Pill camera offered as an alternative to colonoscopy

Clinicians from Loyola Medicine’s digestive health program are the first in the Chicago area to offer this latest alternative to colonoscopy, the PillCam™ Colon 2. Like a colonoscopy, the system can help identify growths called polyps. The “pill camera,” a capsule containing two miniature cameras on either end, is a new noninvasive alternative to colonoscopies that makes examining the colon as easy as swallowing a pill.

As the capsule travels through the digestive tract, it captures images and wirelessly transmits them to a recorder the patient wears on a belt.

During a standard colonoscopy, a flexible tube, or colonoscope, is inserted into the rectum and guided by a physician through the colon. A camera at the end of the colonoscope allows for visualization of polyps, which can turn into cancer if left in place. Thus the polyps are removed during the procedure. Patients are sedated and need to take a day off from their usual activities.

Colonoscopies are safe and have been proven to be an effective way to screen for colon cancer. However, some patients cannot tolerate the procedure, or may be at higher risk for sedation.

Using the pill camera, the patient swallows the capsule with water. After the non-reusable capsule is excreted, it’s flushed down the toilet. The patient returns the recorder to the physician’s office where the images are reviewed. If a polyp is found, the patient arranges to undergo a colonoscopy to remove the growth.

Colorectal cancer is the third-leading cause of cancer deaths in women and second leading cause in men. Early detection and screening are essential to reduce the rates of colorectal cancer.

“The video capsule system is the only alternative screening method for colon cancer that allows for direct visualization of colon polyps,” said Mukund Venu, MD, director of clinical operations and director of diagnostic testing for Loyola Medicine’s division of gastroenterology in Maywood, IL. “Early detection has been proven to save lives, and the video capsule system offers a convenient screening test for people who are unable to have a complete colonoscopy.”

Dr. Venu, who has subspecialty training in capsule endoscopy, will perform the test.

Similar to patients undergoing a colonoscopy, a patient who undergoes the capsule technique must do the same bowel-cleansing preparation. But unlike a standard colonoscopy, the pill capsule system is painless and requires no anesthesia. In addition, patients do not have to take a day off from work or arrange for someone to drive them to and from the procedure.

The US Food and Drug Administration has approved the capsule system for patients who are not candidates for colonoscopies for one of two reasons:

• The anatomy of the colon makes it difficult to guide a colonoscope through the entire colon.
• The patient experiences lower gastrointestinal bleeding, but is not suitable for a colonoscopy because of an elevated risk of complications due to age or other reasons.

Loyola is currently participating in a multicenter clinical trial to determine whether the capsule system is safe and effective for a broader population of patients who could tolerate a colonoscopy but would prefer to swallow a capsule.