Paper Looks at Pill's Ability to Evaluate Barrett's Esophagus, a Common Result of Gastroesophageal Reflux That Can Lead to Cancer
Feb 11, 2004
Capsule endoscopy, the camera pill device already shown to be effective in diagnosing conditions of the small intestine, may now be an effective non-invasive alternative for diagnosing conditions of the esophagus such as Barrett's Esophagus, a common result of gastroesophageal reflux disease (GERD). The paper, authored by Dr. Felice Schnoll-Sussman, a gastroenterologist at the Jay Monahan Center for Gastrointestinal Health at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, was recently presented at the meeting of American Society of Clinical Oncology (ASCO).
In the near future, determining whether a patient has harmless heartburn or Barrett's Esophagus, a serious condition that can lead to cancer of the esophagus, may be as easy as swallowing a camera-equipped pill.
Demonstrating promise for the new technique, the results of our preliminary study of 53 patients showed that in 92 percent of cases capsule endoscopy was able to detect when a patient did not show signs of Barrett's Esophagus, said Dr. Schnoll-Sussman, Assistant Attending Physician at NewYork-Presbyterian/Weill Cornell Medical Center and Assistant Professor of Medicine at Weill Cornell Medical College. While there were occasional false-positives, these cases would be further explored with a standard upper endoscopy. Additionally, future modifications to the capsule may make the screening test more effective.
The study verified the diagnostic findings of capsule endoscopies by giving patients upper endoscopies, the traditional diagnostic tool. The study's co-authors are Weill Cornell Medical College student Adam Hernandez and research assistant Michelle Bigg.
Patients with Barrett's Esophagus, which involves changes in the lining of the esophagus, are 100 to 300 times more likely to develop esophageal cancer. The incidence of Barrett's Esophagus is sharply on the rise, appearing 0.7 times per 100,000 persons in the two years following 1974 and 3.2 times per 100,000 person in the two years following 1992, a 350 percent increase (Devesa, S.S., Cancer 83: 2049-2053, 1998).
The FDA-approved capsule endoscopy device has been shown through numerous studies to be safe and effective. When administered, the capsule glides smoothly through the patient's digestive tract, and is naturally excreted and disposed of. The device, slightly larger than an antibiotic pill, contains a color-imaging camera, a transmitter, and four light-emitting diodes. Patients wear a data recorder around their waist; the recorder stores images that are later downloaded and viewed by the physician. While worn, the data recorder is inconspicuous enough to allow patients to continue everyday activities such as work, shopping, or even eating.
The capsule, while ideally suited to the tight passages of the small intestine, is currently not effective for diagnosis in the stomach or large intestine. The device used is called the M2A™, a patented technology from Given Imaging, Inc., of Norcross, Georgia. It received FDA approval in August 2001.