'Pillcam' Shows Esophagus Damage

ByABC News via logo

March 23, 2006 — -- When Dr. Tim Johnson, ABC News' medical editor, wanted to make sure his chronic heartburn wasn't causing a more serious problem, he tried out a new technology -- a device called a pillcam -- to look inside his esophagus.

The pillcam consists of a disposable camera in a tiny pill that can take up to 2,000 color snapshots. This "heartburn cam" is the second in the pillcam series. The first, pillcam SB, has been used since 2001 to detect ailments of the small intestine.

Dr. Kathy Bull-Henry of Georgetown University Hospital has worked with the pillcam for about two years to screen chronic heartburn sufferers for other problems, such as ulcers and precancerous conditions.

When heartburn occurs frequently -- three times a week, for at least three months -- it may be a sign of acid reflux disease, from which about 15 million Americans suffer. About 12 percent of acid reflux patients have a condition called Barrett's Esophagus, which greatly increases the risk of esophageal cancer. The American Cancer Society estimates that 13,770 deaths from cancer of the esophagus will occur in 2006. Just 16 percent of esophageal cancer patients survive past five years.

The pillcam has been an effective diagnostic tool.

"You can see any kind of damage you might have from reflux into the esophagus," Bull-Henry said.

She first fit Johnson with a receiver pack to record the images. Then it was lights, camera, action as Johnson swallowed the pillcam.

The doctor slowly raised the head of Johnson's bed every two minutes until he was upright. Minutes after the procedure, the photos were ready.

Bull-Henry found that the camera had picked up something minor but still important.

"You can see an area here, within the whitish lining of the esophagus, a more reddish-appearing area, and this I think is a small erosion," she said. "You can see it more clearly here. I think that's a very superficial erosion."

The erosion was caused by an irritation from stomach acid that was backing up into Johnson's esophagus. Luckily, it wasn't serious.

"As erosions go in that area, that's a very small one," Johnson said.

The pillcam not only produces much faster results than a traditional endoscopy -- in which patients swallow a long tube with a camera on the end -- but is much more comfortable. It is excreted in 24 hours to 48 hours.

"It is less invasive," Bull-Henry said. "You don't need to have sedation. You don't have to stay in our recovery area for an hour or two hours, so you can return immediately to your regular routine."

Using a pillcam to detect your heartburn damage is cheaper than having an endoscopy, too. The total cost for a pillcam procedure is about $1,000, while the cost for an endoscopy is about $1,600. However, the pillcam is such a new technology that some insurance companies may not cover it.

Some patients may still need a traditional endoscopy -- especially those who have problems revealed by the pillcam. An endoscopy can remove tissue from the patient so it can be studied under a microscope.

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