User's Manual

Preparing for PillCam Capsule Endoscopy
Creating Patient Instructions for the Procedure 41
Post-ingestion Instructions for Procedures Involving Colon
Visualization
In general, the post-ingestion instructions should result in the preservation of proper cleanliness of the
colon during the procedure and also facilitate the timely progress of the PillCam COLON capsule in
the colon to visualize the entire colon before capsule burn-out or excretion. This is achieved by
instructing the patient in real-time during the procedure to conditionally follow a set of instructions
involving timely ingestion of prokinetics and laxatives. The post ingestion instructions are grouped in
a regimen that is selected by the physician from a library of possible regimens and are loaded into the
PillCam recorder DR3 during patient check-in (see Performing Patient Check-in on page 43) and they
are also printed out in a handout to the patient. During the PillCam COLON procedure, the PillCam
recorder DR3 alerts the user to perform the instructions detailed in the corresponding post-ingestion
instructions handout.
The post-ingestion instructions, i.e. a regimen, consists in general of the following conditional
instructions:
• Continue fasting until capsule leaves the stomach.
• If capsule is delayed in stomach, ingest a customized prokinetic agent.
• Intake the first boost laxative dose (and water when necessary) directly after capsule leaves the
stomach.
• Intake the second boost laxative dose (and water when necessary) 2 - 4 hours after the capsule
leaves the stomach.
• Eat a light meal (depending on capsule progress) 1 - 3 hours after second laxative.
• Take a suppository 1 - 2 hours after the meal (if required).
The execution of these instructions in a regimen is triggered by appropriate alerts from the PillCam
recorder which senses the fulfillment of the conditions for the respective instructions and cues the
patient during the procedure to refer to the associated instruction and execute it.
The difference between the regimens is in the use of specific laxative and prokinetic materials as well as
some timing differences associated with these different materials.
It may happen that the execution of the instructions, some of which drive the capsule through the
gastrointestinal tract, needs to be delayed until the patient reaches suitable environment for the intake of
the associated laxatives. Such a case is when the ingestion is at the physician's office but the rest of the
procedure may take place at the patient's home. Under such circumstances, it is desirable to delay the
capsule-driving instructions until the patient reaches home. The setting for delay of prompting by alerts
may be achieved by appropriate programming of the PillCam recorder DR3, either through check-in
(see Performing Patient Check-in on page 43) or through direct programming before capsule pairing
(see Setting Delay First Instruction in PillCam Recorder on page 79).
The Regimen Manager tool enables the creation and editing of post-ingestion patient instructions for
colon procedures.
Refer to the Regimen Manager section (Regimen Manager on page 183) to familiarize yourself with
this tool.
For pre-capsule ingestion regimen refer to Pre-ingestion Instruction Handouts on page 40, and for post-
capsule ingestion regimen, refer to Post-ingestion Instructions for Procedures Involving Colon
Visualization on page 41.