Wireless Motility Capsule (SmartPill)
The SmartPill measures the function of the bowel whilst you are in the comfort of your own surroundings without the need for invasive intubation, exposure to radiation or a frequent hospital visits. You will only spend about 30 minutes in the clinic; when the capsule is passed naturally with a bowel movement you can contact the department to arrange a convenient time to return the receiver box. Your doctor will be able to explain your upper and lower gut symptoms with one simple test.
What can be learned from the SmartPill Test?
The SmartPill wireless motility capsule works by taking a series of measurements and monitoring pressure as the capsule travels through the gastrointestinal tract over several days.
The device captures ‘events’ such as meals, bowel movements and symptomatic episodes such as bloating, nausea or abdominal pain. It also identifies changes in acidity in different sections of the GI tract and measures how strongly (or weakly) the gut contracts during the test. This gives a comprehensive picture of how the whole gut is functioning.
The capsule is about the same size as a large vitamin capsule and you should let the team know if you have difficulty with swallowing. Once you have swallowed the SmartPill, you will be fitted with a small recording unit that receives wireless transmissions from the capsule. After you are discharged you need to wear the data receiver for approximately one to five days, but can resume normal daily activities.
Once the test is complete you must return the data receiver so the results can be analysed and an appointment will be arranged with you to discuss them. You do not have to make another appointment for the removal of the SmartPill as this passes through your bowel naturally. Most studies last one to three days and you will know when the study is over when the capsule is passed with a bowel movement and stops transmitting to the box. A small cross will be displayed to show the capsule is no longer transmitting.
As with all ingestible capsule devices there some risks (although rare) involved with the procedure:
Capsule aspiration(going into the wind-pipe) during swallowing – there have been a very few cases of this happening, however, patients with proven or suspected swallowing disorders should not be referred for the test. If you have trouble swallowing tablets, please inform your consultant.
Capsule retention(not passing naturally or getting ‘stuck’ in the bowel) – there is a less than 1% report of the SmartPill being retained for longer than 7 days after being swallowed. These have all been either passed naturally or required a further non surgical procedure to retrieve the capsule.
In the extreme event this is retained within the small bowel a surgical option may be considered and an operation to remove it may be required. In the event of a complication or emergency, patient care will be consultant led and you should call your consultant on the emergency number provided.
Preparation & Medication
In order for the test to be successful, it is important to follow the instructions below:
Evening before the test:
- Fast (do not eat anything) from 12 midnight the night before the test (you can have water in the morning).
- Do not use tobacco during the fasting period.
- Do not drink alcohol 24 hours before the test and for the duration of the test.
- Seek advice about medications that you may have to stop.
- If you are a diabetic, consult your doctor about whether to stop insulin the evening before.
For the duration of the test:
- Wear the data receiver at all times.
- Do not allow the receiver to get wet (please place within close proximity when you bathe).
- Do not use the neck cord used to carry the data receiver whilst sleeping.
- Do not eat food for 6 hours once you’ve swallowed the capsule as this may affect the results.
- If you are thirsty you may have small quantities of water during the 6 hour period amounting to ½ a cup of water in total.
- After 6 hours you can resume your normal diet.
During the test you must not:
- Use any medication that affects bowel movement until after the Smartpill has passed.
- Partake in rigorous exercises that target the abdomen area and aerobic activity that lasts for more than 15 minutes.
- Flush the toilet immediately after each bowel movement; wait 1-2 minutes.
- Undergo an MRI as this may have other health implications.
You will be advised about which medications you should stop before the test.