereals, branflakes, weetabix. Brown rice/pasta/flour, pastries. Brown, wholemeal, granary breads. Porridge oats, muesli, fruit and fibre. |
| Cakes and biscuits | White flour crisp breads, meringue. Plain fat free cakes, scones, buns. Plain biscuits, rich tea. | Cakes with cream, fat, jam with seeds, fruit or nuts. Ryvita, shortbread. Biscuits containing high fibre/ fruit/nuts. |
| Meats and alternatives | Lean meats, poultry, liver, kidney. Quorn, tofu. | Fatty meats, poultry skin, duck, goose. Processed meat, luncheon meat, corned beef, black pudding, salami, sausages, and beef burgers. Pate, meat pies. Peas, beans, lentils. |
| Fish | White fish, smoked haddock, trout, salmon, tuna in brine, shell fish, prawns. | Fried or oily tinned fish, herring, kippers, mackerel, sardines, pilchards, anchovies. |
| Eggs | Boiled, poached or scrambled. | Fried eggs, omelettes, or scotch eggs. |
| Dairy products | Skimmed or semi skimmed milk. Low fat, flavoured yoghurt, fromage frais. Low fat cheese, shape, edam, brie, gouda, camembert, cottage cheese. | Full fat milk yoghurt or cheese, cream cheese or yoghurts containing fruit/nuts. Blue cheese, condensed/ evaporated milk full fat ice cream. |
| Fats | Low fat spreads, outline St. Ivel gold etc. Use sparingly. | Butter, margarine, lard, dripping, suet, vegetable oils. |
| Confectionery | Boiled sweets, fruit gums, pastilles, mints, jams without skins or pips, honey, sugar, treacle, syrup, jelly. | Chocolate, toffee, fudge, sweets containing fruit/nuts. Lemon curd, jams with pips or peel, mincemeat, marzipan. |
| Drinks | Tea, coffee, fruit squash, fizzy drinks, oxo, Bovril, low fat hot chocolate and malted drinks, some alcohol. | Full fat chocolate drinks, cocoa, cream-based liqueurs, e.g. Baileys. |
| Miscellaneous | Salt, pepper, herbs, spices, vinegar, ketchup, stock cubes. | Soups, peanut butter, cream or oil based salad dressings. |
Date published: 28 February 2024 Review due: 28 February 2027 PI number: BFT003366