How does that song by the Vapors go? “I want a doctor to take your picture, So I can look at you from inside as well.” All racist stereotypes aside, the pill camera is now approved by the FDA for colon cancer screening in individuals who have “experienced an incomplete colonoscopy,” according to a story on the Associated Press today. The PillCam Colon is a camera the size of a large pill which is swallowed by the patient. It takes a series of pictures as it passes through the body, which are transmitted to a receiver worn by the patient during the day it takes to pass through the GI tract. What do we do with it at that point? Don’t worry. I found from the manufacturer’s website that the device is disposable. Unfortunately the images are not of the same quality as those obtained from a regular colonoscopy. Doctors will still prefer for you to have the more invasive procedure if you are able to have a successful ‘scope. What does this mean for you? Probably nothing… yet. For now it means that patients who have started to have a colonoscopy without being able to finish are approved to use the pill camera. Abortion of colonoscopy can occur because the operator is unable to pass the tube completely through the colon or the preparation was incomplete. Incomplete preparation means not all intestinal contents were irrigated out by the preparation the night before the procedure.
The first hurdle to getting a pill by mouth instead of a tube up your (where the Sun don’t shine) is FDA approval. This may not happen for most patients until the PillCam is able to produce images as good as the colonoscope. The second hurdle is coverage by health insurance companies. Coverage by insurance usually but not always follows FDA approval for a procedure. We see companies most eager to approve paying for a new technology when it saves them money. Getting screening for colon cancer, the second most common cancer to cause death, would be expected to save money for the insurance company because the PillCam is estimated to cost one-fifth of the expense of a regular colonoscopy.
You will not see it soon, but keep asking me when you come in for your regular physical exam. I may be able to recommend the PillCam in place of screening colonoscopy in the future. Until that time, don’t try to do the “Screening Selfie.”