Page last updated at 01:42 GMT, Sunday, 10 January 2010

'Smart pill' test let Dave eat again after 20 years

By Jane Elliott
Health reporter, BBC News

Dave Potts
Dave is starting to eat again after his operation

For nearly 20 years Dave Potts could not enjoy a meal without feeling or being sick.

However careful Dave was with the types and amounts of food he ate, he still had terrible reflux.

He could not sleep flat or eat within a couple of hours of waking without being violently sick.

"I tried eating smaller portions and ate healthy food," he said.

Changed diet

"I stopped eating things like kebabs and I cut down rubbish food by 80%.

"But nothing worked.

"My valve at the bottom of my oesophagus does not work properly so I could never eat or drink for a good two hours after I got up in the morning."

If I had anything like a cup of tea or a bit of toast I would be violently sick
Dave Potts

Doctors gave Dave, 44, various types of medication, but nothing worked.

They suspected he had chronic heartburn, but were unable to confirm it. His symptoms got worse when he reached his 20s.

Chronic heartburn, or reflux disease, is a common problem in the UK and the NHS spends approximately £575m a year to treat it.

It occurs when acid from the stomach flows back up into the gullet. If this happens regularly it can damage the gullet, or oesophagus, and restrict a patient's daily life.

Symptoms include burning pain in the chest and sour-tasting fluids in the mouth and neck.

Now thanks to advances in technology, doctors have confirmed Dave's diagnosis and were able to operate on him.

Smart pill

Dave's doctor Dr Terry Wong, consultant gastroenterologist at Guy's and St. Thomas', explained that they used the Bravo system - a 'smart pill' that is inserted down the throat and temporarily fixed above the patient's stomach.

Without this, a definite diagnosis in Dave's case would have been impossible and he would have been ineligible for surgery.

Until now patients had to undergo a catheter tube being inserted up their nose and down into the gullet to monitor pH levels.

The test lasted for two days and patients often found the catheter was intrusive, uncomfortable and embarrassing to be seen with.

Size comparison between the Bravo and a pencil
The Bravo capsule

The capsule, currently used by just a small number of hospitals in the UK, transmits pH information wirelessly to a portable receiver worn by the patient on their waistband.

Placing the capsule only takes a few minutes and patients can eat, sleep, shower and engage in all normal activities over the 24-48 hour testing period.

After this time the capsule detaches and harmlessly passes out of their body.

Dr Wong said Dave was a perfect example of someone who benefited.

"Before Bravo we would put a tube down through the nose into the oesophagus and leave it for 24 hours.

"This is a 40-year-old procedure and it is good, but it is uncomfortable for the patient. They can't eat and exercise normally so it is not representative of real life.

HEARTBURN
A painful and burning sensation in the oesophagus, just below the breastbone usually associated with regurgitation of gastric acid
It is a very common condition with 20% of the population experiencing it at some point in their lives
Those at the more severe end of the spectrum can end up taking tablets for the rest of their lives

"Dave is a classic case of where Bravo can help, as it established 100% that he had acid reflux.

"Before Bravo he would not have had the operation, because his reflux could have had other causes such as a hypersensitive oesophagus."

Dave, from London, has now had the operation, a laparoscopic fundoplication.

The operation involves wrapping a piece of the stomach around the oesophagus to create a new valve to prevent acid backing up from the stomach.

Dave says: "The operation has been absolutely fantastic. I'd say I'm 99 per cent there now and if this is how I'll be from now on then that will be great.

"I was supposed to be off work after the operation for six weeks but was able to come back after two weeks and a day. I've also been able to come off the tablets controlling my acid which is great.

"For the first two weeks I could only have soup, then for the next two weeks it was blended food with no carbohydrates and now it is normal solids. It is still a bit of struggle with the full solids but I'll get there.

"If someone had said to me six months ago that I'd be where I am now I wouldn't have believed them. I've had this for 20 years, but now feel fine."



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SEE ALSO
Surgery beneficial in heartburn
08 Nov 08 |  Health

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