A disposable camera that's easy to swallow.

Doctors can now examine the human colon and small intestine with a camera that patients swallow. Called a wireless capsule endoscope, this stunning new pill contains a tiny video camera, four tiny light sources, a TV transmitter, and an eight-hour battery. It can send images of the insides of both intestines for several hours. On a recent edition of National Public Radio's Day to Day, Sydney Spiesel, MD, spoke in detail about the promising new technology. Spiesel teaches at Yale Medical School and writes a medical column for the online magazine Slate.

Wireless capsule endoscopes are not only much less invasive, but seem to work better at detecting certain diseases of the intestines than traditional periscope-like cameras. Roughly the same shape and size as a large vitamin capsule, the camera is activated as soon as the patient swallows it. It then transmits images at a rate of about two per second. The patient wears a belt pack that records everything. As the camera drifts south, it continues to record images until the battery runs out, which in most people allows it to cover the full length of the small intestine. Occasionally, patients with strictures in the intestines due to certain illnesses have experienced the capsule getting stuck; Spiesel says it is easily retrieved or washed out in these instances.

In increasingly common procedures like colonoscopy, doctors, look for signs of disease that affect the inside of the intestine. One such sign is GI bleeding, which could indicate a cancerous polyp or tumor, or inflammation of the lining of the bowel. Polyps in and of themselves are not necessarily dangerous, but colon cancer is among the most treatable of cancers if caught early, hence the popularity of regular colonoscopy for the general population. The procedure is recommended to people beginning as early as age 30, depending on family history and other factors.

The ease, comfort, reacquisition of dignity, and improved safety of the new wireless endoscope aside, "these swallowed capsules are one of the best ways of identifying bleeding sites," says Spiesel. He also points out that the pill was superior in detecting Crohn's disease in patients in a recent study in Berlin.

Crohn's disease is a long-term swelling bowel disease of unknown cause that most often affects the lower part of the small intestine, colon, or both. The disease is marked by many attacks of diarrhea, sever stomach pain, nausea, fever, chills, and loss of appetite and body weight. Endoscopy involving a camera on a long tether inserted into the rectum and snaked through the bowel has for many years been the traditional test, but there is evidence now that the capsule method is superior to both traditional endoscopy and x-ray for detecting the disease. In the Berlin study, not only did the pill method of detection spot the disease 35 percent more often than these other methods, but it detected it higher up in the small intestine than it has ever been seen. This latter achievement could change medical opinion about how to best treat the disease.

While the last 20 years have seen major advancements in the preparation before, discomfort during, and recovery after traditional colonoscopy, there is little doubt that patients will delight in the availability of the new wireless capsule endoscope.

(Tiny Video Camera Offers Inside View of Human Body, National Public Radio, Day to Day, May 1, 2006, int. Sydney Spiesel, MD, www.npr.org/templates/story/story.php?storyId=5373685; Mosby Medical Encyclopedia, revised ed., 1992, Plume, New York, NY, 926 pp.)