On his way through Donna Harris' stomach to her small intestine, something red catches Charles Spurr's eye.
"OK, wait a minute. Let me step back here," says Dr. Spurr, a gastroenterologist at University Hospital, as he backs up the image on the screen until a red blotch appeared. "That's a vascular malformation in the stomach."
The red blotch, and probably others hidden in the small intestine, are likely the source of Mrs. Harris' anemia. And a tiny camera she swallowed seven hours earlier will point them out.
In a process called video capsule endoscopy, the tiny battery-powered camera the size of a large vitamin travels through the digestive system and transmits pictures back to a video recorder worn in a harness by the patient, about 50,000 images over several hours. Though it passes through the entire digestive system, and exits the body the way nature intended, it is really effective at viewing only the small intestine, Dr. Spurr said. The stomach is too large for the little camera to see everything and in the colon, it bobs around in semi-darkness because its tiny lights are ineffective there.
For some cases, it can be highly effective. About a third of the 60 million to 70 million cases of gastrointestinal problems in the U.S. involve the small intestine, and for as much as 5 percent of internal bleeding cases there is no discernible cause, according to the Cleveland Clinic Journal of Medicine.
"It's not uncommon for us to be presented with a patient who comes in and they're anemic, the hemoglobin is low and they have blood in their stool," Dr. Spurr said. The first course is to put a camera on a tube, an endoscope, down through the throat and later possibly performing a colonoscopy.
"But there's a certain percentage, fortunately it's a small percentage of those people, where you wind up with no answer," Dr. Spurr said. And though the patient can undergo X-ray studies, those are usually not sensitive enough to pick up the problem in areas the scopes can't reach, Dr. Spurr said.
Enter M2A, the tiny capsule camera. The camera can display the entire 20-foot section of the small intestine. It also can help in detecting not only lesions and bleeding but also things such as Crohn's disease, a constant inflammation of the intestinal wall that often shows up at the end of the small intestine.
In about 55 percent to 83 percent of the cases in which it was used, the capsule was able to detect a problem, according to the Cleveland Clinic Journal.
Medical College of Georgia Hospital and Clinics plans to begin offering it after Thursday, spokeswoman Danielle Wong said.
Compared with the colonoscopy she had undergone, "it's better," said Mrs. Harris, who took it easy at home while the capsule traveled through her.
Still, it almost sounded too much like science fiction.
"When I first heard of it, it seemed gimmicky to me," Dr. Spurr said.
But having gone through it, Mrs. Harris and her husband, Randy, could joke about the comparison to old movies in which tiny people in a submarine traverse the human body.
"They've come a long ways," Mr. Harris said.
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.
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