91110 Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report

Name of the Procedure:

Gastrointestinal Tract Imaging, Intraluminal (e.g., Capsule Endoscopy), Esophagus through Ileum, with Interpretation and Report

Summary

Gastrointestinal tract imaging through capsule endoscopy involves swallowing a small, pill-sized camera that takes thousands of pictures of the digestive tract. It's non-invasive and captures detailed images from the esophagus to the ileum.

Purpose

This procedure is primarily used to diagnose and evaluate conditions affecting the small intestine, including obscure gastrointestinal bleeding, Crohn’s disease, and small intestine tumors. The goal is to obtain clear images to facilitate accurate diagnosis and treatment planning.

Indications

• Unexplained gastrointestinal bleeding
• Suspected Crohn’s disease
• Small bowel tumors
• Unexplained abdominal pain
• Celiac disease with persistent symptoms
• Polyposis syndromes

Preparation

• Patients may need to fast overnight before the procedure.
• Some may require a bowel prep similar to that used for a colonoscopy.
• Certain medications may need to be temporarily paused as directed by a healthcare provider.

Procedure Description

1. The patient swallows a capsule containing a tiny wireless camera.
2. As the capsule travels through the digestive tract, it takes thousands of photos.
3. These images are transmitted to a recorder the patient wears on a belt.
4. After 8-12 hours, the capsule is naturally excreted in a bowel movement.
5. The images are downloaded from the recorder and reviewed by the physician.
6. The physician interprets the images and prepares a detailed report.

Duration

The capsule takes approximately 8-12 hours to travel through the digestive tract, but the actual time for swallowing the capsule and setting up the equipment is around 30 minutes.

Setting

This procedure is usually performed in an outpatient setting, such as a doctor's office or specialized clinic.

Personnel

• Gastroenterologist
• Nurse or medical assistant

Risks and Complications

• Retention of the capsule (rare, but may require retrieval via endoscopy or surgery)
• Discomfort in swallowing the capsule
• Technical failure or incomplete imaging

Benefits

• Provides comprehensive imaging of the small intestine, which is not easily accessible by other means.
• Non-invasive, with minimal discomfort.
• Helps in accurate diagnosis, leading to better targeted treatments.

Recovery

• Patients can go about their day while the capsule is inside them.
• Normal activities can be resumed immediately after capsule ingestion.
• No special post-procedure care is typically required.
• Follow-up appointments are to review the results with the physician.

Alternatives

• Traditional endoscopy or colonoscopy (more invasive, but may be needed for specific areas)
• Imaging studies like CT or MRI enterography (less detailed but useful in some contexts)
• Balloon-assisted enteroscopy (more invasive, used in specific diagnosed conditions)

Patient Experience

Patients swallowing the capsule may experience only minor discomfort. Throughout the day, they can carry on with regular activities, though they must avoid MRI machines until the capsule is excreted. Pain is minimal, and the non-invasive nature means a faster return to normalcy compared to traditional endoscopic procedures.