Tiny Camera Seeks Answers

Thomas Peller, MD
Gastroenterology
Southside Medical Clinic, Eau Claire

Jahn Hansen, MD
Gastroenterology
Eau Claire GI Associates, Eau Claire

In the United States, millions of people suffer from diseases that can affect the small bowel. Unfortunately the length of the small bowel (average length 22 feet) prevents accurate imaging. A recent technological advancement in endoscopy however, is rapidly eliminating this problem.

In 2001, the FDA approved the use of a disposable camera, the size of a large vitamin pill is swallowed . The procedure is called capsule endoscopy or wireless endoscopy. The camera has a built in light, energy source and transmitter. As the camera passes through the intestinal tract, it takes two pictures per second. These images are transmitted to a receiver and a small computer that the patient wears around their waist. In order to transmit the images to the computer, eight electrodes are attached to the patient's chest and abdomen with an adhesive, similar in manner to those used during an EKG (electrocardiogram).The electrodes also help to locate the camera's position within the abdominal cavity.

A typical transit time for the camera through the small bowel is 8 hours, with over 50,000 pictures being obtained. The images are magnified, making it possible to see objects as small as 0.1 mm, which is less than 1/16 of an inch.

Most procedures are started in the morning, after an overnight fast, so that the test can be completed by the end of the day. Patients can continue with most of their usual activities, but vigorous movements, such as exercise, are not recommended.

The camera is swallowed with a glass of water after the electrodes have been placed. The patient is asked to keep a diary of the day's events and to return eight hours later to remove the electrodes and return the computer. The average time for a Gastroenterologist to review the images is 30 - 90 minutes.Patients are then asked to watch for passage of the camera in the next 72 hours. A single x-ray can be done if there is any question as to whether the camera has passed.

The capsule endoscopy is used to provide an examination of the small intestine. It is not meant as a means to evaluate the colon for diseases such as colon cancer or polyps, nor is it meant to evaluate the esophagus or stomach for diseases such as reflux or ulcers. The main use of the test is in evaluating patients with obscure bleeding from the intestinal tract. It is also used to evaluate patients for suspected Crohn's disease, chronic diarrhea and malabsorption.

This procedure should not be used in patients with known or suspected obstruction of the intestinal tract, patients with cardiac pacemakers, implanted cardiac defibrillators or pregnant women. The major complication of the procedure is failure to pass the camera. This occurs in less than 1% of patients.

Capsule endoscopy has improved GastroenterologistsŐ ability to evaluate the small intestine. Unfortunately, during the procedure no sampling of tissue or treatment of diseases is possible. It is hoped that future capsule designs will address these needs and allow for more complete evaluation.

For more information, call Dr. Thomas Peller, Southside Medical Clinic, Eau Claire » 715.830.9990,
Dr. Jahn Hansen, Eau Claire GI Associates » 715.552.7303