Capsule endoscopy (CE) displays the small bowel's entire length (as long as 25 feet) as the intestine's involuntary muscles push this "camera pill" forward. CE heralds an important step forward in the diagnosis of small bowel disorders, demonstrating more abnormalities than standard small bowel imaging techniques. But its greater promise may lie in conjunction with computed tomography (CT). CE does a good job of indicating the presence of abnormalities, but does not tell their location.
The video capsule - the size of a large vitamin pill - is swallowed by a patient after an eight-hour fast. Eliminated about eight hours later, the capsule transmits a continuous stream of digital images to a small data recorder worn around the patient's waist. The physician then downloads the data and analyzes the images at a workstation.
"As the camera tumbles through the intestine, you don't know exactly where the mass is located. CT, by contrast, provides a very good global view of the body, and specialized parameters can be employed to localize lesions," said lead author Amy K. Hara, M.D., diagnostic radiologist at Mayo Clinic in Scottsdale, Ariz.
Among those who may benefit from CE are people with Crohn's disease, a form of inflammatory bowel disease that occurs most often in the lower portion of the small intestine and is marked by diarrhea, abdominal pain and bleeding.
Unlike standard endoscopy, CE-also known as wireless endoscopy-can examine the entire small intestine. Endoscopy, which uses a fiberoptic scope, reaches only the upper and very lower portion of the small intestine.