Friday, January 13, 2006

Have a better look at your health - from the inside!


The PillCam, a video capsule that patients swallow, helps doctors evaluate gastrointestinal conditions
Once swallowed with water, the PillCam takes about 2,600 color pictures inside the body. After 20 minutes, the doctor can evaluate the video images and make a diagnosis.
Source: Houston Chronicle

Almost 50 years ago, Catherine Kent scratched hot dogs off her list of favorite foods.

She was 22 and pregnant, and hot dogs caused a burning in her throat, gas and an unpleasant aftertaste. It seemed a minor sacrifice until the list of proscribed foods grew to the point where only the blandest spared her a case of heartburn.

"No soda. Nothing with tomato sauce, though fresh tomatoes were all right. Definitely no hot or spicy foods, which was too bad. It got so I couldn't eat much of anything without a problem," said Kent, 71 and retired as an office assistant from Shell Oil.

For decades, Kent dosed herself — sometimes four times a day — with bicarbonate of soda and over-the-counter antacids. Those offered effective but short-lasting relief.

In 1994, she saw Dr. Krishnamurthy Shivshanker, a clinical associate professor of gastroenterology at the Baylor College of Medicine. He inserted a thin, flexible, lighted scope down Kent's throat and found her esophagus irritated. It did not, however, show signs of Barrett's esophagus, a precancerous condition that afflicts 700,000 people in the U.S.

"We are seeing increased incidence of Barrett's. It used to be 20th or 22nd on the list of cancers. Now it is eighth or ninth," Shivshanker said.

Kent is one of 19 million Americans with chronic heartburn or gastroesophageal reflux disease who feel a burning sensation behind the breastbone or in the neck and throat. The discomfort is caused by stomach acid refluxing or splashing into the esophagus. Kent takes Protonix, one drug in a large, heavily advertised category called proton pump inhibitors, to ease the condition.

No medications exist to reverse Barrett's esophagus, though treating the underlying GERD is thought to slow the disease. Kent, like others with GERD, is urged to avoid fatty foods, alcohol and other irritants.

Last year, Shivshanker added a new, noninvasive weapon to his gastroenterological arsenal. Instead of the traditional endoscopy, with some patients he uses the PillCam, a plastic capsule about the size of a large vitamin pill that is fitted with video cameras at each end.

The patient is not sedated, as in an endoscopy, but simply swallows the pill with water. It progresses down the esophagus and takes about 2,600 color pictures at a rate of 14 per second. After 20 minutes, the doctor evaluates the video images and makes a diagnosis. The disposable capsule is passed naturally, usually within 24 hours.

Kent underwent the brief procedure in September: "I popped in the office, I popped the pill, then I popped out again."

Shivshanker found no evidence of Barrett's esophagus and no further damage to the tissue in Kent's throat. She remains on Protonix and continues to watch her diet.

"The patient does not take off time from work and does not need to be driven, and yet the results are as good as an endoscopic exam. It could not be more convenient," Shivshanker said.
"I'm 71 years old, and I had no idea you could swallow a pill and have pictures taken of your insides," Kent said. "They've come up with so many things during my life."

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