Capsule Endoscopy in Sharjah

What is capsule endoscopy?

Capsule endoscopy is a way of seeing the small intestine, the long, coiled middle section of the gut between the stomach and the large bowel. That stretch is several metres long and folded on itself, and it lies largely beyond the reach of a gastroscope from above and a colonoscope from below. The capsule solves this by making the journey itself.

The capsule is about the size of a large vitamin tablet. Inside a smooth, sealed shell sit a tiny camera, a light source and a battery. Once swallowed, it is carried along by the natural squeezing movements of the gut, taking many thousands of still pictures on the way. These are sent wirelessly to a small recorder worn on a belt or shoulder strap, connected to sensors on the tummy or built into a belt. The capsule is single-use and leaves the body naturally with a bowel movement.

Afterwards, the recorded images are downloaded and put together as a video. Reading it is careful work: the gastroenterologist steps through the footage looking for bleeding points, inflamed or ulcerated areas, small blood-vessel abnormalities and growths. At Dar Al Kamal Hospital, Sharjah, capsule endoscopy sits within the gastroenterology service, so the doctor who reads your study is the same specialist who sees you in clinic.

Who needs it

Capsule endoscopy is usually a second-line test. It comes after a gastroscopy and a colonoscopy have examined the top and bottom of the gut and a question remains about the middle. The commonest reasons are:

• Hidden bleeding: blood in the stool, black stools or a positive stool test, with both scopes looking normal
• Iron deficiency anaemia that keeps returning, where the source of blood loss is still unexplained
• Suspected Crohn's disease affecting the small bowel, or checking its extent in someone already diagnosed, alongside Crohn's disease management
• Unexplained tummy pain, diarrhoea or weight loss with markers of inflammation in the blood or stool
• Follow-up of certain inherited conditions that cause polyps in the small bowel
• Assessing the small bowel in coeliac disease that responds poorly to a gluten-free diet

Your gastroenterologist weighs your symptoms, blood results and earlier scope reports before recommending the test, and explains what question the capsule is expected to answer.

What happens

You arrive in the morning with an empty stomach. The team fits the recorder and positions the sensors or belt, checks that everything is receiving, and then you swallow the capsule with a glass of water. It goes down like a large tablet, and most people are surprised how ordinary it feels.

Once the capsule is on its way, you are free to leave the hospital and carry on with gentle daily activities such as reading, desk work or walking. You are given a clear timetable for when you may drink clear fluids and when you may have a light meal, because food in the gut blocks the view. Keep the recorder on, dry and close to your body for the whole recording, and avoid strenuous exercise, bending repeatedly and strong magnetic fields, including MRI scanners, during this time.

At the agreed time you return the recorder, or the team explains how to remove it and bring it back. The capsule continues on its way and passes out in the stool over the following days. Most people see nothing of it, and it is simply flushed away.

Preparing for it

Good preparation gives clear pictures. You are given written instructions, which usually include:

• A light, low-fibre diet the day before, then fasting overnight
• A bowel-cleansing preparation in some cases, to clear the small bowel for the camera
• Pausing iron supplements for a few days, as they darken the gut lining
• Guidance on any other medicines, especially diabetes treatment, blood thinners and weight-loss injections

Tell the team about swallowing difficulties, previous bowel surgery, bowel narrowing, a pacemaker or other implanted device, and pregnancy. In some patients the gastroenterologist arranges a patency check first. This uses a dissolvable dummy capsule the same size as the real one, or a scan, to confirm the bowel is wide enough for the camera to pass.

If you are observing Ramadan, the test is best planned outside the fasting month or discussed with the team, as the drinking and eating timetable during the recording rarely fits the fasting day. In the Sharjah heat, drink plenty the day before your fast begins.

Afterwards

When the recording ends, you return to your normal diet and activities. The images are downloaded and reviewed, and the gastroenterologist explains the findings at a follow-up appointment. Depending on the result, the next step may be medication, a treatment plan for Crohn's disease, a further scope to reach and treat a bleeding point, or reassurance.

Keep an eye on your stools for the next couple of weeks if asked, and avoid MRI scans until the team is confident the capsule has passed. If you are unsure whether it has gone, tell the team, who may arrange an X-ray to check.

Contact the team urgently if you develop tummy pain, vomiting or bloating after swallowing the capsule, as these can be signs it is held up. Go to the emergency department straight away if pain is severe, you are vomiting repeatedly, or you pass blood. For questions about results, call 06 599 7777.

Cost and insurance

Many UAE health insurance plans cover capsule endoscopy when it follows a gastroscopy and colonoscopy for bleeding, anaemia or suspected Crohn's disease, and pre-approval is almost always required. Insurers usually ask for the earlier scope reports and blood results, so keep these to hand. Dar Al Kamal Hospital, Sharjah can help you check your cover and arrange pre-approval on 06 599 7777.