Where no scope has gone before

By BOB MASSEY

Feeling Fit Correspondent

There are some places in the human body too small for much of anything to fit -- even an endoscope.

Now, an endoscope is pretty small, as far as diameter is concerned. The serpentine tube -- even with its own light source and video camera -- is only about 4 mm around, give or take, which is smaller than the barrel of a pencil.

Unfortunately, that's still too large to see parts of the small intestine, no matter which side of the digestive system the scope is coming from.

Fortunately, there's a procedure to remedy that dilemma that's easy to swallow.

The small intestine has always been difficult to diagnose and treat without surgery. Existing radiologic procedures can take a good deal of time -- and may not be very accurate, especially when dealing with small growths.

The endoscope, the cutting-edge solution for a multitude of intestinal diagnoses is, as already mentioned, too big.

Enter capsule endoscopy, also known as wireless capsule endoscopy. No tubes are needed.

In a procedure that sounds more like something out of the miniaturization in "Fantastic Voyage," the patient swallows a capsule. It's about the size of a large vitamin -- probably the largest one you've ever taken -- but it's not a pill.

Instead, it contains one or two tiny wireless cameras, as well as a battery, light bulb and radio transmitter. As it makes its way through the digestive tract, a physician can see clearly to evaluate the small intestine.

During the procedure, the physician applies a sensor device around the patient's waist. As the camera passes through the tract, it transmits video thousands of color images of its journey to a data recorder that is strapped to the patient. The process takes about 24 hours.

Afterward, the images are transferred to a computer, where a software program connects the image into a video that can then be reviewed by a physician.

The procedure is commonly used to find the source of bleeding in the small intestine, and also to detect polyps, tumors, ulcers and Crohn's disease (inflammatory bowel disease). It can also be used to check areas that were unclear or inconclusive on an x-ray.

For obvious reasons, the tract must be clear of debris (such as food and bacteria), so a physician will prescribe some kind of laxative or purgative to "clean house," so to speak -- as with any colonoscopy procedure.

The patient doesn't have to worry about getting rid of the camera. It is, thankfully, disposable, and will be passed naturally in the stool.

As with all diagnostic procedures, capsule endoscopy is not a perfect method. Sometimes the camera moves too quickly to see the necessary detail that would indicate a problem. Other times, it moves so slowly, the battery dies before the capsule has finished its journey. One of the worst cases is the capsule could get lodged in scar tissue or tumors, causing an obstruction. And that usually means surgery.

For the most part, however, the procedure is considered very low-risk, highly effective and safer than more invasive procedures.

And, hey, it's not every day you get to swallow an entire camera.