Abstract: Systems and methods for guidance of a gastrointestinal device through a gastrointestinal tract are provided. A gastrointestinal guidewire is positioned through the gastrointestinal tract, by introduction of an introducing element into the gastrointestinal tract. One end of the gastrointestinal guidewire is attached to the introducing element, and the other end of the gastrointestinal guidewire is attached to an anchoring element, anchored to a location outside of the gastrointestinal tract. Movement of the introducing element through the gastrointestinal tract results in positioning of the guidewire through the gastrointestinal tract. The guidewire is then used as a scaffold to guide the gastrointestinal device, wherein the gastrointestinal device may be externally controlled. This allows for speeding up, slowing down, reversal and stopping of the gastrointestinal device during its descent through the gastrointestinal tract.