Patients invited to swallow a tiny camera to look for signs of bowel cancer

NHS England has launched the pilot of a new device to help detect bowel cancer, called a colon capsule endoscopy. The capsule is already being rolled out across Scotland and can be used as an alternative to a colonoscopy to help rule out bowel cancer.

What is the colon capsule endoscopy?

Colon capsule endoscopy involves swallowing a tiny camera that's about the size of a large vitamin pill. As the capsule travels through your bowel it takes thousands of pictures that are sent wirelessly to a digital recording device you wear over your shoulder like a small shoulder bag. This means you can go home and go about your day as normal. Within a day or two, the capsule should pass in a bowel movement.

The pictures taken by the capsule are examined by a specialist doctor called a colonoscopist, who will let you know if further investigation or treatment is needed.

If the test finds something suspicious, a specialist doctor will refer you for further investigation, such as a colonoscopy. If the capsule doesn't detect anything suspicious, there is no need for further testing for bowel cancer. Most people who have the test will not need further investigations. Read more about other common conditions that have similar symptoms to bowel cancer.

This is different to a traditional endoscopy, which is the current gold standard test for diagnosing bowel cancer. During an endoscopy, a small thin tube with a camera on the end is inserted through your back passage to look inside the body.

The new colon capsule endoscopy may avoid the need to go to hospital and help ensure that those who need further, potentially life-saving checks can get them more quickly.

What happens during the test?

• Before the test you will be asked to only eat food and drinks that help soften your poo. On the day before your test and on the morning of the test, you'll be asked to take a strong laxative. This helps makes sure your bowel is very clean so that the camera can get the best pictures. There is more preparation for a colon capsule endoscopy than a traditional colonoscopy.
• On the day a trained nurse will check that you're ready and fit you with a special belt or shoulder bag and receiver. You'll wear the belt and receiver at home during the whole test, which can take around six to eight hours. You'll be given the capsule to swallow.
• After the capsule has passed through your bowel, you can remove the belt and receiver. The next day you'll be asked to return the belt and receiver. A colonoscopist will review your test and your hospital doctor will discuss the results with you.

Why would I have this test?

You may have this test if:

• you have symptoms of bowel cancer
• you have a higher risk of having bowel diseases
• you were unable to have a colonoscopy. This could be for medical reasons or because you do not wish to undergo a colonoscopy.

How will this benefit patients?

Too many people are waiting too long for urgent investigations. The NHS endoscopy units have been overstretched for some time, even before the coronavirus pandemic. The NHS took the difficult decision to pause endoscopy services during lockdown, which has worsened the situation. While the majority of services have resumed there is a now a huge backlog of patients waiting for endoscopy procedures.

The colon capsule can be used to help rule out bowel cancer and should help reduce the demand for a colonoscopy. By reducing the pressure on NHS endoscopy units, patients with bowel cancer can be seen faster when their cancer is easier treat and their chances of survival are better.

The capsule is less invasive than a traditional colonoscopy. It can also be done from home, which reduces the burden of travel for patients who live further away from their nearest big hospital.

What are we doing?

We worked with the Scottish Capsule Programme (SCOTCAP) – a programme of work that evaluated whether the capsule could be a service introduced in Scotland. As part of the study we gathered the views and experiences of people who took part. We also gathered information to understand the reasons why people may have chosen not to take part in the study.

• Read more about how we plan to tackle the endoscopy crisis in our End the Capacity Crisis campaign
• Read more about the colon capsule endoscopy in Scotland
• Watch a video about the colon capsule endoscopy in Scotland, provided by Digital Health and Care Innovation Centre, Scotland