This page is about colonic and pan-enteric capsule endoscopy. These are procedures which look at the lining of the large bowel (colon) or the lining of both the small and large bowel. The colon is the last part of the gut. The small bowel is the part that links the stomach to the colon. Please read this information carefully and make sure you follow the instructions about how to prepare. Please ask if you have any further questions before you attend.
A colonic capsule endoscopy is usually done when patients are unable or do not wish to have a colonoscopy to examine the colon. This procedure is an alternative to a colonoscopy (a procedure performed with a flexible camera which is inserted into the back passage).
A pan-enteric endoscopy is usually done when patients have symptoms which suggest a condition which causes chronic inflammation of the gut (such as Crohn’s disease), or when they already have a diagnosis, and they need repeat assessment.
The capsule is the size of a large vitamin pill (32 millimeters by 12 millimeters). The capsule contains two tiny cameras. You will be asked to swallow the capsule after following a low fibre diet for five days and taking medication to empty your bowel. The capsule takes images (pictures) which are transferred to a recorder which you will carry around in a shoulder bag. You will also need to wear a sensor belt around your waist.
We usually begin the procedure in the morning. During the procedure you will be given medication to help move the capsule through the gut. You will not be able to eat anything for most of the day.
The equipment is removed after the capsule has passed out of the body or the recorder flashes red continuously, which is when the battery runs out (usually after 14-15 hours).
If you are having a pan-enteric capsule endoscopy because you have or may have Crohn’s disease, you may be asked to swallow a capsule which breaks down in the bowel (a patency capsule) a few days before the actual procedure. This is to make sure that your small bowel does not contain any areas of narrowing (called strictures) which might mean the capsule could get stuck.
There is a small risk that the procedure may need to be repeated if:
- the capsule doesn’t leave the stomach
- the colon is not empty enough to see anything.
- the capsule runs out of battery before passing through the whole colon (this usually happens when the bowel is not empty enough).
- the capsule moves through the bowel too quickly.
We will contact you to arrange a new appointment if this is needed.
The main risk of colonic and pan-enteric capsule endoscopy is the failure of the capsule to pass through the small bowel. This risk is less than one in 100 patients (one per cent). The risk can be higher if you have Crohn’s disease. Therefore, we ask these patients to swallow a patency capsule first.
You may get side-effects from the medication to empty your Bowel (described below). You will need to take this medication the day before and the day of the procedure.
You must not have an MRI scan or be near an MRI scanner until the capsule has passed out of the body.
Please tell us if you are pregnant as the procedure must not be performed during pregnancy.
If you have a cardiac pacemaker or internal electromedical device, please let us know.
The most common reason for the capsule not passing through the small bowel is Crohn’s disease. Crohn’s disease causes the bowel to become inflamed and narrowed. Treatment with anti-inflammatory medication may allow the narrowed part of the bowel to heal. This may allow the capsule to pass through by itself.
If the capsule is stuck at the top or the bottom of the small bowel it may be possible to retrieve it using an endoscope. In rare cases the small bowel can be severely ulcerated, scarred or blocked and an operation may be needed to remove the capsule and to treat the disease.
For some patients capsule endoscopy can be performed at home. If this is the case, a courier will drop all the equipment you need at your home usually the day before the procedure.
On the day of the procedure, a member of staff will have a video consultation with you and show you how to put on the special belt and recorder. You will then swallow the capsule and continue your usual activities as normal.
The following day a courier will pick up the belt and the recorder so we can download and look at your bowel images.
There is a video on our Endoscopy Unit page with more information about having a capsule endoscopy at home.
Bowel preparation is used to clear the colon of faeces so that the lining of the bowel can be seen clearly during the procedure.
It is essential that you read and follow these instructions carefully before your procedure. You will be given a bowel preparation medicine called Moviprep®.
There are different steps to follow at each stage of your preparation as soon as you get your appointment:
- 7 days before the procedure
- 5 days before the procedure
- 1 day before the procedure
- On the day of the procedure
Please make a note of what you need to do at each stage as this will help make sure your procedure is successful.
It is unusual for Moviprep® bowel preparation to be harmful but there is a risk of developing dehydration, low blood pressure or kidney problems with this medication. People who are particularly at risk of dehydration and loss of salts include: frail elderly people, children, and people with renal impairment, congestive cardiac (heart) failure, liver cirrhosis, or taking diuretics (water tablets). Moviprep® is especially designed to be safe in these situations so the risk is very low.
If you are pregnant or think you might be, do not take the Moviprep as it could be very dangerous. Please contact the Endoscopy Unit for advice.
The type and seriousness of side effects differ from person to person. Possible ones are nausea or vomiting, bloating, stomach pain, soreness around the back passage and dehydration (please remember to drink plenty of fluids). If you have any allergic reactions including a rash, an itch, redness or swelling please seek medical advice.
Kidney disease
If you are under the care of a kidney clinic, or you know you have chronic kidney disease (CKD) grade 4 or 5, please discuss this with the capsule endoscopy team before starting any bowel preparation.
Tablets and other oral medicines should not be taken within one hour of taking Moviprep®. This is because the medicine may pass through your body too quickly and may not be absorbed properly, so it may not work as intended.
Please follow any specific instructions you have been given about your regular medicines. Your doctor may advise you to stop taking some medicines, including:
- Water tablets (diuretics)
- Pain relief medicines such as ibuprofen (NSAIDs)
Only stop these medicines if your doctor or nurse has
advised you to do so.
Important
If you take anti-rejection medicines after an organ transplant, speak to your transplant doctor before taking Moviprep® as Moviprep may make these medicines work less well.
Contraceptive advice
If you take oral contraceptive pill, use alternative contraception or extra precautions for 7 days after taking Moviprep®, as the pill may not work properly.
7 days before your appointment
- Stop taking iron tablets until after the procedure.
- Stop GLP-1 medicines (used for diabetes and weight loss), such as Ozempic® and Mounjaro®.
5 days before your appointment
Stop taking any medicines that can slow bowel movements, such as:
- Imodium®
- Lomotil®
- medicines containing opiates (for example, codeine phosphate)
Continue taking all other medicines as usual, including any regular laxatives, unless you have been advised otherwise.
Fluid advice
During the five days before your procedure, drink more fluids than usual. Aim to drink at least 2 litres of clear fluids or water each day (about 8 to 10 glasses) and continue this until the day of your procedure.
Please see the section below titled 'The day before your procedure' for a detailed list of clear fluids.
Diet advice
Do not eat high-fibre foods such as wholemeal bread, cereals, fruit or fruit juice, vegetables, nuts and seeds, salad, or muesli. Avoid eating red meat.
Please see the table below for a detailed food list.
Why this is important
High-fibre foods take a long time to digest and may still be in your bowel even after taking Moviprep®. This can make the pictures of your bowel unclear and may make the procedure less successful. For this reason, we recommend following a low-fibre diet for several days before your procedure.
What food to eat 5 days before procedure
| Food type | Foods to eat | Foods to AVOID |
|---|---|---|
| Cereals | Rice crisps, cornflakes, Frosties, sugar puffs | Wheat bran, All bran, Weetabix, Oat bran, Muesli, porridge, Bran flakes |
| Bread | White bread or toast, any bread made with white flour | Wholemeal, oat bread, any high fibre bread, soft grain or granary bread |
| Pasta/rice/potatoes | White rice, white pasta. mash and fried/boiled potatoes (do not eat the skin) | Wholemeal pasta, brown rice |
| Meat/poultry | Fish, chicken, turkey, and eggs - all should be plain, with no added herbs or seasonings (such as oregano or basil). If you are vegetarian, you may eat tofu or plain soya products | All red meat, seasonings like fresh ground peppercorns, herbs etc |
| Dairy | Milk, plain yoghurt, butter, margarine, custard, any cheese and cheese sauce | Fruit and fruit juice, vegetables, any seeds |
| Preserves, sweets and desserts | Seedless jam or Marmalade, Marmite, honey, lemon curd, vanilla ice cream, ice lolly, plain jelly, rich tea biscuits, sponge cakes | Sweets and spreads with nuts/pips/seeds, oatmeal, dried fruit, digestives, any nuts |
| Clear fluids | Water, black tea, black coffee, squash, and all types of sports drinks (Aim to drink at least 2 litres of these clear fluids each day for 5 days before your procedure. See the section below titled 'The day before your procedure' for a detailed list of clear fluids.) | |
Before 9am, have a light breakfast from the permitted list (please see page 11 for detailed food list). After this, do not eat any solid food until after your procedure. You should continue to drink plenty of clear fluids, as shown below.
| Drinks to include | Drinks to avoid |
|---|---|
| Water, black tea, black coffee, Lucozade and all other types of sports drinks, fizzy drinks e.g., Coke, ginger beer, tonic water, fruit squash or cordial (not blackcurrant), hot honey and lemon, Bovril, Consommé (clear soup), any sugar-based sweets, clear jelly | No milk or milk-based drinks during fasting. Avoid blackcurrant and fruit juice. |
At 7pm Mix the first Moviprep bag as directed: Dissolve the contents of sachet A and B into 1 litre of water. Drink this litre over 1-2 hours.
Moviprep® may be easier to tolerate if it is chilled. It can be made up in advance, kept in the fridge, and used within 24 hours. Drinking through a straw may also help. If you do not like the taste, you may add fruit squash (not blackcurrant) or drink a fizzy drink, such as bitter lemon, alongside it. Remember to drink additional clear fluids throughout fasting period.
What to expect after taking Moviprep
Moviprep® cleans your bowel, so stay near a toilet. You will have diarrhoea, usually starting a few hours after the first dose, and you may have crampy tummy pain. Going to the toilet often can make your bottom sore, so may use petroleum jelly or a barrier cream after going to the toilet to help prevent soreness.
Note: If you develop vomiting, severe diarrhoea with dizziness, headache and confusion, contact the Endoscopy unit during working hours. At other times please contact on-call endoscopy registrar via switchboard.
At 6 am (or an hour earlier if you have to travel a long way) please dissolve the last bag of Moviprep® (sachets A and B) into one litre of water and drink this over 1-2 hours to ensure the bowel is empty and clean. After you have drunk the Moviprep® please do not eat or drink anything until after the procedure has started.
Take your usual medications early in the morning unless instructed to do otherwise (should be taken 1-2 hours earlier before the capsule appointment).
Please wear loose fitting clothing, preferably a vest or T-shirt/loose top and trousers when attending your appointment, as the belt will be attached on top of it.
What happens when I arrive at Endoscopy unit?
When you arrive at the Endoscopy Unit, please report to reception. The capsule endoscopy team will then take you in for your procedure. We will take a brief medical history, note any medications you are taking, explain the procedure, and obtain your consent before the procedure.
Delays may sometimes occur due to unforeseen events. We try our best to see everyone on time, but please be patient if your appointment is delayed.
By law we must ask for your consent and will ask you to sign a consent form. This confirms that you agree to have the procedure and understand what it involves. Staff will explain all the risks, benefits and alternatives before they ask you to sign the form. If you are unsure about any aspect of the procedure, please speak with a member of staff again. Remember that if you change your mind you can withdraw your consent at any time.
It may be helpful for you to write down any questions or concerns you have as a reminder so that you make sure you ask about them. Please contact us before the procedure if you wish to discuss anything.
We will prepare you for the procedure by helping you to wear a sensor belt.
We will ask you to take a tablet called Prucalopride which will help the capsule move through your gut. We will ask you to swallow the capsule with water.
During the procedure the recorder will bleep to let you know that you must take action.
At Alert 1 you must drink 30 millilitres of Phospho-® soda and 50 millilitres of Gastrografin® solution diluted in a cup of water. Drink one litre of water over the next hour. This is to help the capsule move through your bowel and make sure it is empty. Wait for the next alert which can be Alert 2 or End of Procedure.
Do not worry if you get an alert with a 0 (zero) before Alert 1 – you can ignore this.
At Alert 2 you must drink 15 millilitres of Phospho-soda® and 50 millilitres of Gastrografin® solution diluted in a cup of water. Drink an additional 500 millilitres (half a litre) of water over the next hour. Wait for the next alert which can be Alert 3 or End of Procedure.
You may receive this alert after two hours if the capsule has not passed out of the body by itself. At Alert 3, you will need to insert a bisacodyl suppository into the rectum and let it dissolve. Wait for the next alert which can be Alert 4 or ‘End of Procedure’.
At Alert 4 you may eat a light meal. Wait for the ‘End of Procedure’ alert.
Once the procedure has ended, the End of Procedure Alert will appear, the recorder beeps and vibrates and shuts down automatically after five minutes.
Important
- Check every 30 minutes that the blue light on top of the recorder is blinking. This shows that images are being recorded properly.
- Stay active and continue your normal activities. Do not lie down or sleep.
If you feel sick while taking the boosters, or have problems with the equipment, contact the capsule endoscopy team during working hours (please see page 20 for contact details).
- For urgent medical problems outside working hours, contact the on-call gastroenterology registrar (please see page 20 for contact details).
When the procedure ends
The procedure ends if:
- you see the capsule pass, or
- the end of procedure screen appears
If this happens, you may remove the equipment and eat as normal.
If the capsule has not passed, wait for Alert 4 before eating.
Once the procedure is complete, put the equipment in the bag and return it promptly to the Endoscopy Unit, so the video can be downloaded and the equipment prepared for the next patient. The capsule is disposable and does not need to be returned.
*table*
Diagram showing the bowel preparation & boosters steps:
| Day before procedure | 19:00-21:00 - one bag of Moviprep® (sachets A and B) in one litre of water the night before the procedure |
|---|---|
| Day of procedure |
|
Note: The capsule may pass between alerts. If this happens, the procedure is complete and the equipment can be removed. There is no need to follow the next alert, and you may eat as normal.
The images acquired during your procedure will then be reviewed. If you have any problems after the procedure such as persistent abdominal pain, nausea, and vomiting, please contact us. Results can take up to 4 weeks to process. This is because of the time it takes to look at the large number of images. Results will be sent to your referring doctor.
You may wish to visit Medtronic: PillCam™ Capsule endoscopy
UCLH cannot accept responsibility for information provided by other organisations.
Capsule Endoscopy Booking Co-ordinator (appointment bookings and dietary advice before the procedure, Monday to Friday 09:00-17:00)
Direct line: 020 3447 7546
Switchboard: 0845 155 5000 / 020 3456 7890 ext. 75496
Email: uclh.
Endoscopy Capsule Nurse Practitioner (medical queries and queries after the procedure has begun, Monday to Friday 09:00-17:00)
Mobile: 07973 720116
Endoscopy Recovery (Monday to Friday 09:00-17:00)
Direct line: 020 3447 3282
Switchboard: 0845 155 5000 / 020 3456 7890 ext. 73282
On-call Gastroenterology Registrar (out of hours emergencies only)
Switchboard: 0845 155 5000 / 020 3456 7890
Address: Endoscopy Unit, University College Hospital, 2nd Floor Podium, 235 Euston Road, London, NW1 2BU
Services
Page last updated: 24 February 2026
Review due: 01 January 2028
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