Capsule endoscopy in Charlottenlund
At EndoCap in Charlottenlund north of Copenhagen, capsule endoscopy is part of an integrated specialist assessment. This page explains when investigating the small bowel is the right next step - and when it is not.
What the investigation is
Capsule endoscopy images the mucosa of the small bowel. The capsule records images as it passes naturally through the bowel. It cannot take biopsies, cannot treat, and cannot exclude all gastrointestinal disease.
Most of the small bowel is beyond the reach of ordinary gastroscopy and colonoscopy. Gastroscopy examines the duodenum, and colonoscopy may examine the terminal ileum. MR and CT enterography provide complementary assessment of the bowel wall and surrounding tissue. The clinician chooses the investigation according to the clinical question; not everyone needs both capsule endoscopy and MR/CT enterography.
Here the decision is medical rather than order-based: we review your history, previous investigations and current symptoms, and on that basis assess whether the small bowel is relevant to investigate.
When the investigation may be relevant
Following an individual medical assessment, capsule endoscopy may be relevant for:
- suspected small-bowel bleeding when gastroscopy and colonoscopy have not shown the cause
- selected cases of iron deficiency where the other investigations do not explain the finding
- suspected small-bowel Crohn's disease after negative ileocolonoscopy, without obstructive symptoms or known stenosis, and following clinical assessment
Capsule endoscopy is not a routine investigation for IBS or bloating alone. The symptoms are non-specific, and a normal result does not exclude another cause that needs to be clarified by other means.
Limitations
It matters to know the limits of the investigation before choosing it:
- no biopsies can be taken and no treatment can be delivered during the investigation
- a normal result does not exclude all disease - the source of bleeding is not always found
- the investigation may be incomplete if the capsule does not pass the whole small bowel within the recording time
- conditions outside the bowel wall are not assessed; cross-sectional imaging may be needed for that
Safety and the risk of retention
Before any capsule investigation we assess the risk of stricture (stenosis) and of the capsule being retained. Known or suspected stricture, previous abdominal surgery, radiotherapy or symptoms of obstruction all form part of that assessment.
For established Crohn's disease, ESGE recommends a dissolvable test capsule (patency capsule) before capsule endoscopy to reduce the risk of capsule retention. The clinician also assesses the need for MR or CT enterography.
Acute symptoms must not wait for the clinic to open
With significant or ongoing bleeding, fainting, a rapid pulse, marked pallor, severe abdominal pain or signs of bowel obstruction, seek acute medical care without waiting for the clinic. Call 112 for life-threatening symptoms in Denmark or Sweden, or the local emergency number outside Denmark and Sweden.
How it fits with the other investigations
The small bowel is rarely investigated first. The assessment usually builds on what gastroscopy and colonoscopy have shown:
Price
The price of capsule endoscopy and of the other investigations is listed on the pricing page. You are told the total price and any surcharges before you enter into an agreement.
Who assesses you
The clinic is led by consultant surgeon Bahir Hadi, who handles both the assessment and the follow-up. Some findings require onward referral to hospital or another specialty.
More about the capsule investigation itself
Technical and practical information about the capsule investigation is available on the separate site endokapsel.dk. This page is about the integrated specialist assessment at EndoCap.