At any local electronics store, a wide variety of digital cameras are on display. Although many vary in capabilities, one common component in most of these cameras is their continually shrinking size. None of the cameras at the local electronics store, however, can match the tiny size of a camera that is making small intestinal endoscopy a much less invasive and more accurate procedure.

Capsule endoscopy, approved by the United States Food and Drug Administration in 2001, involves a vitamin-sized pill that contains a color camera, a battery, a light source and a transmitter. The camera takes two pictures every second for eight hours, transmitting images to a recording device worn by patients around their waists. 

“This is a major advance in the imaging of the small intestine,” says Immanuel Ho, M.D., chief of Gastroenterology at Crozer-Chester Medical Center, who began using capsule endoscopy in May for patients suffering from intestinal bleeding or intestinal disorders. “It can make an accurate diagnosis in minimal time with minimal discomfort to the patient. The technology is amazing and the pictures we get are incredible.”

Previously, physicians had to rely on an endoscope - a thin tube with a camera on its tip that gets inserted into a sedated patient’s mouth and down through the esophagus and stomach into the small intestine – to attempt and find the cause of intestinal bleeding. This type of endoscope is invasive and does not provide a complete picture of the small intestines due to the complexity of maneuvering the tube through the turns of the small intestine.

With capsule endoscopy, the patient can swallow the pill and engage in normal activities throughout the day without discomfort, all while the camera takes pictures and makes its way through the digestive tract. After eight hours, the patient returns the recording device back to the physician. The camera exits the patient’s body naturally and is not retrieved. 

“Capsule endoscopy gains access to the small intestine that is not reachable with the standard endoscope,” says Mark Jacobs, M.D., chief of Gastroenterology at Delaware County Memorial Hospital. “It allows us to see subtle causes of bleeding and diagnose Crohn’s disease.”

Once returned to the physician’s office, the images from the device are downloaded to a computer, where the physician can evaluate the images and make a proper diagnosis.

“It’s a remarkable device. The patients bring the recorder back and we download it to the computer and burn it to a DVD,” says Jacobs. “It takes maybe 45 minutes to an hour to review the DVD and make a diagnosis.”

“The diagnostic yield is higher with capsule endoscopy,” Ho says. “With a higher yield, we can find out a lot more about the small intestine and look for the causes of intestinal bleeding and chronic abdominal pain.”

Ho says that in preparation for the capsule endoscopy, patients must not eat or drink anything the day before. Two hours after the patient swallows the pill, liquids are permitted, followed by solid foods two hours after that.

“As far as complications, there have been very rare cases of intestinal blockages, but no other real complications,” Ho says. “Of course, if a person has problems swallowing, that can complicate it, in which case, we’d have to place the pill in the patient’s stomach.”

Aside from determining the cause of intestinal bleeding, physicians can use capsule endoscopy to detect polyps, Crohn’s disease, ulcers and tumors in the small intestine.

“Capsule endoscopy has become the gold standard for minimally invasive detection of small bowel pathology,” says Ho.

For schedule an appointment with Ho or Jacobs, call 1-800-CK-HEALTH (1-800-254-3258).