A new camera-in-a-pill can help doctors diagnose and evaluate diseases of the esophagus including gastroesophageal reflux disease (GERD), erosive esophagitis and Barrett's esophagus (a pre-cancerous condition) without the use of a traditional endoscope.
"The camera is about the size of a large vitamin pill, and is a non-invasive diagnostic alternative to traditional endoscopy, the most common procedure used to examine the esophagus, " says gastroenterologist Dr. Michael Brown of Rush University Medical Center, the first center in Chicago to offer this to patients.
"In traditional endoscopy, a long, flexible tube (endoscope) is put into the mouth and advanced down the throat into the esophagus. It requires sedation and several hours of recovery.
With the camera pill, we now have a revolutionary technology that offers a quick, easy, office-based test that may help many people avoid traditional endoscopy. It may also encourage more people to see their doctor to get checked for diseases that if caught early can be treated effectively," he said
Brown says patients fast for two hours before swallowing the camera. The smooth plastic capsule is easily swallowed with a glass of water while the patient lies on his back. The patient is raised by a 30-degree angle every two minutes over a six-minute period until he is sitting upright. The capsule makes its way thought the esophagus in about three minutes. It then glides down the esophageal tract taking about 2,600 color digital pictures (14 per second), which are transmitted, to a recording device worn around the patients waist, as a belt. After 20 minutes, the physician has sufficient video images to make an evaluation. The capsule is passed naturally and painlessly from the body within 24 to 72 hours.
Studies show that camera, called PillCam ESO, is comparable in accuracy to traditional endoscopy. Also, unlike traditional endoscopy, the procedure requires no sedation, and patients can resume normal activity immediately.
Brown trains medical residents and to make sure they understand what the patients would experience, he and several other physicians each swallowed a capsule. Brown said it was easy to do, and he sees great benefits to patients. "It's a simple, safe and less invasive alternative. There is immediate recovery since there is no sedation, and a patient could drive himself home. There is little discomfort, and it's convenient."
According to health experts, an estimated 61 million Americans, or 44 percent of the US adult population, have heartburn at least once a month.
GERD is the third most prevalent disease in the US with the highest annual direct costs ($9.3 billion/year). Most of the 19 million GERD sufferers experience symptoms at least twice a week. Five to 15 percent of GERD patients may have Barrett's esophagus, a condition that increases the risk of developing esophageal cancer, the fastest growing type of cancer in America.
GERD sufferers are often treated with prescription or over-the-counter antacids. However, treatments that control symptoms do not prevent the development of more serious complications. "Millions of people are chronic antacid users and have never been evaluated for esophageal disease," says Brown. "We think that the pill camera will make it easier for people at risk to get that evaluation sooner and keep esophageal disease in check."
Brown cautions the pill camera is not for everyone. People with swallowing disorders, pacemakers or with known or suspected gastrointestinal obstruction, strictures, or fistulas are not candidates. Brown says the public may be familiar with the camera pill used for the small bowel/intestine. That camera has been used since 2001 and has been used in more than 150,000 patients nationwide.
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