video capsule endoscopy vs barium xray

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basil
Regular Member


Date Joined Oct 2008
Total Posts : 78
   Posted 12/6/2008 7:52 PM (GMT -7)   
I have already had a colonoscopy but my GI wants to check out my small intestine. He gave me the choice of either the video capsule endoscopy or the small bowel series barium xray. I'm trying to decide which test to have and would be interested in hearing people's experiences.
My main concerns are 1) the video capsule will cost me significantly more out-of-pocket, and 2) my GI said the barium xray could potentially cause a flare, while the video capsule is much less irritating.

I've been doing really well the last few weeks on Colazal so I'm hesitant to undergo a procedure that could make me flare again. I'm also wondering how necessary these tests are, especially given I've been feeling pretty good.
Thanks!
Basil

gachrons
Veteran Member


Date Joined Mar 2007
Total Posts : 4527
   Posted 12/7/2008 4:34 AM (GMT -7)   
Hi Basil I don't know what to say here but I was nervous going for a CT scan because of the telebrex drink and I have had mucus since then so not much help here of course that doesn't mean it was the telebrex either that caused it. Hope others have some info I never had the cam. lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,hemmies,and still alive.lol gail


Blossom28
Regular Member


Date Joined Oct 2008
Total Posts : 47
   Posted 12/7/2008 7:47 AM (GMT -7)   

Basil,  I have had every test in the books.  I would DEFINITELY go for the pill cam . . . it's easy to swallow and I had no problems with it at all, and it delivers a much more comprehensive look at your small intestine and colon. 

The barium test and the CT scan tests are hard because you have to choke down all of that liquid (either Barium, which is like drinking cement, or the CT contrast, which is just nauseating). 

 


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 12/7/2008 10:08 AM (GMT -7)   
I agree with Blossom that you should go for the pill cam. Many have had much more success with the pillcam. It can see inside the small intestines and provides much better pictures. Good luck with your decision.
Been living with Crohn's Disease for 33 years.  Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium.  Resections in 2002 and 2005.  Also diagnosed with Fibromyalgia and Osteoarthritis. Currently my Crohns is in remission.


Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7077
   Posted 12/7/2008 4:01 PM (GMT -7)   
I agree with the others that the pill cam is the way to go unless money is really an issue. If it will be a hardship to pay the out-of-pocket portion, then you might want to do the small bowel follow through [SBFT]. Do bear in mind that many people have had a SBFT that do NOT confirm their disease. My SBFT was normal even though I had/have disease in the ileum.
Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.
 


ozonehole
Veteran Member


Date Joined Dec 2006
Total Posts : 559
   Posted 12/7/2008 6:06 PM (GMT -7)   
I've never done a pill cam myself, and I'm just wondering: is there a chance of the pill cam not being able to get past an obstruction? That could be a serious complication if it happened, I would think.

best regards,
Robert
Crohn's since 1988
3 resections


Joie1
Regular Member


Date Joined Oct 2008
Total Posts : 376
   Posted 12/7/2008 8:28 PM (GMT -7)   
Well...my pill cam never came out. I was in the hospital and they tried it...only I wasn't having bowel moments since they had me on TPN. I asked if they would be sure to remove it during my third surgery since it kinda worried me that it might just be chilling in there. Still, if you're eating...WHOLE different story. Looks like everyone else has had an easy time with the cam. It really is easy to swallow even with an NG tube in the way.

As for the small bowel follow through...not too bad. The way they did mine, drink the nasty stuff, keep a tissue near your face to wipe at your mouth. Don't pee after you take it (they'll give you even MORE of it if you do).
27/f/CD. 4 CD related surgeries: 2 resections, 2 JP drains, 3 NG tubes, many absesses (including the one my most recent surgery scraped off my ovary) and fistulas.
Currently trying to figure out hip and knee joint pain.
Have lost in these surgeries: appendix, 8 in. intestine, R fallopian tube, gallbladder, 10 in. intestine
Dx'd: February 2008.
Pentasa (and much mental screaming)


CrohnieToo
Veteran Member


Date Joined May 2003
Total Posts : 9448
   Posted 12/7/2008 8:57 PM (GMT -7)   

Assuming you have somewhat normal motility, the pill camera endoscopy does give the best, most reliable info about what is going on in your small intestine. Its a difficult area to know just what is going on in there. If there is reason to suspect a stricture then there is, at added cost, the Agile Patency Capsule, same size as the PC but dissolvable w/in 3-4 days. If it passes the PC should pass as well. I can understand cost being a consideration and you might as well ask and know right up front what it is going to cost you out of pocket so you can make the best decision for you.

No mention of the CT Enterography? Its much more clear and accurate than the barium upper GI series w/SBFT. Of course, more radiation risk than w/the SBFT.

SBFT? Bottom of the barrel for Dx'ing purposes. BUT it has been the "gold standard" for small intestine involvement for years and years only recently being surpassed by the CTE and PCE. A good many of us were Dx'd via the SBFT.

I would concur that the PCE is MUCH LESS LIKELY to not irritate the colon. IF you opt to go w/the SBFT by all means DRINK LOTS OF WATER asap after the procedure and for the next 2-4 days until your BMs are natural color again. Start on MOM (Milk of Magnesia) regular dose the day of the SBFT. Bariuim sets up quickly in the intestines and does get HARD by the 3rd day or so. And I do mean HARD! Even the toilet has trouble flushing it down it is so heavy and hard. (Might be interesting to see how these new low flush toilets can handle a 3rd day barium stool *wicked grin*)



Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.

Post Edited (CrohnieToo) : 12/7/2008 9:00:29 PM (GMT-7)


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13451
   Posted 12/7/2008 10:34 PM (GMT -7)   
C2 is so right. Been there & done both. Take the pill cam any day over barium. Susie


basil
Regular Member


Date Joined Oct 2008
Total Posts : 78
   Posted 12/10/2008 7:33 PM (GMT -7)   
I had a feeling the pill cam would win.

So I'm struggling to decide if i even want to do the pill cam right now. A bit of background, like I mentioned in my previous post, the med I'm on now (Colazal) has eliminated my bleeding and D, which were my main symptoms. My doctor diagnosed me with Crohn's based on a colonoscopy and blood tests. I have the disease in my descending colon.
My GI wants to do the pill cam to see if my small intestine is also diseased. His reasoning for wanting to examine the small intestine was 1) his "curiosity" 2) because he would put me on a different med that targets that area if it's diseased, and 3) if i need surgery down the road, he'd like to know what part of my GI tract is diseased.

I'm confused because since the Colazal, which targets the colon, is working great, doesn't that seem to indicate the small intestine is ok??? Or at least that I don't need a new med that targets the small intestine??
If my insurance deductible wasn't about to re-set (which means I'll have to pay at least $2000 for the pill cam), I'd probably just do it. But given the expense, I'm kind of feeling it's not necessary for me at this point.

Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7077
   Posted 12/10/2008 8:26 PM (GMT -7)   
Tough call. I have gone with the rationale of a "doctor's curiosity." Both times it proved zilch. I have "good" insurance so the cost to me was minor. If I were in your situation, I would explain to the doctor what you have said here. While letting diseased areas go untreated can lead to problems down the road, a little more time will allow your small intestine to show its "goods" so to speak since the Colazal has calmed the other symptoms.
Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.
 


hspenser
Veteran Member


Date Joined Dec 2005
Total Posts : 544
   Posted 12/11/2008 6:42 AM (GMT -7)   

Had a full blockage that sent me to the hospital...but resolved itself before they cut me open....

C-scan while in the ER showed the blockage.....

Doctor orders barium x-ray....I do that and while under going the procedure they also do some live action x-rays that showed the intestines as they moved about processing the barium.....now this test was done only 4 days after the blockage....results?????  No major issues or narrowing of the small intestine could be seen.  One area seemed questionable but diagnosis was not possible.

My doctor felt the x-ray was A) wrong  B) inconclusive, so he suggested that I do the pill cam...he also felt that, given my last blockage added to the fact that I had experienced at least two more partial blocks in the week following, I might end up with the pill-cam getting stuck and thus require surgery to remove it.

The test was scheduled for Monday November 3rd.....I blocked on the 2nd, cleared that night, but went in for surgery on the 4th.  They removed 2 1/2 foot of small intestine that the surgeon said was some of the worst (but not the worst) he had ever seen.  There were two sections close to each other, one was about 18 inches long and the other was about 8 inches long with about 4 inches between them....so the entire piece was removed.

The pill cam would have most certainly showed this...but the x-ray did not...even when they knew where top look based on the c-scan taken during the blockage a few days prior.

Conclusion.....go with the best and most advanced tests available.


dx IBS 1999   UC 2000   CD 2001
Tested BIOGEN TYSABRI (gave me 2 years of remission)
tried Naltrexone Jan. 19, 2007 Stopped the Naltrexone July 28th...started Humira Aug 31st, 2007...current dose one shot every week. Also nightly dose of mesalamine.
Surgery Nov 4th, 2008 removed 30 inches of small bowel.
 Crohns is currently active and has been since April of 2005
52 yrs old


Meg S
New Member


Date Joined May 2006
Total Posts : 10
   Posted 1/11/2010 2:46 PM (GMT -7)   
What is the cost, on average of the pill cam??
Thanks,
Megan NF-1
husband Jerry allergy to milk, wheat, animals, molds, diagnosed with Colitis
daughter Angela 6, Down syndrome and Autism, milk allergy
son Joshua 4
daughter Christine Feb 12, 2009


Crohnie4Life
Regular Member


Date Joined Jan 2010
Total Posts : 69
   Posted 1/11/2010 5:11 PM (GMT -7)   
The pill cam was so easy for me. Better than having to drink that icky stuff!

Meg S
New Member


Date Joined May 2006
Total Posts : 10
   Posted 1/11/2010 5:20 PM (GMT -7)   
That stuff is bad! Glad the pill cam was so good! I hope my PPO covers it!
Thanks,
Megan NF-1
husband Jerry allergy to milk, wheat, animals, molds, diagnosed with Colitis
daughter Angela 6, Down syndrome and Autism, milk allergy
son Joshua 4
daughter Christine Feb 12, 2009


gumby44
Veteran Member


Date Joined Nov 2007
Total Posts : 4096
   Posted 1/11/2010 7:00 PM (GMT -7)   
I does kind of make sense that your doc would switch the med based on the severity and location of disease. I take Pentasa which as I understand it, is just like Colazal only it releases in the small intestine instead of lower in the colon. My SBFT showed no disease, but the pill cam showed a large ulcer in my small intestine. At the time, I was very anemic, and we couldn't figure out where I was having blood loss. My colonoscopy was also normal, but a colonoscopy a year later showed a stricture and Crohn's in my ileum. I know it's a hard decision. Will the hospital work with you on the deductible, or let you pay it off slowly? Good luck with your decision. $2000.00 is a lot of money!
51 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007. Also have IBS, and had Salmonella Dec. '07
currently taking Pentasa- 4 500mg pills per day, Metamucil and colace for constipation, probiotics


Meg S
New Member


Date Joined May 2006
Total Posts : 10
   Posted 1/11/2010 7:54 PM (GMT -7)   
For me, I am not sure what they expect to find. I have left side pain, probably 4x a month, lasts for about 8 hours. I had one, large, gastric diverticulum removed in 07 and the spleen and pancreas were injured. For awhile after surgery, my pancreatic enzymes were high. Ultrasounds show nothing. I was going to have a CT scan, but since 07 I have had 3 and am worried about the huge amount of radiation. I also have NF-1 and the doc said the tumors CAN grow in the small bowel. So he thinks the pill cam is the best to see in the small bowel. UGH!!
Thanks,
Megan NF-1
husband Jerry allergy to milk, wheat, animals, molds, diagnosed with Colitis
daughter Angela 6, Down syndrome and Autism, milk allergy
son Joshua 4
daughter Christine Feb 12, 2009

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