SCOTTSDALE, Ariz. — August marks a significant 10-year anniversary for patients with digestive problems. Just one decade ago, in August 2001, the FDA approved use of capsule endoscopy technology to examine the last frontier of the human GI tract — the small bowel.
Mayo Clinic in Arizona was among the first medical centers in the U.S. to perform exams of the small bowel using the pioneering “pill camera” technology that can scan the far corners of the GI tract — painlessly and without surgery.
Over the past decade, Mayo Clinic as a three-site organization (Arizona, Florida and Minnesota) has completed more than 7,000 such exams, where patients swallow a vitamin-sized capsule that contains a miniature camera. The capsule then travels through the digestive tract, snapping thousands of pictures that are transmitted to a recorder that patients wear around their waist for eight to 12 hours. Images saved on the recorder are transferred to a computer to create a “video” of the digestive tract, enabling physicians to look for abnormalities.
The pill camera is not retrieved — patients are asked to watch for it after it passes through the system and is then flushed away.
Traditional endoscopy requires passing a flexible tube, equipped with a video camera, down the patient’s throat or through the rectum. Capsule endoscopy is non-invasive, does not require sedation and is done as an outpatient procedure. The new technology has also spawned other innovations to exam the small bowel for evidence of tumors, Crohn’s disease, inflammatory bowel disease, unexplained bleeding and celiac disease.
Such innovations include balloon-assisted enteroscopy, (visualization of the small bowel using a wireless scope) where a balloon allows instruments to pass further into the small bowel than previously possible, enhancing detection of problems.
“We have patients from all over the world who come to Mayo Clinic in Arizona for such exams that replace the need for invasive evaluation,” says Jonathan Leighton, M.D., Chair of the Division of Gastroenterology at Mayo Clinic. In addition to better diagnosis of disorders of the GI tract, therapy is also possible, using cauterization, to treat bleeding lesions, as well as treatment to remove polyps via endoscopes.
“Along with flexible fiberoptic endoscopy, videoendoscopy and therapeutic endoscopy, video capsule endoscopy represents one of the four revolutionary changes in digestive endoscopy,” says David Fleischer, M.D., Gastroenterology, Mayo Clinic in Arizona.
Mayo has published numerous scientific papers and textbooks in the field of new diagnostic tools for examination of the small bowel, and Mayo GI specialists have led national and international seminars in the field.
According to Shabana Pasha, M.D., gastroenterologist at Mayo Clinic and director of the Small Bowel Interest Group, capsule endoscopy has exceeded expectations in terms of non-invasive diagnosis of the small bowel. “This has made a significant impact for patients, in that the technology is superior to other imaging techniques and allows for complete imaging of the small bowel,” she says.
The future of non-invasive imaging technology for the GI tract shows promise for capsules that are smaller, can be “steered” to travel to designated areas of the small bowel and have a longer battery life. Also under development is a pill capsule that can potentially screen for colon cancer.
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