Kiwis line up to swallow new kind of medicine

By BILLY ADAMS AND KATHERINE HOBY

First there were speed cameras, then webcams. Now doctors are hailing a breakthrough in their battle to cure diseases: the pillcam.

In a concept that could come straight from science fiction, patients in Australasia are swallowing a tiny capsule-sized camera, which constantly takes pictures on its journey through the body.

So far the images have revealed deadly tumours and lesions which more traditional investigations could not detect.

Auckland Hospital has used the pillcam in three patients so far, said Dr Mark Lane of the hospital's gastroenterology department.

It had been helpful in explaining bleeding from the gut, for which experts could not find a cause in two of the three cases.

A number of other patients were "in the queue" to use the pillcam and there had been referrals from as far afield as Invercargill.

"It is true space-age technology and a very useful diagnosis tool, quite a little miracle for mystery conditions I deal with all the time," Dr Lane said.

One of the human guinea pigs, 19-year-old Australian student Matthew Stewart, had suffered from a mystery illness for two years.

A series of endoscopic tests, in which a long tube with a tiny camera at the end examined his digestive system, could not pinpoint the reason for his abdominal pain, anaemia and bleeding from the bowel.

The health problems reaped a significant toll on Mr Stewart's lifestyle. He was forced to give up football, tennis and his favourite foods, and struggled with fatigue and pain.

Last month, doctors at St Vincent's public hospital in Melbourne introduced him to pillcam.

The camera, which includes a flash, battery and radio transmitter, measures 26mm by 11mm.

As it goes through the digestive system, it takes two pictures a second. It transmits the images, via sensors attached to the chest and abdomen, to a recorder at the patient's waist. The images are then downloaded onto a computer for evaluation by doctors.

The pill is excreted naturally within 24 hours.

Mr Stewart was worried the pill might stick in his throat, but taken with water it "just slid down".

And he was delighted with the findings. The images showed large ulcers in the lower part of his small intestine. Although surgery will be required, he has peace of mind knowing what has caused his discomfort.

"I was pretty keen on trying this procedure because I had been in hospital a fair bit, and it's had a pretty bad effect on my life," said Mr Stewart.

St Vincent's and Sydney's Royal Prince Alfred Hospital are testing the M2A capsule endoscopy system as part of wider international trials.

The disposable camera, which was developed in Israel, costs $A800 ($976).

Using conventional tests, Professor Warwick Selby, a gastroenterologist at the Prince Alfred, found causes of intestinal bleeding - such as abnormal blood vessels in the bowel lining, cancer and Crohns Disease - in eight of 13 patients.

But the pillcam found the cause of unexplained gastrointestinal bleeding in 11 patients.

The new technology spotted a tumour in the lining of a woman's bowel, saving her life.

Professor Selby stressed that the new device would supplement, not replace, existing procedures.

"It gives us a way to look at the whole of the small intestine whereas before we were only able to look at about half," he said.

"There is also no sedation or no day in hospital for the patient. They swallow the pill then spend the day doing whatever they want.

"The technology is still in its early days, and it is still being evaluated, but I think this shows great promise."

nzherald.co.nz/health