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New procedure Practice drinking sips of ~15ml of water

New procedure Practice drinking sips of ~15ml of water Please note; we found that training the patient pre-ingestion improves the procedure significantly!. New procedure 2. Drink 100 ml of water to clear saliva. New procedure

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New procedure Practice drinking sips of ~15ml of water

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  1. New procedure • Practice drinking sips of ~15ml of water Please note; we found that training the patient pre-ingestion improves the procedure significantly!

  2. New procedure 2. Drink 100 ml of water to clear saliva

  3. New procedure 2. Lie on right side, ingest Capsule with sip of water, and stay in right side position 0:00  7:00 min Drink 15 ml sips of water every ~30 sec.

  4. New procedure 3. Drink sip of water 7:00 min

  5. New procedure 4. Walk 7:30 – 20:00 min

  6. Results(Demonstrated by some examples)

  7. 36 TT = 00:13 min TT = 00:09 min Study Images(1) Original ProcedureNew Procedure

  8. 265 TT = 05:13 min TT = 00:37 min Study Images (2) Original ProcedureNew Procedure

  9. 266 TT = 05:01 min TT = 00:11 min Study Images (3) Original ProcedureNew Procedure

  10. 3 TT = 01:11 min TT = 00:15 min Study Images (4) Original ProcedureNew Procedure

  11. 263 TT = 00:39 min TT = 00:06 min Study Images (5) Original ProcedureNew Procedure

  12. 101 TT = 01:10 min TT = 00:06 min Study Images (6) Original ProcedureNew Procedure

  13. Conclusions • Presence of bubbles/saliva which obscures the Z-line was significantly reduced, therefore enhancing visualization • Z-line circumferential view is significantly increased • Procedure appears much easier and simple for both subjects and staff* • Shorter esophageal transit time (0:38 ± 1:25 minutes) * Based on staff testimonies

  14. Conclusions(continued) • Accuracy (sensitivity, specificity, NPV, PPV) of PillCam ESO utilized in the new procedure needs to be evaluated against EGD in a comparative study • Impact of new procedure on detection esophageal varices needs to be evaluated • Further potential improvement using real time viewer (to stop water sips when capsule reaches Z-line region) should also be evaluated

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