Capsule Endoscopy
Gastroenterologists now have a newer but already well-established tool for taking pictures of the digestive tract without x-rays, magnetic fields, scopes or invasive steps at all. In fact, this new technology permits them to record images of the gastrointestinal tract from the inside with one easy step. Just swallow a pill.
But not just any pill: a miniaturized, wireless camera in a capsule small to enough be swallowed and later to pass with a bowel movement when its job is done. No retrieval necessary, the PillCam is flushed away (passing within 24 hours). Known as capsule endoscopy, this type of evaluation is growing in use and meeting with increasing popularity among patients and specialists when an internal investigation is necessary for GI symptoms.
Pictures Collected in a Day
The PillCam is no bigger than a large vitamin tablet and so is not difficult to swallow. During the day of the test, the patient wears sensors attached adhesively to the pelvis to pick up the digital pictures that the capsule transmits during its passage through the digestive tract. These pictures can reveal bleeding, growths, tumors, and irritation or inflammation. It can help determine the location and severity of these and other abnormalities.
The patient wears a belt with pouch containing a device that records the pictures from the PillCam during the day of its transit through the bowel. The tiny camera takes tens of thousands of images as it travels the length of the GI passage. The test is easy and completely painless for the patient to undergo. It helps the patient avoid diagnostic or exploratory steps that can include exposure to beam radiation, sedation for endoscopy or incisions for laparoscopic or surgical investigation of GI problems.
The tablet used for video endoscopy measures just one inch and weighs just four grams. Patients easily swallow and expel it. Each capsule contains a lens, imaging device, LED light and transmitter.
Best Look at the Small Intestine
Standard GI endoscopy involves passing a long, flexible tube equipped with a video camera orally into the esophagus or rectally into the colon. But these procedures cannot show the middle section of the digestive tract, consisting of a significant length of the small intestine. And, they require sedation as well as bowel preparation steps by the patient prior to the procedure.
The PillCam procedure can detect such conditions as:
- ulcers;
- vascular abnormalities;
- inflammatory bowel disease;
- celiac disease;
- colorectal polyps or cancer;
- and other abnormalities.
Gastroenterologists use capsule endoscopy primarily to study the small intestine, through which the camera passes in the course of about eight hours. The device is especially useful for the examining this mid-portion of the GI tract, a portion of the small intestine that specialists cannot view using upper endoscopy or colonoscopy. The new generation of PillCam (SB2), used at Lourdes, offers an even wider field of view and higher frame rate, for images that capture the greatest amount of internal intestinal surface. The capsule endoscopy procedure is also useful after certain treatments for follow-up examinations of the GI tract.
Now Also Focused on the Esophagus, with Special Colon Studies to Come
Additionally, Lourdes' gastroenterologists now offer a special form of capsule endoscopy designed for evaluation of the lining of the esophagus and stomach (PillCam ESO). The ESO PillCam capsule records images at a high capture rate from both ends of the capsule, providing a near 360º view of reach inch of the esophagus that it passes through. The images can reveal:
- inflammation of the esophagus (often caused by gastroesophageal reflux or GERD);
- tissue damage and changes that characterize Barrett's esophagus;
- swollen veins in the esophagus that pose a danger of bleeding;
- irritation or ulceration in the esophagus or stomach.
Imaging of this short, initial stretch of the digestive system takes only a few minutes. (The PillCam then passes through the GI system as with standard capsule endoscopy.) The Lourdes team can perform the entire PillCam ESO imaging procedure in about a half-hour and can interpret the results quickly.
On the horizon, as well, is a similar procedure (still awaiting approval in the U.S. by the FDA) that the staff expects to have available in the future at Lourdes: PillCam COLON, a form of capsule endoscopy used to study polyps or cancerous areas in the bowel (large intestine). As with PillCam ESO, the test is useful when standard PillCAM has not adequately visualized these areas, or for patients who are unwilling or unable to undergo traditional endoscopy. The bidirectional capsule is similar to the one used for PillCam ESO, with a wide image coverage area and depth of field. The patient swallows the capsule, as with other PillCam procedures, and the image capture is maximized when the capsule reaches the colon.
Experienced Center for Pill Endoscopy
Lourdes specialists and staff have undergone special training to deliver this advanced from of gastrointestinal imaging. The GI staff provides capsule endoscopy successfully to Lourdes patients for purposes of diagnosing a variety of conditions.
Results have shown a high level of patient satisfaction due to the convenience and pain-free nature of capsule endoscopy—and research shows reliable results from this form of imaging. The FDA approved the PillCam in 2004, and most insurance plans cover the majority of the cost of the procedure.
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