New Pill Camera Used in GI Diagnosis

It sounds like something from a science fiction movie - but patients at the University of New Mexico Endoscopy Center located in UNM Hospital, can now swallow a vitamin-size video camera that allows their physician to more accurately diagnose problems in the small intestine.

In 1981, an Israeli physician, Dr. Gavriel Iddan, began development of a video camera that would fit inside a pill.  It took 20 years for technology to catch up with Dr. Iddan with the approval in 2001 by the FDA of the Given Video Capsule.  This 11 x 26 mm capsule weighs only 4 gms (about 1/7th of an ounce) and contains a color video camera, a wireless radio frequency transmitter, 4 LED lights, and enough battery power to take 50,000 color images during its journey through the digestive tract.  A specially sealed biocompatible material protects the camera from stomach acids and powerful digestive enzymes during its 8 hour journey through the small intestine.

The camera represents a breakthrough in diagnostics of the small intestine when a physician suspects anemia due to intestinal bleeding, said Martin Kistin, M.D.,  within the UNM School of Medicine Department of Internal Medicine.  He and Edward Rose, M.D., a pediatric gastroenterologist, will be using the wireless capsule technology within the endoscopy center.

While the average adult digestive tract is approximately 30 feet in length, only the top four feet - which includes the esophagus, stomach and first portion of the small intestine, called the duodenum - is accessible through upper endoscopy (EGD) while lower endoscopy (colonoscopy) can evaluate only the colon and rectum.  In between the two lies the other 20 feet, the small intestine, where the process of digestion actually occurs.

"Traditional endoscopic tests cannot reach into the intestine and special imaging studies like a CT scan or MRI are not that useful in this circumstance," Kirsten said.  A radiology procedure, called a small bowel series, where x-rays are taken after a patient drinks a chalky solution of barium, has been available for many years, but x-rays can only give a shadowy picture of what is going on in the intestines.  "With a camera, you have sharp pictures being broadcast in real time," he said.

After the capsule is swallowed, it moves through the digestive track naturally with the aid of the peristaltic activity of the intestinal muscles. The patient comfortably continues with regular activities throughout the examination without feeling sensations resulting from the capsule's passage. During the 8-hour exam, the images are continuously transmitted to special antenna pads placed on the body and captured on a recording device about the size of a portable Walkman, which is worn about the patient's waist.

After the exam, the patient returns to the doctor's office and the recording device is removed. The stored images are transferred to a computer PC workstation where they are transformed into a digital movie, which the doctor can later examine on the computer monitor.   Patients are not required to retrieve and return the video capsule to the physician. It is disposable and expelled normally and effortlessly with the next bowel movement.

The camera is being used by both pediatric and general gastroenterologists to diagnose and subsequently treat diseases of the small intestine including Crohn's Disease, Celiac disease and other malabsorption disorders, benign and malignant tumors of the small intestine, vascular disorders, and medication related small bowel injury. 

Contact: Cindy Foster, 272-3322

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