UT Southwestern Medical Center is the first in Dallas to acquire the PillCam ESO technology. It allows doctors to quickly and easily assess the presence of esophageal diseases such erosive esophagitis, Barrett's esophagus and esophageal varices.
Approved by the Food and Drug Administration late last year, the PillCam ESO is a smooth plastic capsule about the size of a large vitamin pill with video cameras on each end, equipped with a battery and internal light source.
After the patient lies down, the PillCam ESO is swallowed and glides through the esophagus, taking about 2,600 color pictures (14 per second). The patient gradually sits up to aid its progression down the esophagus, while the photographs are transmitted to a recording device and then viewed on a computer screen. The single-use capsule is passed naturally in less than 24 hours.
"The main use of the PillCam ESO right now is to find pre-cancerous changes in the esophaguses of patients who had had acid reflux for more than five years," said Dr. Charles Ulrich, associate professor of internal medicine. "It also can be used to find varices or dilated veins, and there are a number of other applications under investigation."
According to the American College of Gastroenterology, approximately 19 million people have gastroesophageal reflux disease (GERD), which is caused by stomach acid moving upward from the stomach into the esophagus. An estimated 700,000 Americans suffer from Barrett's esophagus, a pre-cancerous condition attributed to longstanding GERD. Erosive esophagitis occurs when areas of the esophageal lining are inflamed and worn away, and esophageal varices are a complication of cirrhosis of the liver.
Current traditional diagnosis and evaluation of these conditions usually involves sending a long, flexible tube, called an endoscope, through the patient's mouth and throat into the esophagus. The procedure requires sedation, up to an hour of recovery time, post-procedural transportation and a day off from work.
By contrast, the PillCam ESO study takes 20 minutes, requires no sedation and provides immediate recovery, said Dr. Ulrich, who heads UT Southwestern's endoscopy services. Clinical trials already have shown that its accuracy is comparable to a traditional endoscopy.
PillCam ESO is not recommended for people with swallowing disorders, pacemakers, or known or suspected gastrointestinal obstruction, said Dr. Ulrich. An endoscopy is still needed for tissue samples should the images suggest the presence of Barrett's esophagus or other serious problems.
The PillCam is similar to the PillCam SB, which was FDA-approved in 2001 to detect abnormalities in the small bowel. UT Southwestern researchers are performing studies using both devices.
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