'Magic pill' helps doctors find problems in the nearly inaccessible small bowel.

                                                     By MARK ANDERSEN / Lincoln Journal Star     Monday, Feb 19, 2007 - 12:17:33 am CST

The capsule flashes like a Super Bowl audience at halftime when the nurse takes it from the special container.
Swallowing this beacon can be disconcerting to patients, said Sandy Olive, Clinical Research Director of Gastroenterology Specialties.

But for finding problems in the nearly inaccessible 21-foot small bowel, this pill-size camera is unsurpassed.

“For us, it’s really revolutionized management of this problem,” said Dr. Clark Antonson, a gastroenterologist with the Lincoln center.

The patient wears a receiver about the size of a small book as the encapsulized camera makes its eight-hour journey through the small bowel, tumbling

and flashing as it takes 50,000 high-resolution color photos.

Physician software transforms the photo series into a travel diary, with suspicious images highlighted for closer inspection.

The only concern is making sure the camera passes. In rare events, it encounters the obstruction it’s looking for and briefly sticks.

Each camera is used only once.

In the past, physicians routinely scoped the upper and lower ends of the gastrointestinal tract, looking for ulcers, polyps and the causes of heartburn, Antonson said.

But 15 to 18 feet of the small bowel remained unreachable.

X-rays weren’t much help in the search for small bleeds. Snaking longer scopes into the small intestine wasn’t well-tolerated and didn’t reach the full length.

When necessary, a scope was used in combination with surgery, gaining direct access to the small bowel, but that’s major surgery.

The flipping of the PillCam SB video capsule usually takes multiple pictures of almost every area.  The camera itself costs $450, but there is more expense for

technical work and interpretation.

It’s not perfect coverage, Antonson said, but it’s considerably better than the alternatives.

Patients fast the night before the procedure and take the capsule with a glass of water.

The small bowel accounts for less than 10 percent of internal bleeding, Antonson said, but the center gets referrals from much of greater Nebraska,

or about 80 patients this year.

Recently, PillCam maker Given Imaging announced it was attempting to push its noninvasive technology further.

In October, Endoscopy, the journal of The European Society of Gastrointestinal Endoscopy, published the results of a pilot study using a next-generation

PillCam to evaluate the lower colon.

While still in the study phase, the results appeared promising, said investigators quoted in the article.

Laurie Nesson, a Registered Nurse, shares a laugh with a patient while working in Gastroenterology Specialties at the Lincoln Endoscopy Center Friday,

as the recording device she is wearing monitors the progress of a "pill cam" making it's way through her gastrointestinal tract. (Eric Gregory)