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Posted Aug 27 2009 11:34pm
Endoscopy is one of the most fascinating and fast growing fields of medicine which enables accurate detection and treatment of alimentary or digestive tract diseases. Over the last several years, this discipline has advanced enormously and this has resulted in a boon for patients who are able to get non-surgical treatment in case of alimentary tract pathological conditions that not long ago used to be within the domain of surgery.
Modern diagnostics of the alimentary tract takes advantage of the most modern endoscopic visualization techniques. These include high-resolution endoscopy, magnifying or zoom endoscopy, double balloon enteroscopy, capsule endoscopy, chromoendoscopy, fluorescein endoscopy, narrow band imaging, endosonography and other radiological techniques such as virtual colonoscopy.

One of the major advancements that helps patients is Capsule Endoscopy. In this, a miniature capsule is used to record images through the digestive tract for use in the diagnosis of digestive disorders. The capsule, also known as a capsule camera, is the size and shape of a large vitamin pill used to visualize the gastrointestinal tract. The capsule includes a miniature color video silicon chip camera, a light, a battery and a transmitter. The images captured by the video camera are transmitted to sensors attached to the patient's body and recorded digitally on a device similar to a walkman that is worn around the patient's waist.

Capsule endoscopy is not a substitute for regular endoscopy. It serves as an additional diagnostic tool for patients who have been suffering from unexplained GI disorders especially of the small bowel. Capsule endoscopy is helpful in cases of unexplained GI bleeding, suspected small bowel obstruction, Crohn's disease or tumours or unexplained chronic diarrhoea or pain abdomen. The limitations include high cost (around Rs.20,000 per capsule), limited availability, inability to have therapeutic potential and small but definite chance of capsule retention in a patient of suspected bowel obstruction.

Another new helpful technique is Videoenteroscopy - a new endoscopic visualization of the small intestine. A typical double balloon enteroscope is composed of a 200-cm long endoscope, 145-cm long semielastic external tube and two latex balloons to better fix the endoscope inside the small intestine and for easier penetration. The technique is effective in up to 86 per cent cases and so far there have been few complications described. In addition to diagnostic possibilities, enteroscopy allows biopsy and endoscopic therapy, where it scores over capsule endoscopy. Considerably long time of the examination, sedation and use of fluoroscopy may pose some limitations to the procedure.

The good news for patients is that in the new endoscopic area, we have invented better endoscopes that can go farther and deeper and at that the same time with miniature pill cameras, we can explore uncertainties of human intestine with great certainty. This has led to better understanding, diagnosis and treatment of many digestive disorders considered uncommon or difficult to treat.
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