From the Guidelines
Patients can typically start eating 4 hours after swallowing a capsule endoscope, and normal diet can generally be resumed after 8 hours from capsule ingestion, as there is no strong evidence to suggest a specific post-ingestion dietary protocol after capsule endoscopy, but it is crucial to follow any specific instructions provided by your healthcare provider 1. The most recent and highest quality study on the use of video capsule endoscopy does not provide specific guidelines on post-ingestion dietary protocols, but it emphasizes the importance of ensuring the capsule reaches the small bowel within a certain time frame, especially in patients with poor GI motility or chronic narcotic use 1. Some general guidelines for endoscopy aftercare suggest that patients can return to their normal diet after the endoscopy, but this may not be directly applicable to capsule endoscopy 1. Key considerations for patients undergoing capsule endoscopy include:
- Avoiding strenuous physical activities and magnetic fields that might interfere with the recording equipment
- Following specific instructions provided by the healthcare provider, as protocols may vary slightly between facilities
- Understanding that the fasting period is crucial because food in the stomach or small intestine can obscure the camera's view and potentially affect the quality of the images obtained, which could impact diagnostic accuracy. It is essential to prioritize the patient's safety and the quality of the examination, and healthcare providers should provide individualized instructions based on the patient's specific needs and medical history 1.
From the Research
Post-Ingestion Dietary Protocol
The post-ingestion dietary protocol after capsule endoscopy is not strictly defined, but several studies provide insight into the use of various medications and preparations to improve the procedure's outcomes.
- The use of bowel purgatives and prokinetics has been investigated, with mixed results 2, 3, 4, 5.
- A study published in 2009 found that bowel purgatives and prokinetics do not improve completion rates or view quality at capsule endoscopy, and bowel purgatives reduce patient acceptability 2.
- In contrast, a 2011 study found that the use of polyethylene glycol and metoclopramide with the assistance of a real-time viewer can improve the completion rate and image quality of capsule endoscopy 3.
- Another study from 2011 found that intramuscular injection of metoclopramide decreases the gastric transit time but does not increase the complete examination rate of capsule endoscopy 4.
- A 2015 study evaluated the safety of a bowel preparation consisting of polyethylene glycol plus an oral sulfate solution for colon capsule endoscopy, finding it to be safe and effective 6.
- A 2010 study found that the administration of 10 mg metoclopramide orally 15 minutes before capsule ingestion did not significantly increase the rate of total enteroscopies and had no effect on transit times 5.
Medications and Preparations
Some medications and preparations that have been used in conjunction with capsule endoscopy include:
- Metoclopramide: a prokinetic agent that can help decrease gastric transit time 3, 4, 5.
- Polyethylene glycol: a bowel purgative that can help improve image quality and completion rates 3, 6.
- Oral sulfate solution: a bowel purgative that can be used in combination with polyethylene glycol to prepare the bowel for colon capsule endoscopy 6.
- Senna: a stimulant laxative that can be used to prepare the bowel for capsule endoscopy 6.
- Simethicone: an anti-foaming agent that can be used to improve image quality 2.