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An Alternative to a Colonoscopy

The PillCam Colon 2, A Much More Comfortable Alternative to a Colonoscopy

Nobody really wants to get a colonoscopy, but once you reach a certain age, it’s important. If you’re absolutely averse to colonoscopies, there’s new technology in town to check the colon for pre-cancerous polyps or malignant tumors. All you have to do is swallow a disposable camera that’s embedded in a jelly-bean sized pill. Several hours later, a doctor can view the panoramic images produced by cameras at both sides of the capsule. The device is said to be endowed with artificial intelligence because of its sensory perception and the way it knows how to conserve energy until it starts transmitting relevant images at pertinent times.

The PillCam Colon 2, as it’s called, offers a few advantages over colonoscopies: no sedation and no need for air to be pumped into the bowel. If the camera does detect polyps or other problems, a conventional colonoscopy to remove the lesions still has to be done.

Both methods require a clear diet the day before and bowel preparation laxatives to ensure the colon is absolutely clear.

Chances are the PillCam won’t replace colonoscopies but it’s a good alternative for patients who find the conventional procedure uncomfortable or who have a fear of it. It’s also a good option for patients who have incomplete colonoscopies because they have anatomical anomalies preventing the colonoscope from accessing the whole colon.

The images taken by the camera are transmitted wirelessly to a data recorder worn like a fanny pack around the waist.

Since the introduction of the first generation of the PillCam, many improvements have been made to create a better capsule endoscope. These include a wider angle of view, a faster adaptable frame rate and a new data recorder which is able to control the capsule activity during the transit through the bowel. Recent studies show these improvements had a direct effect on the colon capsule performance, leading to a better diagnostic yield.

This technology was invented in Israel by Gabi Iddan and Paul Swain, independently. Instead of competing they decided to join forces. In 1997 Paul Swain swallowed the first wireless capsule endoscope in Israel. The transmitted images were of poor quality but the possibility of wireless transmission from the digestive tract to an outside receiver (recorder) was proven to be possible. This opened the way for a controlled study. Capsule endoscopy of the small bowel was compared with push enteroscopy in patients with occult gastrointestinal bleeding. The capsule outperformed push enteroscopy by a ratio of 2 to 1. Based on these findings the US Food and Drug Administration (FDA) approved this device for investigations of the small bowel in 2001.

Over the past nine years, wireless capsule endoscopy has firmly established its presence in the practice of gastroenterology. Dramatic technological improvements have created a new wireless capsule endoscopy platform. The future is here and the outlook looks bright for colon screening technology.