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barium swallow vs. camera pill

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Crohn's Disease
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Posted 1/28/2010 10:28 PM (GMT 0)
My doctor says with all my narrowing in my intestines I would not be a good canidate for the pill , but how easy is would it be to swallow a pill compared to a barium drink What do you think ?
Posted 1/28/2010 11:19 PM (GMT 0)
I haven't had a pill cam because I've had narrowing in the past, and the pill could get stuck. I've heard though, that there's a dissolvable pill that they can have you swallow first to see if it goes through, then they can decided whether or not to do the real camera pill.
Posted 1/28/2010 11:21 PM (GMT 0)
Done both. Barrium isn't that big of a deal..except for the taste..but after having Crohns your pretty well adapted to anything not to fun! The pill camera can get stuck. Mine did for 5 days and finally came out and only took pictures where it got stuck!

Either way it's good to at least know...

Posted 1/28/2010 11:36 PM (GMT 0)
13% of patients have the camera get stuck and have to have it surgically removed. Of course that also usually resolves the problem that the patient is trying to have diagnosed.

That was what my doctor told me before my first pill camera test about 5+ years ago. Not really sure if it is/was accurate, but it does sound logical to me.
Posted 1/29/2010 3:04 AM (GMT 0)
There really is little excuse for the Pill Camera to get stuck anymore. Except in rare cases or when the doctor or facility is too cheap to provide the Agile Patency Capsule first. This is a pill the size of the PC but dissolvable. It has a small rod in it as well as being made of a dissolvable substance that is apparent on xray.

You go in early one morning and swallow the APC. You return at 24-26 hours for an abdominal xray. If the APC is revealed on xray you are NOT a candidate for the PC. If it is not apparent, it has passed and you are a good candidate for the PC.

There is considerably less radiation exposure from the xray for the APC than the exposure for the CT enterography.

There is the caveat that if your disease is active, inflammation could cause swelling that could narrow a strictured area enough between the timing of the APC and the PCE that the PCE could get stuck. But that would be unusual. Generally the PCE is administered the morning after the clearing APC xray.

Understand that the APC and PC are pretty good size honkers! But not that much larger than a good size calcium tablet and at least the APC and PC have a "slippery" coating instead of the dry packed powder of the calcium tablets. My APC got stuck so I wasn't able to do the PC, but I didn't have that much trouble getting the APC down. It did take a full glass of water to get it all the way down tho.

The "barium" that you swallow for a CT Enterography is a much lighter substance than the barium for the Small Bowel Follow Thru and much easier to get down, not as "chalky" and w/some pineapple flavoring. I told them the banana flavor was virtually guaranteed to come right back up. I don't even like the smell of bananas much less have to drink a banana flavored anything. And the CTE is much more revealing than the SBFT somewhat offsetting the additional radiation of CTE vs SBFT xray.

Posted 1/29/2010 3:09 AM (GMT 0)
Have you considered CT enterography? I just had it done a couple of weeks ago, there is obviously quite a bit of radiation with this test, which my doctor cautioned me about. In my case, we decided to opt for the CT enterography because we thought it would give us the best picture since we really had no idea what was causing my problems. I would recommend this test over the barium though. At the clinic I went to, the contrast agent that I had to drink was actually milk (and then a small glass of water right before the scan). They inject you with iodine and buscopan and do the scans. If you have narrowing going on, I wouldn't really say that a pill cam is the best idea, and there's a good chance you wouldn't be able to pass the APC anyway.

Here's an article I just read on CT enterography... It does compare it to the pill cam in the article as well.

http://radiographics.rsna.org/content/26/3/641.full

*activated your link*

Post Edited By Moderator (Nanners) : 1/29/2010 8:08:45 AM (GMT-7)

Posted 1/29/2010 3:18 AM (GMT 0)
i heard that it is a big pill if it is i couldnt do it i cant stand taking my reg med
Posted 1/29/2010 5:09 AM (GMT 0)
I have done both test multiple times and neither one was that hard. The barium test was difficult after only because the barium shoots through me every time so fast but then coats the intestines and causes bad constipation. I am not that big of a fan of the barium test due to the fact that it does not show as much as the pill cam about your disease. I was diagnosed through the pill camera test nearly 6 years ago now. I have done it 2 times sinces and it has been the only test that has given me accurate results. The camera is not that big but you will have to wear a belt containing a receiver and have multiple sensors attatched to your body for about 8 hours. I always hold the pill cam up and smile at it before I swallow to make sure that the movie has a good beginning cause the ending is always crappy.
Posted 1/29/2010 6:41 AM (GMT 0)
CT-glad you responded...I think you responded to a similar thread about the APC. I'll have to talk to my dr about that when I next talk to her. She wants a colonoscopy ($900 copay) and I'd like to exhaust all other options first, and hold off another year for the colonoscopy. Maybe a PC this year and colonoscopy next year.

tsiodawg...that's so funny...if I ever have to have a PC, I'll smile at it before I swallow it!
Posted 1/31/2010 3:08 AM (GMT 0)
My insurance has a high deductible, and the patency test was going to run just shy of $1500. I contacted the company that makes it; the hospitals buy the pills for $100 each, minimum purchase of 5 in a pack. I figure- a $100 pill, a $100 abdominal X-ray, and a $100 radiological consult ("Yeah the pill's still there" or "Nope the pill's gone"), billing $1500 is insane. Hopefully it's more reasonable at other facilities.

And that was just the patency test- not even the camera itself, just the barium + lactose pill!
Posted 1/31/2010 4:24 PM (GMT 0)
Those are the billing prices. If you don't have insurance that is what they will bill you. But they will then almost always negotiate downward to somewhere near what insurances ACTUALLY PAY which is CONSIDERABLY less.

If you have insurance but a high copay be aware that IF they try to bill you the copay on the billed amount rather than the insurance allowed amount again you can negotiate them down to the copay based on the insurance allwed amount.

I was leery of the size of the APC and pill camera as well. But I wanted it bad enough I was willing to try choking them down. I didn't have all that much trouble w/the APC. I did have to use a full glass of water to get it moved out of the throat and esophagus to the tummy but it went down. No choking. The APC had dissolved completely and the small rod passed w/in 3 days w/no discomfort at all. (Yeah, I used an old rustry strainer to find that little ole rod).
Posted 1/31/2010 6:43 PM (GMT 0)
I wish it was just the billing price- that was my true out-of-pocket expense because I haven't hit my limit this year ($2500 annual deductible). I used to do the insurance billing for a doctor- that's been a long time now, but I still remember (mostly) how it works. The $1467 I was quoted was the cash price for the patency test.

My doctor later asked if I got the test, and I informed him I didn't because of the expense. He noted that, yes- that facility has very high costs associated with it. That was in Scottsdale, Arizona. Very expensive area to get healthcare.
Posted 2/3/2010 1:17 AM (GMT 0)
I had the barium test and results are in I have three blockages and I know one is where the large and small intestines meet .My doctor wants me too see the specialist I saw before from Mt Sanai in NYC. In the mean time they put me on two new drugs for a week. They are Metronidazole and Ciprofloxacin and I will be on them for a week. They are both new for me ,I never have been on these before.
Posted 2/3/2010 1:20 AM (GMT 0)
Waterman - I've been on those for about a month now, I was also having a lot of blockages and a lot of pain, and they have completely cleared up all of my symptoms. I'm on them for 3 months total though, I'm seeing a new doctor tomorrow who's going to try to figure out what to do with me lol. They worked quickly, within a couple of days I was back to normal. Good luck.
Posted 2/3/2010 4:31 AM (GMT 0)
Metronidazole is the generic name for Flagyl. Ciproflaxin is another name for Cipro.

Cipro is a flouroquinolone broad-spectrum antibiotic.

Flagy isn't a true antibiotic altho it has some antibiotic properties. I'm not sure of the other term for the class of drug it is, anti-microbial, maybe?

Flagyl was a miracle drug for me - but - I couldn't stay on it long as I encountered peripheral neuropathy (tingling, etc. in the extremeties) and that is a side effect you do NOT want as it can be permanent. If you encounter tingling in the extremeties IMMEDIATELY STOP taking it and notify your scripting doctor the very next business day.

Cipro's most common dangerous side effect is muscle tearing so do NOT do any strenuous exercises, the achilles tendon is one of the most likely tendon to be damaged.

I took Cipro for 5-6 months instead of Entocort when I was started on Imuran until the Imuran could kick in and take full effect.
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