Capsule endoscopy: The ultimate disposable camera

by Laurel Fischer, MD

Swallow this camera; watch what happens in your small intestine

It’s hard to believe any procedure could be a patient’s favorite, particularly when it comes to gastrointestinal procedures. But that’s exactly what a capsule endoscopy has become for patients who need it to diagnose digestive health issues.

The procedure involves swallowing a tiny camera the size of a jellybean. The camera travels down past the stomach and into the small intestine, the organ responsible for breaking your sandwich down into carbohydrates, proteins and fat.

Once there, the camera takes photos of your small intestine — 50,000 to 60,000 digital images – and the shots are transmitted into a recorder worn in a pouch strapped around your waist.

Images are then downloaded onto a computer.

What’s happening in the small bowel

The University of Michigan Health System has done nearly 4,000 endoscopy capsule studies since the FDA approved the procedure in 2001.

This photographic capsule helps us look for a variety of things in the small bowel, such as:

• Sources of bleeding in the gastrointestinal tract
• Inflammation that can help us diagnose Crohn’s disease and other inflammatory bowel diseases
• Signs of Crohn’s disease which can be monitored to help treat patients
• Surveillance for Familial Adenomatous Polyposis (FAP), a genetic condition characterized by cancer of the colon and rectum
• Presence of polyps or bleeding in patients with chronic colitis
• Changes in the lining of the small bowel in Celiac disease patients or information about how severe it is, changes and complications
• Reasons for abdominal pain and diarrhea
• Development of tumors or signs of cancer

Goodbye barium

Before 2001, the only way to look at the small bowel was through a barium study. You’d have to drink thick white barium, and have x-rays taken of the small bowel. Those studies would provide no information about bleeding, just an image of the silhouette of the small bowel. The difference with capsule endoscopies was revolutionary.

Over the years, the resolution has gotten much better. Companies keep improving imaging. We can see very subtle ulcers and areas that might bleed.

Clear, precise images

The technology is used best in the small bowel because it gives us the clearest, most precise image of the lining of the small bowel and visual access to the entire small intestine. A video capsule for use in the colon has recently been FDA approved, but the jury is still out on it because of the anatomical characteristics of the colon.

The best way to look at colon is still a colonoscopy because if we see something like a polyp in the colon, we fix it right there. The video capsule is only a diagnostic tool and can’t treat or biopsy a lesion.

The capsule endoscopy is the ultimate disposable camera. It passes naturally and patients never see it. It’s painless and simple.

Take the next step:

• Read about polyps, tumors and malabsorptive diseases in the small bowel.
• Learn how we diagnose digestive health disorders.
• Watch a video of how the digestive process works from the time food enters the mouth.

Dr. Fischer is one of the gastroenterologists who practices at the new U-M Northville Health Center, now open to offer specialty care for the whole family. Conveniently located at 7 Mile and Haggerty Roads. Learn more at uofmhealth.org/Northville or call (248) 305-4400.