How Long for Pillcam to Pass?

You can read about my adventures in arriving at my diagnosis of Crohn’s disease, which was ultimately made with the use of the Pillcam sb3 camera pill.

Information from the company that makes the Pillcam cites studies showing around a 2% retention rate. They define retention as not passing within 2 weeks. I’ve read in various places that the retention rate in Crohn’s disease can be higher than 5%.  The downside of a retained Pillcam is that it got stuck and could lead to an obstruction and it very possibly will require surgery to remove.  The upside (if there is one) is that the Pillcam likely identified a stricture – a narrowing in the bowel that can most easily be conceptualized as a result of scarring inside the intestines.  Severe strictures often require surgery anyway, so the surgery to remove the Pillcam can also include removal of the stricture.

From what I had read, the vast majority of Pillcams pass within 24hrs and 72hrs.

In my case, it didn’t pass until around 96hrs (4 days), so obviously there is some variation. I had gotten really bad stomach flu like symptoms (vomiting, severe loss of appetite, stomach pain) that started a few hours before I passed it, so I called my GI doc worrying I had retained it. I had a few bowel movements since taking the test, but I didn’t see the Pillcam. I figured maybe I just missed it as I think many people won’t notice it in the stool.

My GI doc reassured me saying they had seen the camera entering the colon. I think once it gets into the colon, it is probably much less likely to get caught up. Also, I’d had a colonoscopy a few years before that was clear, so it would be unlikely that something grew in my colon in the interim that could have led to a blockage. Nonetheless, they wanted me to check back later that day because they said maybe they would do an x-ray to see if it was still there.

The Pillcam passed a few hours later, but I still had the stomach flu symptoms for another 24 hrs. No idea if the Pillcam was related to my symptoms or not. My GI doc thinks maybe it did get hung up somewhere giving me symptoms, but there is no way to know. I would think that if the Pillcam really did make it into the colon, then it seems unlikely that it got hung up some where.

It seems most GI docs don’t seem to explicitly recommend closely watching your stools for the Pillcam to pass, but it seems to me that perhaps they should. And that they should do an x-ray after a certain number of days without seeing it.

My own thought is if you didn’t see it pass after 72hrs, I would give your doctor a call and see what they think. Obviously if you have pain or GI symptoms before that time, you should call them sooner.