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Objectives Rapid transit risks inadequate oesophageal capsule endoscopy. Success rate, completion of examination, time taken to read the video and impact on management of a novel dual camera capsule capable of 35 frames per second were determined.Methods Patients referred for screening or surveillance of oesophagogastric varices who declined gastroscopy and throughout the COVID-19 pandemic were examined by capsule endoscopy using the PillCam UGI capsule.Results Capsule endoscopy was performed on 207 patients (median (IQR) age 62 (±18), 53% men). The median reading time was 4 (±2) min. Oesophageal views were complete in 205 (99%); no views were obtained in 2 (1%) patients. Cardiac views were complete in 197 (86.5%), partial in 11 (5.3%) and not seen in 17 (8.21%). Fundal views were complete in 108 (52.2%), partial in 27 (13%) and not seen in 72 (34.8%). Oesophagogastric varices were detected in 58 (28%) patients, mostly (55 (94.2%)) oesophageal varices (38 (66%) grade 1). Overall, 23 (11.1%) patients required further management on the basis of capsule endoscopy findings, and gastroscopy was avoided in 194 (94%) of patients. During a median follow-up period of 24 months (±19), two patients were successfully treated for variceal bleeding. Capsule retention required endoscopic retrieval in one patient (0.5%).Conclusions A dual camera capsule endoscope capturing 35 frames per second provided excellent oesophageal views, avoided gastroscopy in the majority of patients and effectively and safely guided management.