Atrium Health Navicent Gastroenterology & Hepatology

Pill Cam®

Middle aged couple sitting on a couch smiling

Gastroenterologists are often tasked with the difficult job of looking inside a patient's digestive tract to find problems and signs of disease. Unfortunately, doing so often requires the doctor to insert a long scope into the patient's throat or colon, both of which can be quite uncomfortable for the patient; uncomfortable enough that some refuse treatment and preventive screenings. Based in Israel, the Given Imaging company is changing this with the PillCam®

What is a PillCam®?

About the size of a multivitamin, the PillCam® is a disposable clear capsule. The capsule contains two cameras, a LED light, a transmitter, and a battery. After the patient swallows the capsule, the light turns on and the cameras take pictures of the digestive tract as the pill passes through it. These pictures, taken in color at 14 frames per second, are transmitted to a receiver the patient wears on his or her waist. After the PillCam® has passed through the intestinal tract, the doctor downloads the pictures and examines them.

Who Can Use a PillCam®?

In the United States, the Food and Drug Administration (FDA) initially approved the PillCam® only for use in diagnosing problems of the esophagus and small intestine. In 2014, the FDA expanded their approval to include colonoscopies, but only in patients who are unable to have a traditional colonoscopy due to unusual anatomy, disease or other medical concerns. Though the images from the PillCam® are not quite as clear as those from a colonoscopy, the Associated Press reports that the FDA's approval of the device for colonoscopy will allow 750,000 more patients a year to get the procedure.

Contraindications

While the PillCam® is an excellent option for many patients, a few people who should not use the device. The PillCam® is not recommended for those who are known to have fistulas and other obstructions of the gastrointestinal tract. Those with swallowing disorders should also avoid the PillCam®, as should anyone with a pacemaker or any other type of electronic medical device that is implanted in their body.

Benefits

The PillCam® provides many benefits, perhaps the most important of which is the ease of the procedure on the patient. Patients simply swallow the capsule and then pass it, usually within 24 hours. The PillCam® is much more comfortable than scopes. It also makes colonoscopy possible for those who are otherwise ineligible for this important screening. Cost is another key benefit of the PillCam®. According to Slate, the camera pill price is around $500 while a colonoscopy costs an average of $4,000. This reduces the cost for insurers as well as for those without health insurance who are forced to pay their medical expenses out-of-pocket. Because the capsule is disposable and sends its pictures to a device outside the body, no one is left with the unfortunate job of retrieving it. It can simply be flushed away once passed.

Risks

Naturally, there are risks involved every time a foreign object is introduced into the body. Complications of the PillCam® are rare but they are possible. The risks of the PillCam® include aspiration of the pill into the lungs if normal swallowing is interrupted as well as capsule retention. If the capsule is retained rather than passed normally, surgical intervention may be required to remove it. Patients should avoid being near any type of strong electromagnetic field, such as an MRI machine until the pill has left the body. Failure to comply with this directive could cause serious complications.

Used in more than 80 countries by more than 1.5 million patients, the PillCam® is an excellent alternative to more uncomfortable diagnostic procedures. Though the camera is able to detect and help diagnose problems without invasive and unpleasant procedures, it is unfortunately not able to repair the problem. If a problem is discovered, surgery or other interventions may be needed to correct it. The PillCam® is limited in this way but is still able to help make medicine more affordable, comfortable, and accessible.