A camera encased in a pill is giving doctors at Arkansas Children's Hospital a look at their young patients' entire digestive tracts _ about 90 percent of which had gone unseen before.
The Given Imaging M2A Capsule, developed in the United States by an Israeli missile specialist in the mid-1990s, was given to the first two Children's Hospital patients Thursday. It is equipped with flash bulbs and takes 50,000 pictures over the course of eight hours, or the amount of time it takes the pill to work its way through the gastrointestinal tract.
Children's is one of about 1,700 hospitals worldwide using the pills, according to a representative for Given Imaging, the company that manufactures and distributes the pills. The hospital is also one of nine pediatric hospitals to begin using the pills since the Food and Drug Administration approved them for pediatric use last fall.
Gary Gramling, 17, of Paragould, and Caleb Strange, 11, of Log Cabin, La., were the first to take the pill at Children's. Doctors suspect both may have Crohn's Disease, an ailment that can cause intestinal blockage and sores or ulcers that can tunnel through the intestinal wall, become infected and require surgery.
The pill is about the size of a multivitamin _ a little less than an inch long and about as big around as the tip of an average woman's pinky finger. Patients swallow the pill with a glass of water and spend eight hours wearing a belt fitted with a wireless digital image recorder to record images sent by the camera. At the end of the day, they return the recorder to the hospital and the images are downloaded onto a computer for viewing.
Hospitals began using the pill in 2001 for diagnosis as an alternative to a traditional endoscopy. An endoscope is a long, flexible tube with a camera at the end that is inserted through the patient's mouth. Dr. Emmanuel Siaw, a gastroenterologist at Children's, said an endoscopy only allows doctors to see the first six to eight inches of the small intestine. The M2A pill provides photographs of the full 20- to 27-foot-long organ.
Siaw said Gramling and Strange had each had endoscopies and that doctors had been unable to confirm the Crohn's diagnosis.
Carlo de la Mata, a spokesman for Given, said even though the pill does not have some of the advantages of an endoscopy, "its value is in the diagnosis."
The pill photographs the intestine in its natural state, de la Mata said, because it is being pushed through like food would without the interference created by an endoscope.
"An endoscopy is not seeing the natural state," he said. "It works very well, but now we're seeing things we never saw before ... and it's very patient-friendly; a little less invasive than an endoscopy."
Siaw said he does not believe the M2A capsule will replace the endoscopy because the capsules can't take tissue samples during their trips. However, he said about 40 percent to 50 percent of patients with intestinal problems are affected in areas doctors are only able to see with the capsule.
To help doctors sift through the 50,000 photographs, they use software that identifies abnormalities, Siaw said. It takes about two or three hours to read the results from the test, he said.
The better look at patients' small intestines will allow doctors to better diagnose various diseases, including cancer, but Siaw said the pill would mostly be used for detecting diseases other than cancer at Children's because gastrointestinal cancer is uncommon in children.
Siaw said the one-time-use pill usually leaves the body on its own within 1 to 3 days.
