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by Ano Puchalski, '05

This is what the crazed, serial killer said on the phone to actress Drew Barry Moore in the Hollywood horror flick, Scream, starring Neve Campell, and Courtney and David Cox-Arquette.
In a less suspenseful, and far less painful way, patients and their doctor’s can now get an exact image of their insides, thanks to a new, tiny, technological innovation called the “Pillcam ESO.”
The Pillcam is a tiny tablet sized, camera-containing, pill specifically designed to view the inner lining of the esophagus. Before taking the pill, the patient must be sure not to eat anything two hours prior to the procedure. The patient swallows the pill lying down and is then raised in a series of inclinations over a total of five minutes.

The “bite-sized” camera travels down 21 feet of smaller intestine, between the stomach and colon, snapping about 2,600 pictures (about 14 frames per second). The video capsule is equipped with two miniature color video cameras (one on each end), a battery, and a flashing light source.

The data is then transferred from a recorder belt, which is attached to the patient, to the RAPID Workstation (a computer and monitor used for viewing, editing, archiving, and e-mailing video images that also saves individual images and short video clips). The doctor then reviews the video and makes a definitive diagnosis. The total procedure takes about 20 minutes in the doctor’s office, clinic, or hospital.

Melinda Ching, a 42-year-old attorney and married mother of two, was one of the first patients in Hawai‘i to try the new procedure. Ching said she suffered thru two years of excruciating abdominal pain before using the Pillcam.

“ They (the doctors) still hadn’t been able to find out why I was having this pain,” she said. “They thought I was just reacting to the stress in my life.”

After the procedure, doctors were able to successfully detect and diagnose the cause of Ching’s symptoms: the flaring up of her lymph nodes, which contained cancerous particles. “It would not have been found any other way,” said Dr. Jack DiPalma, an expert on the diagnostic procedure and director of gastroenterology at the University of South Alabama.

After undergoing a biopsy and several chemotherapy treatments over the course of four months, Ching said, she was pain-and cancer-free.

DiPalma said that the PillCam may even be able to replace more invasive diagnostic tests needed for people who suffer from digestive problems such as bleeding, gall stones, polyps, Crohn’s disease and some forms of cancer.

Inscope, manufacturers of the Pillcam ESO, said it was primarily designed to help in the diagnosis of people suffering from Barrett’s esophagus (a pre-cancerous condition as a result of abnormal cell growth in the lower esophagus), and esophagitis (inflammation of the lining of the esophagus) often caused by Gastro-esphageol Reflux Disease (GERD).

The video capsule evolved from an Israeli-based missile technology that transmits images back to a base station before a missile hits a target, DiPalma said. He added that the procedure is covered by most health insurance policies, including Medicare, and can cost between $800 and $1,800. The PillCam alone costs about $450. After dropping into the stomach, the pill is later excreted naturally and is never reused.

Ching said people have asked her what happened to the camera. “I didn’t go looking for it,” she said. “I’m assuming everything came out all right.”


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