Wireless Capsule Endoscopy



Overview



Camera Tablet
Camera Tablet

Wireless Capsule Endoscopy is a method used to capture and record images of the digestive tract. This method is more simplistic and effective to use, which is why many doctors commonly use this preferred method. How does it work? The patient swallows the capsule that has a camera

embedded inside the pill, after the patient swallows it, the camera inside will start to take pictures of the patient's internal organs, more importantly, the patient's gastrointestinal tract. The main use of this capsule is to help doctors understand and view areas of the intestinal tract in a different perspective. There are times where the doctor can't see everything in the patient when they are on the surgical table. This way they are able to diagnose the patient better.

Applications


What if you're a plumber and you don't know where the leak is? Well, that's where the Wireless Capsule comes in for doctors. Sometimes, doctors are unable to tell where blood loss or leakage may occur from. They don't want to take the risk of doing surgery because that may disrupt their other internal organs. With the wireless capsule endoscopy, doctors are able to pinpoint exactly where the source is coming from. This capsule was developed in the mid 1990's and it was approved by the Federal Drug Administration in early 2003. It can be used in ambulatory or hospital settings. Doctors use it as a diagnostic tool to quickly identify the source of the trouble and to diagnose the patient properly. The capsule repeatedly takes 50,000-60,000 pictures per study. The patient will wear a device on their belt, and the capsule will
repeatedly send images to the belt for the doctor to view. The wireless capsule endosco
py is a perfect tool for doctors to use in order to visualize the most inaccessible body organs in the human body.


How does it work?


A bowel prep to clean the intestine, similar to that used for colonoscopy, may be recomm
external image capendoscopy.jpg
ended by your doctor to take the night before undergoing a capsule endoscopy. The exam is usually done in an office setting. Sensors are placed on the patient’s abdomen and the data recorder is attached to a large belt worn by the patient. The capsule is then activated and swallowed with a sip of water. The patient may leave the doctor’s office and continue with routine daily activities, including eating a light meal after several hours. Later, the patient returns for removal of the equipment, and then returns home. There is no sedation needed for the procedure and it is completely painless. The capsule is disposable and usually passes out of the GI tract unnoticed. The results are discussed in a follow up appointment with the patient’s doctor. Capsule endoscopy can also be performed in hospitalized patients and in children as young as 2 years old in special circumstances.






"The video above shows the capsule traveling through the body of patient with chronic iron deficiency anemia."

Wireless Capsule Endoscopy Procedure Helps Diagnose:


  • Obscure Gastrointestinal Bleeding- GI bleeding is defined as obscure when the bleeding continues or recurs after endoscopic examinations have found no source of the bleeding. Most obscure bleeding occurs in the small intestine, a notoriously difficult area to examine. Prior to adoption of the wireless capsule endoscopy(WCE) several invasive procedures(colonscopy, push enteroscopy) would be performed to find the cause of the bleeding. The WCE technology allows for a better view inside the small intestine which allows physicians to pinpoint the bleeding.
  • Inflammatory Bowel Disease- There are two major forms of inflammatory bowel disease, Chrons Disease and Ulcerative Colitis. While they both disorders affect the colon the difference in a diagnosing the two can be seen in the upper GI tract. This is where the WCE technology comes into play by allowing physicians to make an accurate diagnosis which leads to the most effective treatment for the given form of inflammatory bowel disease.
  • Celiac Disease- In order to diagnose celiac disease a histological examination of the duodenal tissue must be obtained must be obtained. In recent years, the use of WCE technology has become a secondary option in which the duodenum can be viewed without removing a piece of the tissue.
*This list is not exhaustive of all the disorders that WCE techblolgy can help diagnose.
**All Diagnosiss information provided by:
http://emedicine.medscape.com/article/197525-overview#aw2aab6b3

Limitations



While a wireless capsule endoscopy is still one of the best ways to view the inside of the upper GI tract (esophagus, stomach and duodenum) and the small intestine (the small intestine is the most difficult to diagnose and treat) there are still several limitations of the procedures that doctors are working to fix.
According to medicinenet.com, these limitations include:
  • "Abnormalities in some areas of the intestine are missed because of rapid transit of the capsule and blurred, uninterpretable
    photographs"
  • " At times transit is so slow that the capsule only examines part of the small intestine before the battery fails."
  • "If abnormalities are discovered that require a surgical resection or futrther investigation, it may be difficult to determine where in the small intestine the abnormality is"
  • "If there are narrow areas due to scarring (strictures) or tumors in the small intestine, the capsule can get stuck in the narrow area and cause an obstruction of the requires a surgical removal. (For patients that are believed to have strictures in the small intestine they are given a 'dummy' capsule that will dissolve if it gets caught in a stricture. The capsule can be seen through an x-ray prior to it dissolving so Dr's will know where in the small intestine the stricture occurs.)"
  • "Finally, reviewing the tens of thousands of photographs is very time consuming for physicians and nurses."
- All limitations provided by:
http://www.medicinenet.com/capsule_endoscopy/page2.htm


Resources

http://www.asge.org/press/press.aspx?id=8140
http://www.ncbi.nlm.nih.gov/pubmed/10840312
http://www.medicinenet.com/capsule_endoscopy/article.htm
http://www.umm.edu/gi/wce.htm
http://www.medicinenet.com/capsule_endoscopy/page2.htm
http://www.youtube.com/watch?v=yB-wm2x6woc
http://emedicine.medscape.com/article/197525-overview#a1