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Man Reports PillCam Stuck In His Gut For Over 12 Weeks
A Portland man appears to have a pill-sized camera stuck in his gut. That man is me... Let me explain.
For the average Joe, the following statement might sound a bit peculiar: I have swallowed a pill-sized camera a number of times. You see, I have Crohn's Disease (CD) in the small intestine -- a 20 foot-long portion of the gastrointestinal tract that runs between the stomach and the large intestine (colon). A "PillCam" is the most non-invasive, detailed method to survey this area as it doesn't require a scope up the rectum or down the esophagus, nor does it require any tissue slicing. It's also one of the safest procedures available -- the retention rate is as low as 1%. Unfortunately, this most recent capsule endoscopy resulted in my admission to the 1% club.
On March 27th, 2018, I swallowed the PillCam that is currently lodged in my small intestine. If you do the math, that's more than 82 days ago (over 12 weeks). After hiking Smith Rock and summiting Black Butte a couple weeks later, I thought for sure the pill would have exited. It didn't, as evident by the follow-up X-ray. It can be difficult to find research on such a what-if scenario that happens to so few, but I did manage to find a Motherboard article telling the story of Scott Willis, a CD patient that had a PillCam lodged in his gut for eight weeks. One of the key differences between him and me is that he had a partial block and endured more symptoms, prompting him to schedule a procedure to get it out quicker. I'm relatively symptom free.
We have tried upping the dose of corticosteroids to reduce inflammation and help the pill pass through the strictured areas, but that didn't seem to work. Most recently, I had two double-balloon enteroscopy procedures done within a week apart. They were able to locate the PillCam during the second procedure, but weren't able to retrieve it without risking the scope itself becoming stuck. The next step is to try again via the esophagus. The potential issue/complication here is the location. As my doctors warned, the PillCam is stuck 15 feet down and the scope is only 20 feet in length. There's little wiggle room if the pill is slightly further down the GI tract than estimated.
I am sharing this story with the Slashdot community for two reasons. First, those entrenched in the world of cyborgs and/or modern-day medical procedures may find this experience particularly interesting. Second, the more people who know about the procedures and complications of Crohn's Disease the better. For those interested, I'll update this post after the next procedure. Have you or someone you know experienced a capsule endoscopy? Please share what you feel comfortable with.
UPDATE 7/11/18: Yesterday, I had the procedure to remove the PillCam via the esophagus and it wasn't successful. The doctor said he tried everything he could to retrieve it but the scope wasn't quite long enough to reach the pill. I'll be talking with a surgeon next week and will update this post when a surgery date is confirmed.
For the average Joe, the following statement might sound a bit peculiar: I have swallowed a pill-sized camera a number of times. You see, I have Crohn's Disease (CD) in the small intestine -- a 20 foot-long portion of the gastrointestinal tract that runs between the stomach and the large intestine (colon). A "PillCam" is the most non-invasive, detailed method to survey this area as it doesn't require a scope up the rectum or down the esophagus, nor does it require any tissue slicing. It's also one of the safest procedures available -- the retention rate is as low as 1%. Unfortunately, this most recent capsule endoscopy resulted in my admission to the 1% club.
On March 27th, 2018, I swallowed the PillCam that is currently lodged in my small intestine. If you do the math, that's more than 82 days ago (over 12 weeks). After hiking Smith Rock and summiting Black Butte a couple weeks later, I thought for sure the pill would have exited. It didn't, as evident by the follow-up X-ray. It can be difficult to find research on such a what-if scenario that happens to so few, but I did manage to find a Motherboard article telling the story of Scott Willis, a CD patient that had a PillCam lodged in his gut for eight weeks. One of the key differences between him and me is that he had a partial block and endured more symptoms, prompting him to schedule a procedure to get it out quicker. I'm relatively symptom free.
We have tried upping the dose of corticosteroids to reduce inflammation and help the pill pass through the strictured areas, but that didn't seem to work. Most recently, I had two double-balloon enteroscopy procedures done within a week apart. They were able to locate the PillCam during the second procedure, but weren't able to retrieve it without risking the scope itself becoming stuck. The next step is to try again via the esophagus. The potential issue/complication here is the location. As my doctors warned, the PillCam is stuck 15 feet down and the scope is only 20 feet in length. There's little wiggle room if the pill is slightly further down the GI tract than estimated.
I am sharing this story with the Slashdot community for two reasons. First, those entrenched in the world of cyborgs and/or modern-day medical procedures may find this experience particularly interesting. Second, the more people who know about the procedures and complications of Crohn's Disease the better. For those interested, I'll update this post after the next procedure. Have you or someone you know experienced a capsule endoscopy? Please share what you feel comfortable with.
UPDATE 7/11/18: Yesterday, I had the procedure to remove the PillCam via the esophagus and it wasn't successful. The doctor said he tried everything he could to retrieve it but the scope wasn't quite long enough to reach the pill. I'll be talking with a surgeon next week and will update this post when a surgery date is confirmed.
Maybe you can use some strong rare-earth magnets to help it along?
Have you tried eating only meat? http://meatheals.com/category/... Other, lower tech approaches: The Core Strategy | Crohn's Dad http://bit.ly/15S3dWL
"Tempers are wearing thin. Let's just hope some robot doesn't kill everybody." --Bender
It sounds really shitty.
https://www.youtube.com/watch?...
Slashdot, fix the reply notifications... You won't get away with it...
When I saw the title of the post I knew this would be about someone with Crohn's. I have it too, and my doctor wanted to do a PillCam, but luckily he decided to do an abdominal MRI first to make sure there weren't any strictures narrow enough to prevent the pill from passing through. After the MRI the doc decided it was too risky, and went for a traditional colonoscopy instead.
I hope they find a way to get yours out without resorting to major surgery. :)
Good luck! Crohn's sucks enough without problems like this to deal with.
Hopefully the Crohn's MAP vaccine will be approved soon and we can all put this behind us.
Plain and simple: thanks for taking about this, both for the interest and the education.
I'm typically jokey here, but really: thanks, and good luck losing that thing.
And best wishes for a speedy recovery (or at least as speedy as it can be at this point.)
You should hear about my kidney stones. But that was nothing compared the migraines. Severe pain, the doctor recommended castration to relieve them. Of course I didn't want to comply but the pain was so bad finally I agreed. After the surgery, I didn't have headaches but for obvious reasons I was feeling down. To cheer me up I went to get a nice, custom tailored, French suit. The tailor measured me, and said, "you wear size 35 pants." I said, "No, I do and always have worn size 32. Don't tell me what I know." The tailor said, "No Monsieur, I am sorry, but for a man like you, wearing size 32 will be too tight and give you severe migraines. I'm surprised you haven't had them already."
Anyway I hope your camera pill passes better than my kidney stones.
"First they came for the slanderers and i said nothing."
Try Apple cider Vinegar , with your next attack. It works within a minute takes the pain away. Works perfect for me. (a couple shot glasses full mixed with a little water).
[($)]
This is not a joke. Try smoking (or vaping, or eating) some marijuana. It tends to relax internal muscles and may help you pass it. At worst, it's a cheap, harmless, fun thing to try before going in for a more complicated, potentially needless procedure.
You might have missed the news on CD awhile back, ask your doctor if he/she knows what causes Crohnâ(TM)s (get treatment targeting the Candida fungi and E. Coli and the S. marcescens), hereâ(TM)s two relevant quotes from https://www.sciencedaily.com/releases/2016/09/160920151435.htm
The researchers found strong fungal-bacterial interactions in those with Crohn's disease: two bacteria (Escherichia coli and Serratia marcescens) and one fungus (Candida tropicalis) moved in lock step.
Additionally, test-tube research by the Ghannoum-led team found that the three work together (with the E. coli cells fusing to the fungal cells and S. marcescens forming a bridge connecting the microbes) to produce a biofilm -- a thin, slimy layer of microorganisms found in the body that adheres to, among other sites, a portion of the intestines -- which can prompt inflammation that results in the symptoms of Crohn's disease.
It sounds as though despite active disease, stricture, and these technical headaches, that you are active (hiking tall rocks) and thus not acutely complicated by your palsied pill. If you are not sick, then no urgent risk. The big concern of course is that the thing will lodge in the stricture and you will get acutely obstructed.
I assume that your doctors have already tried various things, but on hearing the story anew, several things come to mind. They might have all been done already, but it doesn't hurt to get fresh ideas:
- Steroid boost. I see that that has been tried, but all too often when I hear that steroids were raised, it is often just trivial amounts. If reduction of inflammation and edema will loosen the stricture and de-narrow the lumen, one to two weeks of sizeable doses might be needed, e.g. the kinds of doses used for severe life threatening flares of autoimmune disorders such as lupus or pemphigus.
- Lubrication. Mineral oil is a classic stool softener and lubricant. It is less in favor today because (1) concerns about hydrocarbon aspiration and pneumonitis if you are obstructed and vomiting, and (2) high priced pharmaceutical pills are more in the minds of most physicians these days. If you are not obstructed (sounds like you are not), then a good swig or two of the stuff might help.
- Bulk flow. The concentrated osmotic agents that are used for bowel preps might create a wave of peristalsis and flow that might carry the flotsam forward. This could be a concern if you are obstructed, but evidently you are not. But if you were . . .
- Gastrograffin swallow. This is intestinal x-ray dye. It is very hygroscopic and can induce bulk fluid flows as well as dehydrating the mucosa (lining tissue) of the bowel surface. It is often used as a first line intervention to alleviate an early bowel obstruction before resorting to surgery. A gastrograffin swallow would partly combine the effects of steroids and osmotic agents, which if primed with mineral oil might get the thing to sneak by.
- Technical. If they could see it with the 2-balloon enteroscope, then they might have snagged it except that they either could not reach it or else not grab it with a biopsy forceps. Instead, they could use a stone basket. If the stone baskets are on too short a wire, then weld-solder-splice an extension. Big companies such as Olympus that make the equipment will often make custom modified hardware for special circumstances, and making a 20 or 25 foot long stone basket might be easy if you ask your local rep for help.
None of these are guaranteed to work, but they have a fair chance of doing so, and they are safe. Perhaps one or some of these have not been tried yet, in which case it is worth discussing them with your doctors.
Good luck.
I’m sure there’s someone that’s willing to pay to watch that livestream. Or maybe just livestream it with sponsorship from laxative companies.
This, too, shall pass.
I've calculated my velocity with such exquisite precision that I have no idea where I am.
! YOU SHALL NOT PASS
I thought for sure the pill would have exited.
Is that what the kids are calling it these days? I'm not judging.
I am sorry you have this problem.
I am a Trauma, General surgeon.
This is what I would do:
1) removing the pill does not fix the stricture problem. It simply kicks the proverbial can down the road. The next time something gets stuck there, (and there will be a next time) it will be possibly worse. It may lead to a perforation and an emergency surgery with possible ostomy (stool bag) as the outcome.
2) I would do laparoscopy using three 5mm ports. Identify the stricture, and do the correct surgery which is a stricturaplasty And removal of the Pill Cam. If stricturoplasty is inadequate then you may need a resection.
Thatâ(TM)s it.
The real problem is that you can not avoid the inevitable which is you have a relatively asymptotic stricture which is symptomatic by virtue of the Pill Cam not passing through. Consider it a warning and deal with it in semi-elective manner. Better now then as an emergency which given enough time it will become.
This smacks of editorial over reach, and I don't like it.
If Slashdot is going to start deleting comments, they're removing one of the last reasons to stay here.
Of course, it could also be dangerous, but it might be worth talking to the doctor about. {...} Rare earth magnets that are SWALLOWED can do damage,
The danger of swallowing rare earth magnets comes from the plural -s at the end of the word.
If you swallow just one, nothing of significance happens, you'll eventually just shit it out.
The risks rise dramatically if there's more than one magnet, specially if swallowed on separate instance (not stuck together as 1 block, but separately).
They'll travel with a distance apart from each other along the 20feet of gut tract.
If they come (from the outside perspective) close to each other, while they are in 2 distinct part of the gut (from the perspective of the length of the gut).
(Say, each magnet is in a turn, and both turn happens to be close to each other. Basically think a long labyrinth and the magnets only having a couple of walls inbetween), then there's a high risk that the magnets will attract each other and get stuck.
They'll be stick magnetically to each other, which might prevent from moving further along the gut.
They'll also be very strongly pinching whatever (mostly gut wall of the different loops) is in between them, which could damage the tissue, and/or block the blood flow due to the pinching.
These can lead to the the gut wall dying.
Regarding the camera, as you say it might be an idea worth talking but could be dangerous.
The poor guy isn't healthy, he has a gut disease (chronic inflammation).
His gut doesn't behave like a simple 20feet long hose. But instead due to the inflammation, the gut's wall is partly damaged, and in some points is stuck together (that's the "strictures" he's talking about). The hypothesis is that the pill is stuck in one such stricture.
Pulling it with magnets could potential help it go further along the gut.
But pulling it with magnets could also pull the pill against damaged wall, burrowing it further into the walls, or risking to rupture a peculiarly damaged wall.
For the double-balloon procedure, which end did they enter? If via the colon, I'll have to reference this in the future when BeuHD makes very silly posts a about solar-electric and such.
Given that he mentions that the eosophagus would be the next entry to try, I think we can guess that the colon was the entry used in the first 2 attempts.
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
The very last reason, you mean. I hear about things in other places first these days, even G+regularly beats /. To the punch
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
Let me preface by saying I am a Gastroenterologist; you obviously have discussed the options here, and it sounds like you've developed a fibrostenotic stricture. While retrieving the capsule may give you some peace of mind for a while, it will not address the underlying issue, namely the fibrosis that has developed in this segment of bowel. First, you need to be on biologic therapy, either an anti-TNF like remicade, humira or cimzia, or one of the newer drugs such as entyvio, or things will, eventually get worse. Assuming this is already the case, I would proceed with a small bowel resection, performed by an experienced colo-rectal surgeon, preferably one with extensive experience inflammatory bowel disease. If you have not had a recent MR enterography, they can run the small bowel during surgery to evaluate for any other likely strictured or heavily diseased areas. I would not be in favor of stricturoplasty as recommended above, as recurrence rate is higher with stricturoplasty.