by LaRusso LB

hospital care image (big) A capsule containing a tiny camera that takes pictures of the lining of the intestines is one tool doctors have to help detect polyps, cancer, and sources of bleeding in the small intestine that current tests cannot always find. The procedure is called capsule endoscopy.

How It Works

You swallow a small capsule that contains a camera. As the capsule passes through the small intestine, the camera snaps pictures 4 times per second. The capsule is eventually excreted naturally, without you feeling anything unusual.

As the capsule moves through the GI tract, it sends signals to a data recorder worn on a belt around your waist. You wear the recorder for about 8 hours as you go about your daily activities. The images stored on the data recorder can be downloaded to a computer and viewed by a physician.

The Hardware

Swallowing a capsule with a camera may seem like a science fiction plot, but the technology is available. The capsule and supporting system include:

  • A tiny camera and transmitter inside the capsule, which is about the size of a large vitamin.
  • Abdominal sensors (which are placed on your abdomen) pick up the transmission and send the information to a data recorder.
  • A data recorder which downloads images to a computer equipped with special software.

How This Technology Helps Doctors and Patients

In many cases, doctors rely on endoscopy to view the small intestine. This involves inserting a thin, lighted tube with a camera, down the throat, through the stomach, and into the small intestine. However, an endoscope cannot reach all of the 20-foot-long small intestine. Capsule endoscopy can provide pictures of the entire length of the small intestine.

This helps to find problems in the small intestine that may not have been previously be seen.

The capsule results are used along with other endoscopic and radiological tests to help make a diagnosis. It is not a replacement for these tests.

The capsule is able to detect signs of health conditions as it passes through the digestive tract. These may include:

Safety, Effectiveness, and the Future

The capsule is safe, but there may be minor side effects. Very rarely, the capsule can get stuck in the digestive tract and surgery may be required to remove it.

Studies done on the effectiveness of the capsule in the small intestine have been positive, especially when it is used to evaluate sources of bleeding. Capsule endoscopy has been found to be equal to or better than some other tests that are commonly used.

Some evidence shows that capsule endoscopy may also be effective in evaluations of the colon, but more evidence is needed. More research is being done on the effectiveness of capsule endoscopy in routine colon procedures.

The capsule may not be used on people with:

  • Cardiac pacemaker
  • Implanted electromagnetic devices
  • Intestinal blockage
  • Narrow small bowel
  • A abnormal connection between the bowel and another organ—fistula

Technology will bring improvements. Newer forms of the capsule may allow for controlling movement, biopsies, or dispensing medication. Capsule endoscopy is a peek into exciting medical innovations that may keep us healthy without certain hassles of endoscopies or colonoscopies.

RESOURCES

National Digestive Diseases Information Clearinghouse  http://digestive.niddk.nih.gov 

US Food and Drug Administration  http://www.fda.gov 

CANADIAN RESOURCES

Canadian Association of Gastroenterology  http://www.cag-acg.org 

Canadian Task Force on Preventive Health Care  http://canadiantaskforce.ca 

References

Acute upper nonvariceal gastrointestinal bleeding . EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T905671/Acute-upper-nonvariceal-gastrointestinal-bleeding . Updated July 15, 2014. Accessed October 27, 2014.

Colonoscopy. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T114112/Colonoscopy . Updated August 12, 2016. Accessed October 13, 2016.

Given diagnostic imaging system—K010312. US Food and Drug Administration website. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm085396.htm. Updated May 16, 2016. Accessed October 13, 2016.

Hale MF, Sidhu R, et al. Capsule endoscopy: Current practice and future directions. World J Gastrointest Endosc. 2014;20(24):7752-7759.

Leighton JA, Fleischer DE. The role of capsule endoscopy in GI practice in 2012. American Gastroenterological Association website. Available at: http://www.gastro.org/mobiletools/news-item/1299. Accessed October 13, 2016.

Sieg A. Capsule endoscopy compared with conventional colonoscopy for detection of colorectal neoplasms. World J Gastrointest Endosc. 2011;3(5):81-85.

Van Gossum A, Munoz-Navas M, et al. Capsule endoscopy versus colonoscopy for the detection of polyps and cancer. N Engl J Med. 2009;361(3):264-270.

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