New alternative to colonoscopy is as easy as swallowing a pill

The patient ingests PillCam™ Colon 2, a capsule containing two miniature cameras on either end. As the capsule travels through the digestive tract, it captures images and wirelessly transmits them to a recorder the patient wears on a belt.

Loyola Medicine's digestive health program is the first in the Chicago area to offer this latest alternative to colonoscopy. Like a colonoscopy, the system can help identify growths called polyps.

During a standard colonoscopy, a flexible tube (colonoscope) is inserted into the rectum and guided by a physician through the colon. A camera at the end of the colonoscope allows for visualization of polyps which, if left in place, can turn into cancer. The polyps are removed during the procedure. Patients are sedated and need to take a day off from their usual activities.

Colonoscopies are safe and have been proven to be an effective way to screen for colon cancer. However, some patients cannot tolerate the procedure, or may be at higher risk for sedation.

With the new system, the patient swallows the capsule with water. After the non-reusable capsule is excreted, it's flushed down the toilet. The patient returns the recorder to the physician's office. If a polyp is found, the patient arranges to undergo a colonoscopy to remove the growth.

Colorectal cancer is the third-leading cause of cancer deaths in women and second leading cause in men. Early detection and screening are essential to reduce the rates of colorectal cancer.

"The video capsule system is the only alternative screening method for colon cancer that allows for direct visualization of colon polyps," said Mukund Venu, MD, director of clinical operations and director of diagnostic testing for Loyola Medicine's division of gastroenterology. "Early detection has been proven to save lives, and the video capsule system offers a convenient screening test for people who are unable to have a complete colonoscopy."

Dr. Venu, who has subspecialty training in capsule endoscopy, will perform the test.

A patient who undergoes the capsule technique must do the same bowel-cleansing preparation as a patient undergoing a colonoscopy. But unlike a standard colonoscopy, the pill capsule system is painless and requires no anesthesia. Patients do not have to take a day off work or arrange for someone to drive them to and from the test.

The U.S. Food and Drug Administration has approved the capsule system for patients who are not candidates for colonoscopies for one of two reasons:

- The anatomy of the colon makes it difficult to guide a colonoscope through the entire colon

- The patient experiences lower gastrointestinal bleeding but is not suitable for a colonoscopy because of an elevated risk of complications due to age or other reasons

Loyola is participating in a multicenter clinical trial to determine whether the capsule system is safe and effective for a broader population of patients who could tolerate a colonoscopy but would prefer to swallow a capsule.