Colon Capture

 • Candid camera The pill camera has been approved by the FDA; Photo: Tehelka

• Candid camera The pill camera has been approved by the FDA;
Photo: Tehelka

Let’s admit it. Some point in life, you got to do it. And, you don’t like a tube shoved up the butt, do you? Colonoscopy does exactly that.

Colonoscopy, and for that matter, endoscopy in general, is not something patients like about medical examinations. It irritates, and often hurts.

Patients often find endoscopy scary as it may be done with or without anaesthesia and even causes severe chest pain, damage to organs, persistent pain and bleeding.

But a pill camera, which has recently been approved by the US’ regulatory body, the Food and Drug Administration (FDA), is set to calm down nerves and make colonoscopy a much easier procedure.

Developed by Given Imaging Ltd, PillCam Colon is an ingestible pill camera to help photograph polyps and detect early signs of colon cancer.

Given Imaging claims that it is “the only accurate, non-invasive test directly visualises the colon to detect polyps”.

“PillCam Colon uses a miniaturised camera contained in a disposable capsule that naturally passes through the digestive system, allowing physicians to directly view the entire colon, without sedation or radiation. For patients who have had an incomplete colonoscopy, which was not due to poor prep, PillCam Colon can be used to non-invasively complete the colon exam,” says a statement from Given Imaging.

The Israeli firm had received FDA approval for a similar device in 2001 but the images of the colon it sent were not clear enough for proper diagnosis. Given Imaging continued to work on the product and the Pill- Cam Colon targets patients who have trouble undergoing standard colonoscopy.

The capsule endoscope has the camera on one end and the radio transmitter unit on the other. The capsule can enter the small bowel either with the camera or with the radio transmitter leading. Since the small bowel is narrow, the length of the capsule (27 mm) prevents it from turning around. The capsule thus remains oriented in the same direction as it enters the small bowel and transmits images that cover the entire length of the small bowel.

However, the colon has a much wider diameter. This allows the capsule to flip around its own axis. Therefore, the camera can change directions: sometimes, the front of the capsule with the camera may be leading and, at other times, the camera may be oriented in the opposite direction. So, with a standard capsule there are areas that would be screened twice (when the capsule flips around its axis) and areas that were not to be screened at all. The developers have fixed this problem by placing two cameras at both the ends of the capsule.

Capsule endoscope helps to detect inflammation or bleeding in the small intestine that cannot be detected or visualised by conventional endoscope or colonoscope.

Although capsule endoscopy is found to be effective, it has its limitations as well. The main drawback is that a biopsy cannot be done. Also, due to the quick passage of the pill through the gastrointestinal system, it causes certain disruption or poor visualisation of the correct location of the lesion or inflammation. In addition to this, intestinal debris also interferes with the clarity of the images.

Colonoscopy is generally advised since colorectal cancer is in most cases detected rather late. By the time the patient shows symptoms like difficulty in passing stools or blood in the stools, the cancer would have been fairly advanced.

While colorectal cancer does not figure among the highly prevalent cancers in most states in India, it is one of the lifestyle-related cancers that seem to be on the rise here, according to doctors.

The global endoscopy market is expected to reach approximately $47 billion by 2020, growing at around 7 percent from 2014 to 2020. The major drivers for the growth are an aging population, increase in cancer, diabetes, and obesity patients, along with a rise in patient’s preference for minimal invasive surgeries. North America accounts for the largest market share with increase in endoscopic treatment options and obese population, followed by Europe and Japan. Although the US has a high market share, there is a growing demand for endoscopy in emerging countries such as India and China.



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