Swallow this camera; watch what happens in your small intestine

A Jelly bean size camera used in capsule endoscopy.

A Jelly bean size camera.

It’s hard to believe any procedure could be a patient’s “favorite,” particularly when it comes to procedures involving the GI tract. But that’s exactly what a capsule endoscopy has become for University of Michigan Health System patients who need it.

The procedure involves swallowing a tiny camera the size of a jelly bean. The camera travels down past the stomach and into the small intestine, the organ responsible for breaking your sandwich down into carbohydrates, proteins and fat. Once there, the camera takes shots of your small intestine (50,000 to 60,000 digital images), the photos are transmitted into a recorder worn in a pouch strapped around  your waist. Then images are downloaded onto a computer. The physicians at the U-M Small Bowel Program have done between 3,500 and 4,000 endoscopy capsule studies since the FDA approved the procedure in 2001.

This photographic capsule helps us look for a variety of things in the small intestine, such as:

  • Sources of bleeding in the GI tract
  • Inflammation that can help us diagnose Crohn’s disease and other inflammatory bowel diseases
  • Signs of Crohn’s disease which can be monitored to help treat patients
  • Surveillance for Familial Adenomatous Polyposis (FAP), a genetic condition characterized by cancer    of the colon and rectum
  • Presence of polyps or bleeding in patients with chronic colitis
  • Changes in the lining of the small bowel in Celiac disease patients or information about how severe it is, changes and complications
  • Reasons for abdominal pain and diarrhea
  • Development of tumors or signs of cancer

It’s a procedure that patients don’t mind or feel. It’s painless and simple.

Before 2001, the only way to look at the small bowel was through a barium study. You’d have to drink this thick white barium, and have  x-rays taken of the small bowel. Those studies would provide no information about bleeding, just an image of the silhouette of the small bowel. The difference with capsule endoscopy was revolutionary. Over the years, the resolution has gotten much better. Companies keep improving imaging. We can see very subtle ulcers and areas that might bleed.

The technology is used best in the small bowel because it gives us the clearest, most precise image of the lining of the small bowel and visual access to the entire small intestine. A video capsule for use in the colon has recently been FDA approved, but the jury is still out on it because of the anatomical characteristics of the colon. The best way to look at colon is a still a colonoscopy because if we see something like a polyp in the colon, we fix it right there. The capsule is only a diagnostic tool and can’t treat or biopsy a lesion.

The capsule endoscopy is the ultimate disposable camera. It’s like swallowing a jelly bean. It passes naturally and patients never see it.

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laurelDr. Laurel Fisher completed her residency and fellowship training at the University of Michigan and then joined the faculty in 1994. She is a graduate of the Temple Univeristy School of Medicine. Dr. Fisher is the Director of the Capsule Endoscopy Program at the University of Michigan. She sees patients with obscure gastrointestinal (GI) bleeding, inflammatory bowel disorders, reflux disease, hepatitis C, and other disorders of the GI tract. Dr. Fisher sees patients at University Hospital in Ann Arbor, the U-M Northville Health Center and the U-M Livonia Center for Specialty Care.


The University of Michigan Digestive and Liver Health HS_180x180services is one of the largest programs in the country, providing prevention, diagnosis and treatment of diseases involving the gastrointestinal tract and liver. Our 60-plus physicians are experts in the diagnosis and treatment of all diseases of the gastrointestinal system.