COVID-19 has caused many to delay important medical appointments and procedures. In fact, traditional gastrointestinal (GI) screenings and care declined substantially during the pandemic as patients did not want to risk exposure if not needed. However, if you have unexplained GI symptoms, early diagnosis and treatment are important to optimize outcomes.[1]
Dr. Michael Bass of GI Specialists of Delaware and his patient, Adam Buccine, answer a few questions about their experience with the PillCam™ SB 3@HOME program – currently made available for at-home ingestion during the COVID-19 Public Health Emergency declared by the United States Department of Health and Human Services (HHS), providing a quick and convenient option for receiving a capsule endoscopy procedure in the comfort of your home.[2]
What would you tell patients who put off medical appointments and procedures for their GI issues due to COVID?
Dr. BASS: Patients missing or delaying medical care can result in late diagnosis, delayed care, and negatively impact their GI health. Early diagnosis and treatment are important for achieving the best outcome for GI patients, and fortunately with telehealth options, some patients can receive their GI diagnosis conveniently from home.
What symptoms prompted your visit to Dr. Bass?
ADAM: I had experienced some uncomfortable GI symptoms for about six months prompting me to call Dr. Bass. At first, Dr. Bass ran a number of diagnostic tests, but everything came back negative which led him to run bloodwork that indicated that I could potentially have Crohn’s disease.
What options did you and Dr. Bass discuss for further testing?
ADAM: Dr. Bass explained that he wanted to be able to get a visual of my small bowel and spoke to me about an option that can be done at home using PillCam™ capsule endoscopy. Dr. Bass told me that this option was convenient, and he would be able to rule out or confirm Crohn’s disease.
Was it important for you to have a telehealth option for this procedure?
ADAM: I was hesitant to be in a medical setting, so an option that allowed me to have a procedure done in the comfort of my home was appealing and seemed convenient. I am an essential worker and am around people all the time, so it was important for me to make sure I was keeping others safe as well as myself and family members.
What type of patient would be a good candidate for the PillCam™ SB 3@HOME program?
Dr. BASS: The program is used for patients who have unexplained GI issues. Patients who are experiencing symptoms such as persistent abdominal pain, severe diarrhea, weight loss or lab tests that may indicate Crohn’s disease, obscure bleeding, or iron deficiency anemia but has not been detected by conventional upper and lower endoscopy.
How does the program work?
Dr. BASS: I would order the PillCam™ kit to be delivered to my patient. Once my patient has received their kit, I would then conduct a telehealth appointment to guide them through the procedure. Once my patient has completed and returned the data recorder and sensor belt, the information from the recorder is securely transferred to the cloud where I can then download the video and make my diagnosis.
How would you explain the technology behind the program to a patient?
Dr. BASS: The capsule endoscopy is a widely used, patient-friendly tool that can obtain images of the small bowel where traditional tests cannot. The technology takes approximately 50,000 images over the course of an 8-hour period.
How convenient was the program?
ADAM: It was fantastic. The kit showed up at my house and was really easy to put together. It came in four parts and the pill was about the size of a vitamin. I had a 10-minute conversation with my doctor and after that I went on about my day. I watched TV, I played with my kids, and I did things that I wouldn’t be able to do if I were at the doctor’s all day. After two days from when I sent back the kit, I received my diagnosis from Dr. Bass.
What have you heard from your patients about this program?
Dr. BASS: From my patients’ perspectives, they’ve had nothing but positive things to say. First of all, it saves them a significant amount of time. Secondly, it minimizes any unnecessary risk to COVID. And lastly, they feel essentially like they’re on the cutting edge of technology and medicine.
How did you feel after you received your results from Dr. Bass? What would you tell others who may be putting off their GI appointments?
ADAM: I definitely had a sense of relief that Dr. Bass was able to rule out Crohn’s disease. If people are putting off their GI care due to COVID, I would let them know how important it is to speak with your doctor about potential telehealth options that may be a good fit for them.
To learn more about GI Specialists of Delaware, visit: www.delawaregi.com/.
PillCam™ SB 3 Indication for use
The PillCam Platform with a PillCam SB capsule is intended for visualization of the small bowel mucosa.
- PillCam Platform with PillCam SB capsule may be used in the visualization and monitoring of lesions that may indicate Crohn’s disease not detected by upper and lower endoscopy.
- PillCam Platform with PillCam SB capsule may be used in the visualization and monitoring of lesions that may be a source of obscure bleeding (either overt or occult) not detected by upper and lower endoscopy.
- PillCam Platform with PillCam SB capsule may be used in the visualization and monitoring of lesions that may be potential causes of iron deficiency anemia (IDA) not detected by upper and lower endoscopy.
The Suspected Blood Indicator (SBI) feature is intended to mark frames of the video suspected of containing blood or red areas.
The PillCam platform with PillCam SB capsules may be used as a tool in the detection of abnormalities of the small bowel and is intended for use in adults and children from two years of age.
PillCam™ SB 3 Contraindications
The PillCam SB capsules are contraindicated for use under the following conditions:
- In patients with known or suspected gastrointestinal obstructions, strictures, or fistulas based on the clinical picture or pre-procedure testing and profile.
- In patients with cardiac pacemakers or other implanted electromedical devices.
- In patients with swallowing disorders.
- NOTE: For remote procedures, the following conditions are also contraindicated:
- In patients with swallowing disorders, including those patients with history of aspiration or difficulty swallowing medications
- In patients with cognitive or physical disabilities that may impact the safety of swallowing the capsule
- In patients with neurologic or muscular disorders that may affect swallowing, such as a history of stroke, or an acute central nervous system (CNS) injury
- In children under age 18
PillCam™ SB 3 Risk Information
- The risks of PillCam™ SB 3 capsule include capsule retention, aspiration, obstruction, perforation, and mucosal injury or bleeding.
- Endoscopic placement may present additional risks.
- Medical, endoscopic, or surgical intervention may be necessary to address any of these complications, should they occur.
- After ingesting the PillCam™ SB 3 capsule, and until it is excreted, patients should not be near any source of powerful electromagnetic fields, such as ones created near an MRI device.
- Please refer to the product user manual for detailed information.
- Physician should take special consideration before administering the capsule in patients with chronic lung disease such as chronic obstructive pulmonary diseases (COPD.)
[1] Gupta, Samir, and David Lieberman. “Screening and Surveillance Colonoscopy and COVID-19: Avoiding More Casualties.” Gastroenterology vol. 159,4 (2020): 1205-1208. doi:10.1053/j.gastro.2020.06.091
[2] 510K cleared by the FDA as of August 27, 2021
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