June 23, 2023 – When patients complain of stomach pain within the emergency room, doctors have limited options. Scans and ultrasounds cannot visualize the inner lining of the digestive tract, so patients are sometimes sent home without answers.
Upper endoscopieswhich involves inserting a versatile tube with a tiny camera into the upper digestive tract, requires anesthesia and may only be performed by a gastroenterologist, so patients could also be sent to a different department or admitted to hospital, or asked to come back back one other day. This can delay the diagnosis and treatment of probably life-threatening conditions akin to stomach cancer or bleeding ulcers.
However, a recent technology could speed things up and make diagnosing abdominal pain easier and faster. It consists of a tiny camera, a big magnet and two video game-style joysticks. The technology, referred to as magnetically guided capsule endoscopy, was recently tested for the primary time within the US.
Here's how it really works: The patient swallows a magnetic, pill-sized device with a tiny camera. Then they lie on their back while a dome-shaped magnet hovers over their stomach. Using joysticks, a physician controls the magnet, steering the capsule across the stomach and taking real-time images that might be reviewed by a gastroenterologist outside the hospital.
“I can almost grab the capsule and pull it over,” said study creator Andrew Meltzer, MD, a professor of emergency medicine on the George Washington School of Medicine & Health Sciences. “If I bring the magnet closer to the patient, the capsule rises to the front of his stomach, and if I pull the magnet away, the capsule falls down. I can also rotate the capsule and look in all directions.”
In the Pilot studyEmergency room doctors were in a position to guide the capsule through the stomachs of 40 patients and discover necessary gastric features 95 percent of the time. The capsule's wide-angle lens captures six frames per second, “which actually looks like a relatively smooth video,” Meltzer said. Standard endoscopies later confirmed that the capsule had not missed any high-risk lesions.
Capsule endoscopy: A rising trend
The study is predicated on research into magnetic capsule endoscopy in China, where most hospitals already use this technology, because the country Stomach cancer ratesThe technology, which can be utilized in Great Britain, HungaryAnd Italyhas been shown to be effective in stomach cancer screening. 11,000 people within the USA die of stomach cancer every yr.
“If this method were as precise as endoscopy and the risks and costs to the patient were much lower, we might consider more comprehensive screening for stomach cancer,” Meltzer said.
Capsule endoscopy has been used because the early 2000s to look at the small intestine and, more recently, the big intestine, says Dr. Shabana F. Pasha, an authority in small-bowel endoscopy and professor of medication on the Mayo Clinic in Arizona. But these non-magnetic capsules are pushed forward by gravity and peristalsis, the natural movement of the digestive tract, making them less effective on an organ as large because the stomach.
“Examining the upper gastrointestinal tract with capsules proved extremely difficult because we could not control their movement. T“They basically stumble through the gut,” said Pasha, who was not involved in the study.
“This is where joystick technology comes in, allowing us to now maneuver magnetically controlled capsules and visualize the entire stomach and key landmarks in a noninvasive way,” she said.
Meltzer cautions that more extensive studies are needed to substantiate the capsule's accuracy, including studies of high-risk patients who can have dyspepsia or gastritis. The capsule also can use artificial intelligence to look at your entire stomach by itself, without the necessity for joysticks.
Meltzer and researchers on the University of Massachusetts are conducting follow-up studies of the capsule, but with a removable holder that enables examination of the lower esophagus.
“The cool thing about it is that it mimics the capabilities of traditional tube-based endoscopy, which we often do in patients with upper abdominal pain,” he said.
In the longer term, the capsule could possibly a biopsy and therapy for bleeding lesions. “All of these things that are coming our way seem pretty exciting, almost like a little Mars rover,” Meltzer said.