July 17, 2007
A pill-sized video camera is giving doctors a clear view inside the small intestine
"Video capsule endoscopy is essentially a capsule that enables the doctor to examine the patient's entire small intestine," explains Joseph Fares, MD, a gastroenterologist on staff at the hospital.
Here's one "photo op" that's more than a pretty picture. It's a detailed study of your small bowel taken from the inside by the Pillcam video capsule endoscopy system, a new diagnostic marvel at John C. Lincoln Deer Valley Hospital. Its availability underscores John C. Lincoln's commitment to leading edge technologies that have a beneficial impact on patient care.
"When we do upper GI scope-type exams, we can examine the stomach and the uppermost part of the small bowel, and when we do colonoscopy, we examine the large intestine or colon. But much of the small bowel is usually inaccessible to conventional endoscopic examination. This is where Pillcam comes in and why it's so important," he says.
Pamela Rodgers, who describes herself as a "young 60-year-old," recently underwent the Pillcam™ procedure at John C. Lincoln Deer Valley Hospital. "I initially came to the hospital because they thought I was having problems with my heart," she says. "In the ER, they found I was three units low on blood. They hospitalized me, gave me the blood transfusions I needed, and my GI doctor did a colonoscopy and scoped my esophagus and stomach looking for the source of my bleeding. Unfortunately, my doctor couldn't find the bleeder. So he asked me if I would swallow the camera pill, and I told him I would."
Pamela was able to have the procedure as an outpatient after being discharged from the hospital. It didn't slow her down much at all — she could go her merry way and engage in normal activities, as long as she didn't do anything too strenuous.
"The night before the procedure," she recalls, "I had to drink a bottle of laxative to help cleanse my upper GI tract. I had to stick to a clear liquid diet, and I couldn't eat anything after midnight the day before. I went into the hospital and they gave me the camera pill to swallow at about 6:45 a.m. that day. It was a pretty good-sized pill, but it went down just fine. I had no problems."
"The Pillcam is essentially the size of a vitamin pill. It has been made smooth so that it can be swallowed easily. It contains a camera, a light source and a battery with a battery life of about eight hours," Dr. Fares explains.
Patients simply swallow the Pillcam capsule with a glass of water. Eight small sensors are attached to the patient's abdomen. The sensors are connected to a small device that the patient wears in a belt around his or her waist.
As the Pillcam capsule passes naturally through the patient's digestive tract, the capsule captures images at a rate of two images per second — or about 55,000 images in approximately eight hours. The capsule is disposable and eventually excreted by the patient.
Pamela could consume clear liquids two hours later, and eat a regular meal within four hours. She was asked to return to the hospital at 2:45 p.m., eight hours after swallowing the camera. The nurses removed the sensors from her stomach as well as the belt containing the device. And that was all there was to it.
Considering its benefits, the state-of-the-art Pillcam is an easy pill for patients to swallow, according to gastroenterologist Joseph Fares, MD.
The captured images are downloaded and processed on a special workstation for analysis. The imaging quality is superb — in fact, superior to that of conventional methods physicians use to look inside. The system lets doctors see extremely fine detail of the intestinal wall. No sedation or anesthesia is required for the procedure, and it may be performed on bedridden hospitalized patients as well as active outpatients.
The system has been shown to be remarkably effective in diagnosing upper GI illness when conventional diagnostic methods — including scopes and barium X-ray studies — show nothing wrong but the patient isn't getting better.
While there are several possible medical reasons to use Pillcam, Dr. Fares says the main reason is when patients are experiencing GI bleeding and the source cannot be identified by upper and lower GI endoscopies.
At press time, Pamela was still awaiting the results of her test, but she had very positive things to say about the experience. "It was much better than the other two procedures. It was a lot easier — and I had no pain whatsoever!"
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