Capsule endoscopy: Doctors at UNC now use camera patients can swallow
CHAPEL HILL -- Physicians at the University of North Carolina at Chapel Hill School of Medicine are using cameras patients can swallow to look at the small intestine without surgery.
March 24, 2003
Capsule endoscopy: Doctors at UNC now use camera patients can swallow
By JOY BUCHANAN, UNC School of Medicine
CHAPEL HILL -- Physicians at the University of North Carolina at Chapel Hill School of Medicine are using cameras patients can swallow to look at the small intestine without surgery.
The new procedure is called capsule endoscopy. It allows gastroenterologists to take pictures of the small intestine where bleeding, inflammation and other causes of abdominal pain might occur.
“That's really the last frontier in visualizing the gastrointestinal system,” said Dr. Robert Sandler, professor of medicine and chief of the division of digestive diseases and nutrition at the medical school. “We’ve been able to see the esophagus, stomach and large intestine. The small intestine is really something that we've not been able to see.”
About 5 percent of digestive diseases occur in the small bowel, which cannot be visualized using colonoscopy or endoscopy, said Dr. Douglas Morgan, assistant professor of medicine at UNC. Thus, the only option has been open surgery.
“Studies show capsule endoscopy is better at finding the cause of bleeding in the small intestine than traditional exams,” Morgan said.
“Traditional methods find the source of bleeding about 15 percent of the time, but capsule endoscopy finds the source about 50 percent of the time.”
The capsule is about the size of a large vitamin. First, nurses attach eight sensors to the patient’s abdomen. The sensors link to a small data recorder worn by the patient. The patient then swallows the capsule with water. Flashing light emitting diodes, or LEDs, in the capsule light up the intestinal tract. The capsule’s camera takes two pictures per second – nearly 60,000 pictures after eight hours. Data from the capsule is transmitted to the recorder.
Patients can go about their normal routines as the capsule travels through the small intestine. The patient returns to the hospital eight hours later to drop off the data recorder. Images from the recorder are downloaded to a computer to view later. The patient passes the capsule in about two days.
Capsule endoscopy is not for everyone: People who are not candidates for surgery or who have known strictures or blockages in the digestive tract would not use the new exam. The capsule cannot take biopsies or remove abnormal tissue.
People who have had traditional colonoscopy or endoscopy exams can appreciate the less invasive nature of capsule endoscopy, which does not require anesthesia or long, flexible tubes snaked up through the colon or down the throat, said Morgan.
“We’re moving to an untethered patient – not tethered to a scope, not tethered to a doctor,” Morgan said.
The next generation of capsules will be maneuverable, will have longer lasting batteries and will be able to take tissue samples or cauterize bleeding areas, he said. “We’re going to continue to look for new technology that will set us apart,” Sandler said.
Along with Morgan, Drs. Ian Grimm and Kim Isaacs now use the technology at UNC. Morgan said UNC Hospitals anticipates performing about 100 such tests each year.
Note: Contact Sandler at (919) 966-0090 or robert_sandler@med.unc.edu. Contact Morgan at (919) 843-8104 or douglas_morgan@med.unc.edu.
School of Medicine contacts: Tom Hughes, (919) 966-6047 or tahughes@unch.unc.edu; and Leslie Lang , (919) 843-9687 or llang@med.unc.edu.
