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DIGESTIVE DISEASES: SEARCHING THROUGH THE BOWEL
In April 1984, George Poydinecz, a real estate investor in Clifton, New Jersey, traveled to Georgia to watch a golf tournament. While in a restaurant, he felt weak. In the men’s room he found he had passed a dark, bloody stool. “I didn’t have pain,” he says. “I just felt weak – my blood pressure dropped. I was bleeding inside.”
Doctors tried to pinpoint the digestive tract area that was bleeding. Barium X rays and CAT scans found nothing. Then, at Mount Sinai Medical Center, Manhattan, Dr. Henry Janowitz ordered a new search.
Dr. Stanley Goldsmith, of Mount Sinai’s nuclear medicine department, put radioactivity on the job. He took some blood from Mr. Poydinecz’s vein, mixed it with radioactive technetium, and injected it back into his patient. The red blood cells then sent out radioactive rays. Using a special camera to detect those rays, Dr. Goldsmith tracked the circulated radioactive blood. He found a pool of blood in Mr. Poydinecz’s small intestines, where a dilated vein had burst. Two days later, surgery solved the problem.
Such techniques are revealing the fundamental behavior of the entire digestive tract. By mixing radioactivity with food, scientists can see exactly how each digestive organ handles food. In some people, food is dumped quickly from the stomach, but it slows down in the small intestine. In others, it stays longer in the stomach but passes quickly through the rest of the digestive tract. Such individualized information helps doctors improve treatment for severe constipation, gas pains, and heartburn.
By linking radioactivity to cancer-seeking antibodies, chemicals that attach themselves to cancers, doctors can locate tiny cancers in the large intestine long before any symptoms show.
Finally, gastroenterologists (digestive tract specialists) use a fiber-optic tube, an instrument that enables them to see every nook and cranny of the digestive system. It consists of fine glass fibers bound together in a bundle as thick as a pencil and 9 feet long. Light travels down the tube even when it bends and moves, so the doctor can see into the twisting labyrinth.
Recently, doctors at Mount Sinai reported being able to examine the entire length of a small intestine in about 5 hours, with no damage to the patient. They could locate the kind of bleeding that afflicted George Poydinecz. Previously, physicians could use such fiberoptic tubes to explore no more than 6 feet of the intestine at a time.
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