Ashok Sikdar was at a complete loss. For months, his haemoglobin count would hover around a critical 7-8, and he would pass blood in his stool. But the numerous doctors he went to couldn’t figure out where he was bleeding from. Both upper and lower GI tract were normal on endoscopy and the inference was “obscure GI bleed”.
The picture remained foggy till the middle-aged telephones official came in touch with Mahesh K. Goenka and the magic capsule. The consultant gastroenterologist and endoscopist told Sikdar he was bleeding from his small intestine and offered him a capsule endoscopy to locate the bleed. The wonder diagnostic ‘guided missile’ clearly showed two sites of bleeding ulcers in the distal part of the small intestine, the ileum.
After dozens of blood transfusions, the patient was operated upon and the affected part of the intestine removed. Now, Sikdar has a healthy haemoglobin count of 12 — “something I have never had before” — and is back on life’s track, full steam.
“The M2A (mouth to anus) capsule is really a camera with a lens, a light source, two batteries and an antenna, and is a diagnostic marvel. The patient swallows it like a therapeutic capsule and once inside the body, it flashes twice every second to take 60,000 images over the eight hours it stays inside the GI tract,” explains Goenka.
All the images are recorded in a data recorder strapped to the patient’s body along with electrodes. Later, the pictures are downloaded on to the computer, enabling the doctor to pinpoint the site of the disease.
Invented by an Israeli scientist, Iddan, who was involved in developing the Cruise missile during the 1990 Gulf War, the M2A capsule was approved by the FDA in 2001. Goenka’s Eko Endoscopy Centre at 54, J.L. Nehru Road, is among the five centres in the country and the only in eastern India offering the hi-tech investigation, having done 29 cases since last August.
“It’s a scientific boon and makes diagnosis of ulcers, tumours, abnormal vessels or tuberculosis in the small intestine that much easier,” observes Goenka. The 20 ft-long small intestine was always the dark area of the GI tract, not accessible through routine endoscopy, and doctors had to rely on barium-meal X-rays, that would often miss more than it would diagnose.
Capsule endoscopy is painless, and helps doctors avoid surgery in a significant number of cases, while doing well-planned ones in others. GI tract specialists hope once the cost comes down — a procedure now costs Rs 30,000 at Eko — the capsule could be further upgraded to even act as a therapeutic instrument.