FDA Clears Camera-in-a-Pill for People Who Could Not Complete Colonoscopy

A pill that can take pictures of the inside of the colon is now available for people who have not been able to complete a colonoscopy. The US Food and Drug Administration (FDA) has cleared for use the PillCam COLON, which houses a battery, a light, and 2 miniature color video cameras.

The patient swallows the pill, which is approximately 1 ¼ inches long and ½ wide, and wears a recording device on a belt. As the pill makes its way slowly through the digestive tract, it takes video pictures which are wirelessly transmitted to the device. It takes up to 10 hours for the pill to complete its journey, during which time the patient must limit physical activity and avoid stooping or bending. The video is then uploaded to a computer, and a doctor later reviews the results. A bowel preparation is required for the procedure.

According to the manufacturer, Given Imaging, about 750,000 people each year undergo a colonoscopy that can’t be completed for some reason. This is usually due to the size and shape of the colon, past surgeries, or colon disease.

Examination of the colon, through the PillCam or another method, is designed to look for signs of colon cancer or pre-cancer, such as polyps. Polyps are small growths that over time can become cancer. If the PillCam finds polyps or another problem, the patient may need to have another procedure to remove them. The PillCam is only approved for use as a follow-up procedure at this time. It is not recommended or approved as the first method of screening for colon cancer.

How much will it cost?

According to Richard C. Wender, MD, American Cancer Society Chief Cancer Control Officer, understanding the costs associated with colon cancer screening is complicated. For example, while the cost of a screening colonoscopy is now covered without a co-pay by most commercial insurance plans, the costs of some procedures associated with the colonoscopy may not be fully covered. This may include some types of anesthesia, or the lab work needed to examine a polyp.

“Patients are likely to face the same challenge for a follow-up test done following an incomplete colonoscopy,” said Wender. “The colonoscopy may be covered but all the costs associated with the follow-up tests may not be covered – and I’m certain that some patients would face an unexpected charge.”

Other options

The PillCam is not the only option for follow-up of an incomplete colonoscopy, and according to Wender, it may not be the best option. “CT colonography, sometimes called virtual colonoscopy, also has a very important role to play in this setting and, for now, is the option that is most available and with which most centers have the most experience,” he said.

CT colonography is a scan of the colon and rectum that produces detailed cross-sectional images so the doctor can look for polyps or cancer. It requires bowel prep, but no sedation. If suspicious areas are seen on the test, another procedure may be needed.

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