Minimally Invasive Diagnostics For Patients With Troublesome Digestive Symptoms

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Gastroenterology is usually associated with fibre-optic endoscopy. Upper gastrointestinal endoscopy provides images of the inner lining (mucosa) of the gullet (oesophagus) and stomach whilst colonoscopy delivers video images of the large intestine (colon). Upper and lower endoscopy cannot visualise the 20 feet of small intestine and the procedure is performed as a "day case" in hospital, with sedation and analgesia as appropriate.
When patients present with abnormal gut feelings, specialists will almost always recommend an upper and/or lower endoscopy to seek possible mucosal disorders such as hiatus hernia, oesophagitis, gastritis, gastric ulcers, polyps, diverticulosis and cancer. Fortunately, around 80% of these endoscopies are normal or only reveal trivial abnormalitis. Most patients have disorders of bowel movement (known as peristalsis) or abnormal communication between the gut and brain (known as the "brain-gut axis").
New technologiy can change the diagnostic journey for patients with abnormal gut feelings. The inner mucosal lining of the entire 26 feet of digestive tract can be recorded by wireless capsule endoscopy, which is a TV stdio in a capsule. The capsule is swallowed with a sip of water. Natural bowel motility (peristalsis) then propels the capsule from mouth to anus where it is expelled naturally and flushed away. As the capsule journeys through the digestive tract, it broadcasts a video to small receiver worn on a belt. In most individuals, the mucosa is normal or reveals benign change that may or may not explain the symptoms. In a minority, where biopsy or other intervention is required, the patient can be referred to the appropriate specialist for an traditional endoscopy who will be armed with information from the scout capsule study. What about the majoirty of patients where the mucosa is not the cause of symptoms? There are now minimally invasive tests that dig deeper into peristalsis and the brain gut axis and breath testing can also be used to look for Helicobacter pylori and lactose intolerance and SIBO (small intestinal bacterial overgrowth)/
This short video uses high quality animations that describe the anatomy of the 26 feet (6 meters) of the digestive tract and summarises three minimally invasive ("high tech") diagnostic steps that can distinguish the possible origins of abnormal gut feelings.