video capsule endoscopy vs barium xray

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

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.

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

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*)

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.

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.

The pill cam was so easy for me. Better than having to drink that icky stuff!

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!