easy to swallow
new pill camera shows promise
[color=#31319c]april 19-sharon dunn, who had been suffering from severe abdominal pain and mysterious internal bleeding for more than a year, was at her wits' end about what to do.
after undergoing nearly a dozen tests, including a variety of invasive diagnostic procedures, doctors could not find the cause. with a demanding job as a flight attendant, and a young daughter to take care of, dunn considered her symptoms to be stress-related.
but then she swallowed a pill-sized diagnostic device equipped with a tiny videocamera. the camera quickly picked up the problem-and, dunn says, saved her life.
the camera test was administered by dr. blair lewis, a gastroenterologist at mt. sinai hospital in new york. lewis, who specializes in disorders of the small intestine, was contacted a few years ago by given imaging, an israeli-based company that had developed the pill-sized camera and was testing it.
initially, lewis was very skeptical that a tiny camera could live up to all the hype.
"it seemed sort of far-fetched that pictures could be transmitted out of the body," he remembers. "that there could be a capsule small enough that people could swallow."
at the time, doctors were already using miniature cameras at the end of fiber-optic tubes that were inserted into the digestive system from above or below. but those cameras could not reach one part of the digestive system: the small intestine, a narrow, 21-foot-long tube connecting the stomach to the large intestine or colon. the new device, known formally as the given diagnostic imaging system, was so small it could even pass through the small intestine.
as the device passes through the digestive system, it takes two pictures every second, transmitting them wirelessly to a receiver pack that the patient wears like a belt. during the eight-hour voyage through the digestive tract, the camera transmits around 50,000 images.
lewis explains that the vitamin-sized pill is packed with more than just promise.
"there's a lens in front, and then behind it is the chip. now, the chip is actually fascinating. and it's very inexpensive. it requires very little energy to power it. that's why only two batteries inside will power it for eight hours. there's a wide-angle lens inside. there's also a color television transmitter in the back and an antenna all packed into this pill," he says.
nearly an hour and a half after the pill camera began its journey through dunn's digestive system, it found she had a grapefruit-sized growth inside her small intestine.
despite receiving the bad news that she had cancer, the good news was that this device had finally found it and the disease could soon be treated.
"if you don't know the problem, then you can't fix it," dunn says. "and it was clear that with all the tests that i had in the past that nothing was ever found. this camera was able to spot it. it saved my life."
lewis says the camera pill is proving far more helpful than he ever imagined.
"we've examined approximately 120 patients at this point and the majority come in with unexplained bleeding. and they've gone through an average of 10 tests without a diagnosis made. that means two or three colonoscopies, two and three upper endoscopies, small bowel series, cat scans and no diagnosis made," he says.
"sixty to 65 percent of the time we're able to make a diagnosis of where their bleeding emanates from. and then guide their therapy," says lewis. "that's a huge payoff."
dr. david cave, lead investigator of the pill camera clinical trials and chief of gastroenterology at st. elizabeth's medical center in boston, believes the capsule should not be the first diagnostic procedure patients undergo to diagnose gi bleeding. it should be the third option, behind endoscopy and colonoscopy.
and although it's effective in diagnosing problems of the small intestine, it is not, at least at this point, going to replace the colonoscopy.
"the battery only lasts seven to eight hours," explains cave. "by the time it gets through the small intestine, it starts to run out. also, the colon doesn't move the capsule properly because of the way it contracts. and the colon is so big, that we're not sure where the camera is pointing, as opposed to the small intestine which is much narrower."
nevertheless, the pill that dunn says probably saved her life will now also be used to keep track of what is going on inside her during and after treatment. "i will be swallowing capsules in the future because that's the only way that they will be able to determine if it grows back," she says.
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