Half a Decade Later....

5 years?! That has to be some sort of record!

I recall one member here a few years ago who got a pillcam stuck. Unfortunately, surgical removal was required. I believe it was only in a month or two. 

If it can be reached by endoscopy, it can be removed that way.

Jan

What did the doctor say?? And since they left it in there do you still have to pay to get it out?

Ok...you may wish to send that to the Guinness book of records.

I wish you a very pain-free and quick removal (some sort of bowel prep may work)...

Sharon

As mentioned above, I had my appointment with my GI on Monday and he presented the following course of action: 

• We would try a balloon dilation through the rectum in hopes of securing the pillcam and extracting it
• If option 1 failed, we would try a double balloon telescoping endoscopy through the mouth. He told me that procedure is very specialized and there weren’t any trained docs in Fort Worth, TX able to perform it.  So, if it got to that, he’d consult with the nearest trained doc in Dallas (about 45 minutes away) to see if the Dallas doc would be open to trying the procedure.  My GI’s concern is that because my gut has so much scar tissue, the Dallas doc may not be willing to try.
• If both option 1 & 2 didn’t extract the pill, it would need to be removed surgically. 

My GI got me scheduled very quickly for option 1 and that was yesterday.  It didn’t yield the result we were hoping for. 

In addition, since he went further up into the lower areas of the small bowel, passed my Jpouch, he discovered a stricture. 

 He said it was his recommendation to skip option 2 and proceed straight to surgery to kill two birds stricture with one stone (removal of both the stricture and pillcam). 

 So, that’s where we are currently.  Needless to say, when I woke up from anesthesia I was very upset to hear the news.  I would’ve been ok with simply not retrieving the pillcam, knowing there was option 2 still on the table.  But with the discovery of the stricture, surgery is inevitable.

Wow, craziness! Sorry they weren't able to retrieve it. All the best for a speedy recovery from the surgery. 

What a hassle! Is the stricture what trapped the pillcam, or is it further upstream? It might be worth asking if an imaging study is warranted to ensure that you only have the one stricture. Once you're having surgery it's best to get all the work done at once. If you have adhesion problems, that's also worth discussing with the surgeon in advance (lysis of adhesions at no extra charge). I'm also wondering if it can be done laparoscopically.

Good luck!

Scott F, correct, the stricture prevented the pillcam from exiting and is stuck "floating" around in my small intestine.  I appreciate your advice to ask about additional strictures, because I'd definitely prefer to take care of all of this at once.  I have an appointment with the surgeon on Wednesday.  Due to the fact I've had the pillcam and stricture since 2010, my vote is going to be to put off surgery until October - unless he feels very strongly that it must be done sooner. My GI felt it would not be able to be done laparoscopically, I'll be interested to see if the surgeon agrees.  

What would be symptoms of adhesions - i'm not familiar with them at all?

Just curious...Can they reactivate the pillcam to check for further strictures??? 

Killing 3 birds with 1 stone!

Sharon

ps...would standing on your head help (no joke here...What cannot go down may well go up)...they can use an antigravity table.

SKN69, the problem is the battery has died, so reactivation isn't possible.  My GI said the battery was made by the manufacturer to never leak but it's still a concern.  

The problem I'm facing is two fold - the stricture and the stuck pillcam.  Even if the pillcam were able to come out by standing on my head, I'd still have to deal with the stricture.  

The symptoms of troublesome adhesions (almost all of us have adhesions after surgery, but only some cause trouble) can be hard to distinguish from strictures. Periodic obstructions (complete or partial), and unexplained pain. The best part of surgery is that he can get rid of some. The worst part is that it will cause new ones to form.

Blake, 

Did they say if they can do it through laparoscopy or are they discussing open surgery?

Here, they are starting to do most surgeries though Lap, or a twofold process of endoscopy + Lap...makes it much easier on the recovery and helps to avoid more adhesions (although as soon as you go in you start the process, no matter how you get there)

Sharon

Update: I had my surgery on Monday and it was a success, stricture removed and pillcam retrieved (they let me keep the souvenir, see attached pic!)! Stayed in the hospital three nights and am now home healing. Pathology confirmed the pillcam got caught on the scar tissue from the staple line where the ostomy had been reconnected. Only real discomfort is when I stand up as it feels like everything inside is finding a new resting place now that some real estate has come available from the resection. Hurts when releasing gas also. Overall, wish I hadn't had to go thru this but doc confirmed everything inside looked good and I hope to be on the up & up from here!

Congrats on the newfound freedom and nifty little gift!

S

Wonderful news! Hope it is all smooth sailing from now on!

Jan

Wow! What an adventure you've been through. Congrats

When I was offered the pillcam as a diagnostic test to further look at what was suspected to be Crohn's Disease, I was specifically warned by my GI that there was the chance that the pillcam could get "hung up" somewhere in the ileum, with the possibility of emergency surgery to get it out.  This was in around 2008.  Right around the same time somebody my father knew who worked for one of the investment brokerages told my father about the pillcam and actually got him one for me to look at.  Between seeing what I would have to swallow and the possibility of it getting blocked up (not a small possibility in my case due to the stricture that had been recognized at my J pouch inlet even at that time), I passed in favor of CT and MRI Enterographies, which along with subsequent biopsies were inconclusive in proving or disproving Crohn's Disease.

I'm in the same boat!  I've had a pill cam stuck inside my j-pouch since 2009 and it is still there.  I had a flex-sig in 2014 to check for pouchitis that resulted in a perforation and emergency surgery.  I had to get a diversion and temporary ileostomy because of the perforation.  But what they found after the surgery on a routine X-ray was the pill cam.  My surgeon has tried to find it with scope but it has been unsuccessful.  He doesn't believe its doing me any harm at this point but I have to make a decision soon on whether to keep my pouch or take it out.  It no longer functions properly and the chronic pouchitis has been an issue for me from the beginning.  

My question to you is what exactly did your doctor say about the pill cam?  Could the battery leak?  And I know it is made of biocompatible plastic but how long can that plastic hold up?  Did he mention any of that?

Also, why is the color of it black?  or is that just a shadow?  

Glad to know there has been someone else with a pouch who has been through this and had success in removing it.

Wish you a speedy recovery!

Joelsmith, I am so sorry to hear all that you have been going through. I hope you decide the best for yourself and get a relief soon.

These hi-tech devices are supposed to make life easler for us, not turn our lives into a nightmare... maybe having a j-pouch should be considered a counter-indication to use pill cams for GI tract examinations.

Do the endoscopists / GI doctors make you sign a consent form in the US before such examinations? Can't you hold them responsible afterwards if something bad happens?

Linguist,

Part of informed consent is you are told of the risks of the pillcam and you sign off on that risk or not. It was explained to me that there is this risk that the pillcam gets stuck and doesn't come out. And that emergency surgery can be the endgame. I chose not to accept that risk. If you accept the risk it's on you. It's so wrong to believe Doctors are guarantors of a good outcome if they explain this risk and it comes home to roost. There is no liability on the provider if the risk is explained and assumed. Lots of things can go wrong with many medical procedures and surgeries. People have individualized reactions that sometimes can't be predicted. The complication described in this thread is a well known risk and it was explained to me. I said no. I doubt that if I had the pillcam and it went through it would have provided any more conclusive evidence than an MRI Enterography. So I saw very little upside and a big downside to this procedure. These others had a different analysis. Not sure what the actual% is that it happens to but I know it does happen and this risk was explained to me back in 2008 before these guys had theirs.

Joelsmith, I'm sorry for my delayed reply. I had a couple difficult days of recovery from what felt like ab muscle strain or spasms near the resection site beneath the area where I had my stoma years ago.  It's been excruciating. Could barely breathe or move. For those of you who haven't had to go through any stomach surgery in awhile, never take your ab muscles for granted. Prior to this surgery, it had been 10 years for me and I had forgotten how much i relied on them until they were isolated.

To follow up on your questions here's what I can tell you:

-My question to you is what exactly did your doctor say about the pill cam?  My doc said the pillcam itself wasn't an immediate major  concern but it's never good to have foreign bodies in your body. The more pressing concern was the stricture which was sure to result in a variety of problems with blockages at the top of the list.

-Could the battery leak?  My doc said the pillcams are designed to never leak. Just like the Titanic was designed to never sink, right? He didn't anticipate any leakage issues but the only way to guarantee that was to have it removed.

-And I know it is made of biocompatible plastic but how long can that plastic hold up?  Same answer as above, the plastic was designed to last a lifetime.

-Why is the color of it black?  The pillcam was swallowed looking normal, white body and clear dome where the lens and flash were housed. Now it's definitely a dark hunter green. Not sure if the bile/stool stained it over the years or what but it's nasty looking. I have attached another pic in hopes of it being better resolution. And by the way, it smells terrible!!

Blake,

Thank you for answering my questions.  I have had a really difficult time since I swallowed this pill.  When they x-rayed me in 2014 the pill was seen at the old ostomy incision, that section had become distended and bottle necked, above that they made a new temporary ostomy because of a perforation I had suffered from a flex-sig.  My pouch, from what my surgeon saw, was no longer functional.  At the time it had been 5 years that the pill camera was swimming inside.  My previous GI had seen that there was a piece of metal as described by a CT scan, in my rectum the year before but did not follow up, I actually thought it might have been something I ate, as I remembered having had some takeout and seeing a little piece of aluminum foil mixed in with the broccoli.  I actually thought that was what was causing me all this pain and discomfort!  Bad Chinese take out!  The reason I never even gave the camera pill another thought was because I was told by the GI that he saw the pill exit through the video images!  

I began to feel better after a course of antibiotics and things seemed to improve, but I had chronic constipation and the feeling that the pouch was not emptying.  I went to a new doctor after a few months where I again was having what I thought was pouchitis, thats when I had the perforation and the loop ostomy had to be made.

I can honestly say that I feel so much better with the ostomy then with the pouch.  My surgeon doesn't feel the pouch is of much use to me anymore and after a couple of months of chronic pain and drainage, I agree. 

So instead of continuing to suffer with a non functioning pouch, a pill camera and a section of distended and inflamed GI, I've recently decided to have the pouch taken out.  

I think this is the best option for me and I've read all the posts and information about this procedure, its basically a second colectomy.  But there's no use in putting this off any longer.   

I will continue to post and when they find the camera pill I will take a photo.  

I hope your pain is better.  I remember that pain all too well and I don't look forward to it again, but just gotta get through it.

Wish you the best!

Wow, can't believe how much you've been through! Keep up your positive attitude as that'll continue to be your greatest ally! 

Good luck in getting the retained pillcam out, hopefully sorry sooner than later. 

Wishing you all the best!

Blake