Pediatric Capsule Endoscopy

Pediatrics: Join experts from the Komansky Center for Children's Health/Weill Cornell Medical Center, a part of NewYork-Presbyterian Hospital to learn about a pioneering method of making capsule endoscopy modality more pediatric-friendly. Learn about Dr. Sockolow's "Jellybean Test", live, 7:00 PM EDT (23:00 UTC)

Wireless capsule endoscopy represents an extraordinary technical innovation in diagnostic gastrointestinal endoscopy. Capsule endoscopy is highly useful to evaluate for inflammatory changes in patients suspected to have small bowel Crohn's disease in whom conventional imaging failed to confirm the diagnosis. It is now the method of first choice to assess for small bowel polyps or tumors, to find a source of blood loss in obscure intestinal bleeding, and for undiagnosed malabsorptive conditions such as intestinal lymphangiectasia

As in adult patients, it opens new horizons that permit an accurate and noninvasive approach to identifying occult lesions in the small bowel in children and adolescents.

Although many gastroenterologists have accepted the use of capsule endoscopy in adults, usage in children has lagged; possibly due to a belief by pediatricians that the pill is too large to be swallowed by children (Barth et al, 2004; Seidman & Dirks, 2006). In fact there are reports of children as young as two and a half years old successfully undergoing capsule endoscopy (Kavin at al, 2006), and in studies the majority of pediatric patients can swallow the pill (Thompson et al, 2007).

Dr Robbyn Sockolow of the Komansky Center of NewYork-Presbyterian has pioneered a method of screening and preparing children to take the camera pill which has been very successful and made the capsule endoscopy modality more pediatric-friendly. This program gets children to swallow very small candies and work their way up to larger ones – culminating in swallowing a jellybean (which is the same size as the pill), as such, Dr Sockolow has named it the ‘Jellybean Test'.

This program helps to indicate patients who are not able to make use of capsule endoscopy modality. More importantly it reduces apprehension when taking the pill, which means that patients swallow the pill more quickly. This avoids the necessity of inserting the pill into the esophagus endoscopically requiring sedation etc.

Small pediatric studies have indicated that the capsule endoscopy has greater diagnostic sensitivity than more traditional endoscopic procedures for macroscopic gastric and small bowel pathologies (and that patients prefer it) (Shamir et al, 2007; Thompson et al, 2007).

Dr Sockolow has been using capsule endoscopy with children at the Komansky Center since 2004.

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Sockolow.

Robbyn Sockolow, MD

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Aliza Solomon, MD

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