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An amazing pill which contains a camera to help diagnose serious bowel conditions; Doctors and nurses in Wales are using amazing cameras in pill-form to detect signs of serious bowel conditions. Here, Mark Smith speak to two clinicians about the technology which is speeding up the diagnostic process...

Byline: Mark Smith

Patients who suffer problems with their small bowel can now swallow a pill-sized camera which captures tens of thousands of images as its travels through the body.

Capsule endoscopy, which is being carried out at University Hospital Llandough, is a painless diagnostic test which speeds up the detection of certain conditions such as inflammatory bowel disease (IBD) or anaemia.

A wireless PillCam, which is roughly the size of a large vitamin or antibiotic tablet, takes several highdefinition pictures per second as it reaches parts of the small bowel that conventional, more invasive camera tests cannot reach.

The pictures captured are then transmitted to a belt the patient wears around their waist - or sticky pads that are placed around the stomach and lower chest - before being connected to a device which records all the data.

Once the tablet is naturally passed through the body and disposed of, the rest of the equipment is then given back to the hospital where hours of footage are analysed.

Nurse Angela Green and consultant Jeff Turner, both specialists in gastroenterology, look out for polyps, ulcers and tumours of the small bowel, as well as any sources of bleeding.

"It's a fantastic diagnostic tool. It allows us to visualise parts of the small bowel where we haven't been able to previously," said Angela.

"It gives us answers where other procedures don't."

Jeff added: "The test is non-invasive and not painful in any way, shape or form.

"And the nice thing is that patients can be in the comfort of their own home while the camera is capturing the images.

"You just need to come into the hospital for an hour or so, swallow the tablet and then pop the equipment back the next day."

The plastic pill-form camera, which cots around PS500, has two sections: one which is white and houses a tiny battery with an 11-hour life, while the other clear section includes four light sources and the state-of-the-art camera.

"The tablet gives us roughly a 340-degree magnified view of the small bowel as it travels through," added Angela.

"It takes up to 50,000 very clear images in the small bowel, and the quicker it travels the more pictures it takes, so it's quite a clever piece of kit."

Patients are typically referred for a capsule endoscopy after having several other camera tests to examine the stomach and large bowel (colon).

They may also have had an X-ray test on the small bowel, which does not produce such well-defined images, or an endoscopy which is more invasive and uncomfortable.

"There are people who have had a normal X-ray test and it's only when we do the capsule test that we see the ulcers and other things in their bowel," added Jeff.

"These people can be quite symptomatic with diarrhoea and have a poor quality of life, so if we do notice any problems it's really nice to be able to give them treatment more quickly than before."

Before the examination takes from eating from 1pm the day before and can only drink clear soup, non- fizzy drinks and black tea. Then at 5pm, 8pm and 6am on the day of the test, the patient is required to drink a litre of laxative which empties the bowel to allow for the clearest images possible. Jeff said that while this was the biggest drawback to the examination, a capsule endoscopy is a far more beneficial procedure to both patients and the NHS alike. Currently around 12 capsule endoscopies are being carried out at University Hospital Llandough each week, while the procedure is also being used at centres in the Royal Gwent Hospital and Neath Port Talbot. Jeff added that before the capsule endoscopy started being carried out by Cardiff and Vale University Health Board around seven years ago, there was a significant section of the small bowel which couldn't be captured. Jeff added: "A gastroscopy test can capture the very top of the small bowel, and a colonoscopy test sometimes reaches the very bottom end of the small bowel. "But there's probably about seven or eight metres in between which we can't very easily get to [without a capsule endoscopy]. "There are specialist camera tests which are done in places like Bristol, but again hey are very invasive tests." Intensive training is carried out before clinicians are able to carry out a capsule endoscopy and be able to use the software and analyse the footage. "When we bring the patients back into the hospital we can show them what their bowel looks like. "Some really like having a little look as it allows them to feel a bit more in control of the whole process." If patients have a narrowing of the bowel due to inflammation the camera can get stuck, but this only occurs in around one in 100 procedures and 13 in 100 with Crohn's disease. Jeff added: "It is important to remember that the capsule only gets stuck in areas where there is narrowing of the bowel and often diagnoses the problem causing the patient's symptoms. "It is also very rare that the test needs to be repeated." The clinicians also warn patients not to travel on public transport while wearing the capsule belt as it can be mistaken for a terrorist device.

The test is non-invasive and not painful in any way, shape or form. And the nice thing is that patients can be in the comfort of their own home while the camera is capturing the images

CAPTION(S):

<B A wireless PillCam, which is roughly the size of a large vitamin or antibiotic tablet, takes several high-definition pictures per second as it reaches parts of the small bowel that conventional, more invasive camera tests cannot reach

<B Patients with bowel problems can now swallow a tiny camera which captures thousands of images to help spot certain conditions

<B Specialist nurse in gastroenterology Angela Green and consultant Jeff Turner carry out the procedure at University Hospital Llandough

Healthy small bowel >Dilated blood vessels (angioectasia) >Bleeding in the small bowel >Beedling ulcer in a small bowel
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Publication:South Wales Echo (Cardiff, Wales)
Date:Jul 24, 2019
Words:1017
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