A tiny camera that looks like an oversized pill has been used in the last few years to diagnose some gastrointestinal system problems that can’t be detected by other means. In fact, the camera sort of works like a pill — swallow it and go about your day. As the camera travels (or tumbles usually) through the digestive system, it transmits digital images to a belt-worn recorder that are later downloaded into a computer.

Called capsule endoscopy (CE), this wireless technology has been proven to diagnose some conditions not easily detected otherwise. The most recent advance in endoscopy technology, it’s considered a breakthrough in diagnosing diseases related to the small intestines.

“It’s a better diagnostic tool for the small intestine, which is notoriously difficult to evaluate with standard endoscopic technology or radiological techniques,” says Dr. Spencer Root, M.D., a gastroeneterologist with The Doctors Clinic who sometimes refers his patients to Tacoma to undergo the procedure. “I see it as a diagnostic tool in cases of unexplained gastrointestinal blood loss.”

Ironically, the concept of remote imaging was first envisioned by a mechanical engineer who conducted research for Israel’s Ministry of Defense, then later applied the technology to the small intestine with the help of some medical acquaintances. Twenty years later, in 2001, as his research had morphed with that of a British gastroeneterologist and the technology was tested, the U.S. Food and Drug Administration gave it the thumbs up.

The CE can help spot ulcers, blood vessel changes (vascular malformation), and has been used widely to diagnose Crohn’s Disease, an inflammatory bowl disorder. Patients swallow the camera and then must wear a “belt” for eight hours, with a recorder that continuously receives transmissions from inside the body, as the camera — which has its own lights — travels through the intestines, stomach, and bowel. Patients in the meantime can continue moving around and doing light activities. For the physician, wading through the images later can be a strenuous process. Downloading the data alone takes two to three hours.

A study by the Mayo Clinic, published in January, confirmed that capsule endoscopy can detect abnormalities better than other small-bowel imaging techniques, but since it doesn’t indicate the location of the abnormalities, it is more effective when used with computed tomorgraphy (CT).

Dr. Root concurs that for now, CE’s use is narrowed to the unexplained gastrointestinal bleeding or perhaps confirmation of other diagnoses like Crohn’s. “Unless the technology changes dramatically so it can move around into corners, it’s limited,” he said, but added that CE could eventually become a more widely used tool. Indeed, according to a March 2004 clinical update published by the American Society of Gastrointestinal Endoscopy, other CE uses are being examined, and perhaps future innovation would allow the device to make biopsies, take samples, or have controlled movement.