Father and son to the rescue at MUHC
Capsule endoscopy sees patients swallow tiny camera that can transmit images
A father and son who both suffer from inflammatory bowel disease (IBD) and are deeply grateful for the care they have received at the McGill University Health Centre for this painful, chronic and often unpredictable condition have chosen to express their gratitude by funding an innovative diagnostic program that had its budget slashed.
Harold Abrams and his son, Ryan, are underwriting the lion’s share of the $150,000 cost of the MUHC’s video capsule endoscopy program for the coming year: $115,000. Their gift, being made through joieshop.com, the online retail shop of their kitchen gadget business, means that about 140 people will be able to undergo the procedure, up from just 30 following last year’s budget cut.
The two are being honoured Thursday at the annual fundraiser of the McGill IBD Research Group, Laugh Your Butt Off. Since its founding 25 years ago, the group has raised money to fill gaps in the health system for the benefit of patient care and welfare. Among other things, it has funded salaries for nurses and psychologists, public education events, training for the next generation of IBD specialists and research projects.
The video capsule endoscope is a tiny camera, complete with flash, housed in a capsule the size of a large vitamin pill. After a day on a liquid diet, the patient swallows the capsule, and during its subsequent 12-hour trajectory through the small bowel, it transmits video images to a recording device worn by the patient. The images make possible the detection of diseases or lesions doctors previously could not see. At the end of its voyage through the bowel, the capsule is eliminated and discarded.
Invented in the late 1990s in Israel as an application of military technology, the video capsule endoscope “provides extraordinarily beautiful and precise images,” said Ernest Seidman, a gastroenterologist and professor of medicine and pediatrics at McGill and director of gastroenterology research. Among his other titles, he is director of the MUHC video endoscopy program and was the first in Canada to use the device, back in 2001. “It has changed our field of gastroenterology dramatically,” he said.
Unlike a CT scan, visual capsule endoscopy involves no radiation exposure. An MRI machine can be used to view the bowel, but it makes a great deal of noise, takes a long time and is potentially terrifying for children, Seidman said. Ultrasound is less expensive, “but not very refined.” And traditional endoscopes, flexible tubes equipped with a video camera and guided down the throat or up the bottom, can together image only about half a metre of the four-metre-long small bowel, he explained.
In addition, the traditional procedure requires a nurse, sedation and a recovery room — and yields an image less clear than the video capsule endoscope.
One can question whether private citizens should be funding programs insured and previously underwritten by the public purse. Indeed, Seidman, medical adviser to the McGill IBD Research Group, said he hesitated initially when the Abrams men approached him to ask: “What is your most pressing need in terms of patient welfare?”
“To me, the most impact they could have with their donation is to help support the video capsule program,” he said. “People are suffering because of these budget cuts.”
Yet he was reluctant at first to ask them to do it because, “in my experience, once the hospital knows there is a donor, they’re off the hook. Hopefully, this is a shortterm solution,” he said, and the MUHC will restore the program’s full funding.
“We are both very aware of the pain that people suffer, and if this can help people not suffer, then it’s something we want to do,” Harold said.
IBD is a rarely discussed condition, in large measure because it
relates to goings-on in the bowel, but it “can be excruciatingly painful,” Ryan said. Part of the nature of the disease is its unpredictability. “You go from feeling well to not feeling well.”
When the condition flares up, the bowel becomes inflamed and food and feces get stuck in place.
“It’s so painful,” Harold said, “that you don’t know what to do with yourself. The only thing to do is to go to hospital and get painkillers until it passes.”
What makes the Abrams gift “so noble” is that it will benefit not only people with IBD but others as well, Seidman said. In young people, video capsule endoscopy is used mostly to diagnose IBD, but in adults its main function is to diagnose unexplained bleeding.
“It outperforms all the other medical tools we have,” he said.
Producers of the television show House approached Seidman for help when the plot of an episode in the medical drama’s first season involved a case of bleeding in the small bowel. He reviewed the script for accuracy and provided a video clip of small bowel capsule endoscopy — and his name appeared in the credits.
Harold Abrams and his son, Ryan, at their kitchen-accessory business, MSC International, in Saint-Laurent. They will fund the capsule endoscopy project for the next year at the McGill University Health Centre.