Dr. Luis Coppelli recounted remarkable advances in treatment and imaging of gastric problems in a talk at the Senior Circle.
Photo by Teresa McQuerrey.
Investigating gastric distress is getting easier for doctors who are using a pill camera and other technology, Dr. Luis Coppelli told members of the Senior Circle and guests on Jan. 23.
The pill camera — Small Bowel Capsule Endoscopy or PillCam® SB video — allows doctors to view the small bowel almost more easily than they can the large bowel with a colonoscopy.
“It is a great enhancement for diagnosis (of gastric problems in the small intestine),” Coppelli said.
The patient prepares for the test with fasting and forcing down liquids so they have an empty stomach for the start of the exam. They are outfitted with sensors, swallow the camera pill with water and have a data recorder attached. A technician activates the system and the patient goes about his or her normal day. The camera transmits signals every two seconds for eight hours. Patients can resume eating four hours after swallowing the camera pill.
The sensors and data recorder are removed after eight hours and the pill camera is naturally eliminated from the system. The technician downloads the data on the recorder for review and diagnosis by the doctor.
Coppelli said the PillCam® can help diagnose celiac disease, gluten sensitivity, Crohn’s disease and diverticulitis. It can also discover tumors, bleeding, scarring and distortions of the small bowel.
It is an outpatient procedure and very benign, Coppelli said.
Help with heartburn
Another new technology used to help diagnose gastric issues related to heartburn is available through the Bravo® pH Monitoring system. It also uses a capsule, this one about the size of a gelcap. But patients don’t swallow this pill. Instead, the doctor attaches it, catheter-free, to the esophagus. It stays in place for 48 hours, transmitting data to a receiver placed on a patient’s belt or waistband. After a few days, the capsule detaches and passes through the system naturally.
During the test, the system monitors the pH in the esophagus.
Coppelli said heartburn is uncomfortable, but it won’t kill a person. However, it can cause damage to the delicate lining of the esophagus, resulting in such things as stricture, which is a narrowing of the organ due to scarring; ulcers; and a very aggressive cancer.
“So we must be aggressive in diagnosing and treating acid reflux,” Coppelli said.
Initial treatment is possible with a change in diet and both over-the-counter and prescribed medications. However, in severe cases the patient may need surgery. The Bravo® pH Monitoring system helps in this kind of diagnosis.
“The surgery is effective and safe and gives good results,” he said.