Camera Pill Technology
New endoscopic technologies have made a major impact on the diagnosis and treatment of upper gastrointestinal tract (esophagus, stomach and duodenum) and colon diseases. Despite these advances, until recently there have not been many diagnostic options for problems in the small intestine. Now through the use of capsule endoscopy – a camera pill – the diagnostic capabilities in the small intestine have been significantly expanded. This technology is replacing more costly surgical and radiological procedures that were once used.
“Capsule endoscopy is an excellent diagnostic tool for patients with small intestine concerns,” says Richard Curtis, MD, Chief of Gastroenterology. “This non-invasive tool was designed for the purpose of investigating the GI tract in real time. It is a key tool in finding sources of bleeding within the small intestine, which otherwise are very difficult to detect. This is a high-quality procedure that we are able to provide for our patients at Newton-Wellesley Hospital.”
Capsule endoscopy is a technology that uses a tiny wireless camera, located in a pill-size capsule, to take pictures of the digestive track. The capsule is swallowed by the patient and takes photographs of the inside of the esophagus, stomach and small intestine as it travels through the GI tract. The small intestine, located between the stomach and colon, can be difficult to reach with traditional endoscopy imaging tests making this technology an excellent non-invasive option.
“Prior to capsule endoscopy, the only non-invasive way to diagnose these issues was using X-ray studies, which can’t detect small lesions that may be bleeding,” adds Dr. Curtis. “Most times enteroscopy would have to be used, which is performed in the operating room or with heavy sedation.”
How The Technology Works
On the morning of their capsule endoscopy study, patients come to Dr. Curtis’ office to receive instructions for the test.
“We meet with patients in the morning to walk them through how the technology works. We are with them when they swallow the capsule, which is the size of a large pill,” says Dr. Curtis. “The capsule contains a camera, an LED light, a battery and a built-in antenna. The antenna transmits the images to a small recording unit that the patient wears on their waist during the study. The unit is slim and lightweight and allows patients to go about their everyday activities with ease and comfort.”
As the capsule travels through the esophagus, stomach and small intestine, it takes photographs rapidly. The photographs are transmitted to the recording unit worn by the patient. At the end of the study, the photographs are downloaded from the receiver into a computer and reviewed by a Newton-Wellesley gastroenterologist. Using computer software, a video is made out of the images captured during the procedure.
“The capsule is about the size of a large vitamin pill and is easily swallowed,” adds Dr. Curtis. “Once swallowed, it cannot be felt as it moves through the body. Since we ask patients to limit their diet the night before a study, the pill has a clear view of the digestive track as it travels down. Patients can resume eating once the capsule has been swallowed.”
Patients do not need to collect the camera capsule – it can be safely flushed down the toilet. As each person’s digestive system is different, the body may expel the camera capsule within hours, or it may be expelled after several days.
“Patients are able to go about their normal activities while the study is taking place,” says Dr. Curtis. “We have them wear the recording unit for about eight to 10 hours to ensure we have the images we need. We have had great feedback from our patients. The study is very easy to complete. Other than limiting their diet the night before, there are no restrictions.”
Conditions Diagnosed with Pill
Physicians may recommend a capsule endoscopy procedure to diagnose the following conditions:
- Gastrointestinal bleeding – areas of bleeding that have not shown up on other diagnostic tests may be revealed.
- Crohn’s disease – the study may reveal areas of inflammation in the small intestine that can help your physician diagnose inflammatory bowel diseases, such as Crohn’s disease.
- Cancer – capsule endoscopy may show tumors in the small intestine or other parts of the digestive tract.
- Celiac disease – this technology can be used to diagnose and monitor celiac disease.
- Polyps – patients who have inherited syndromes that can cause polyps in the small intestine may occasionally undergo screening capsule endoscopy.
“We also recommend capsule endoscopy if a patient’s X-ray or other imaging test results were unusual or unclear,” says Dr. Curtis. “Our patients are very grateful to have a non-invasive testing option as their next step.”
In the future, as the capsule endoscopy technology continues to develop, Dr. Curtis explains there could be more uses for this diagnostic tool.
“We have started to use capsule endoscopy to diagnose problems in the esophagus like chronic reflux and Barrett’s esophagus,” says Dr. Curtis. “This is a great non-invasive alternative for our patients and we are turning to it more and more often.”
Currently, the capsule only has diagnostic capabilities, but Dr. Curtis believes this will change as it advances.
“In the future, I think we will be able to develop other capabilities such as the ability to perform biopsies or give injections,” adds Dr. Curtis. “Having therapeutic abilities would provide an even greater benefit to our patients. We are always looking for ways to provide the highest quality of care. New technologies – like capsule endoscopy – allow us to bring the patient care at Newton-Wellesley to new levels.”
For more information about Gastroenterology at Newton-Wellesley Hospital, please call CareFinder at 1-866-NWH-DOCS (694-3627) or visit www.nwh.org/gi.
Richard Curtis, MD
Chief of Gastroenterology
Dr. Curtis is board certified in internal medicine and gastroenterology. He received his medical degree from Cornell University and completed his residency at University Hospitals in Cleveland, Ohio and his fellowship in gastroenterology at Brigham and Women’s Hospital. Dr. Curtis is an associate professor of medicine at Tufts University.
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