Swallowable capsule, system and method for measuring gastric emptying parameters
Embodiments provide devices, systems and methods for measuring a gastric emptying (GE) parameter (GEP). Many embodiments provide a swallowable capsule having three electrodes one covered by a coating which remains in the stomach but is degraded in the small intestine (SI). The electrodes are coupled to circuitry such that when the capsule is in the stomach, current flow occurs between the first two electrodes generating a first signal and in the SI current flow occurs between the second and now uncovered third electrode generating a second signal. These two signals can be transmitted and analyzed externally or by an internal controller to determine a GEP e.g., GE time. The patient may wear an external device configured to receive and analyze the signals to determine GE time. Embodiments of the invention may be used to diagnose gastroparesis and provide patient's information on when to eat meals or administer insulin after eating.
1. A swallowable capsule for measurement of a gastric emptying parameter, the capsule comprising:
a capsule body sized to be swallowed and pass through the intestinal track of a patient, the capsule body having an outer surface and defining a capsule body interior;
at least a first, second and third electrode disposed on the capsule body outer surface; an enteric coating disposed over a portion of the capsule body outer surface including the third electrode, the coating configured to electrically insulate the third electrode while in the stomach and degrade in response to a selected pH in the small intestine to expose the third electrode;
a first circuit electrically coupled to the first and second electrodes, the first circuit configured to generate a first input signal based on a current between the first and second electrodes; a second circuit electrically coupled to the second and third electrodes, the second circuit configured to generate a second input signal based on a current between the second and third electrodes;
a controller operatively coupled to the first and second circuits, the controller disposed within the capsule body interior and configured to generate a driver signal sent to the second electrode and receive the first and second input signals from the first and second circuits, to generate a first output signal in response to the first input signal and a second output signal in response to the second input signal, to determine a time of passage of the capsule between the stomach and the intestines based upon the first and second output signals, and to determine the gastric emptying parameter based on the time of passage;
a power source coupled to at least one of the controller, the first circuit and second circuits; and wherein when the capsule reaches the stomach, the first and second electrodes electrically couple with stomach fluids to allow current flow between the first and second electrodes to generate the first input signal and when the capsule reaches the small intestine the enteric coating degrades allowing the second and third electrodes to couple with fluid in the small intestine to allow current flow between the second and third electrodes to generate the second input signal.
2. The capsule of claim 1 , wherein the enteric coating comprises copolymers derived from esters of acrylic and methacrylic.
3. The capsule of claim 1 , wherein the power source is a battery, a lithium battery, a lithium ion battery or an alkaline battery.
4. The capsule of claim 1 , wherein the driver signal is an alternating current (AC) signal.
5. The capsule of claim 1 , wherein the controller comprises a processor or microprocessor.
6. The capsule of claim 1 , wherein the first and second input signals comprise a voltage.
7. The capsule of claim 1 , wherein the first and second circuits include an operational amplifier (opamp).
8. The capsule of claim 7 , wherein the opamp is coupled to the first or second electrode and the controller.
9. The capsule of claim 1 , wherein the first and second circuits include a resistor.
10. The capsule of claim 9 , wherein the resistor has a value greater than 1 mega ohm.
11. The capsule of claim 9 , wherein the resistor includes a first and second resistor.
12. The capsule of claim 1 , wherein the controller is configured to discontinue the first output signal after a selected period of time.
13. The capsule of claim 12 wherein the selected period of time is between 1 to 10 seconds.
14. The capsule of claim 1 , wherein the controller is configured to discontinue the second output signal after a selected period of time.
15. The capsule of claim 14 , wherein the selected period of time is between 1 to 10 seconds.
16. The capsule of claim 1 , wherein an amplitude of the first output signal decreases after the controller starts generating the second output signal.
17. The capsule of claim 16 , wherein the first output signal amplitude is a voltage amplitude.
18. The capsule of claim 17 , wherein the voltage amplitude of the first output signal decreases by a factor of 2.
19. The capsule of claim 1 , wherein the first output signal corresponds to a first chirp signal.
20. The capsule of claim 19 , wherein the second output signal corresponds to a second chirp signal.
21. The capsule of claim 1 , further comprising a transmitter coupled to the controller, the transmitter configured to transmit the first or second output signal.
22. The capsule of claim 21 , wherein the transmitter is integral to the controller.
23. The capsule of claim 21 , wherein the transmitter is a radiofrequency (RF) transmitter.
24. The capsule of claim 21 , wherein the transmitter comprises a power amplifier.
25. The capsule of claim 1 , wherein the controller includes logic to determine at least one of a start time of at least one of the first or second output signals or a gastric emptying parameter.
26. The capsule of claim 25 , wherein the gastric emptying parameter is a gastric emptying time, an average gastric emptying time, a gastric emptying time with food, a gastric emptying time for a selected meal type, or a gastric emptying time for a selected meal portion.
27. The capsule of 25 , where the gastric emptying time is determined based on the start time of the first and second output signals.
28. The capsule of claim 25 , wherein the controller is configured to generate signals encoding information on the start time of the least one or second output signals or the gastric emptying time, the encoding signals being transmittable by the controller or a transmitter coupled to the controller.
29. The capsule of claim 1 , wherein the selected pH is above 6.
30. The capsule of claim 29 , wherein the selected pH is above 6.5.
31. The capsule of claim 1 , wherein a density of the capsule is in a range from 0.5 to 1.5 gram/cc.
32. The capsule of claim 31 , wherein a density of the capsule is in a range from 0.8 to 1.2 gram/cc.
33. The capsule of claim 32 , wherein the density of the capsule is 1 gram/cc.
34. The capsule of claim 1 , wherein a surface tension of the capsule body outer walls is in a range from 30 to 45 dynes/cm.
35. The capsule of claim 34 , wherein a surface tension of the capsule body outer walls is in a range from 30 to 31 dynes/cm.
36. A swallowable capsule for measurement of gastric emptying time, the capsule comprising:
a capsule body sized to be swallowed and pass through the intestinal track of a patient, the capsule body having an outer surface and defining a capsule body interior;
at least a first, second and third electrodes disposed on a capsule body outer surface; and
an enteric coating disposed over a portion of the capsule body outer surface including the third electrode, the coating configured to cover the third electrode while in the stomach and degrade in response to a selected pH in the small intestine to expose the third electrode;
a first circuit electrically coupled to the first and second electrodes, the first circuit configured to generate a first input signal based on a current between the first and second electrodes; a second circuit electrically coupled to the second and third electrodes, the second circuit configured to generate a second input signal based on a current between the second and third electrodes; a controller coupled to the first and second circuits, the controller disposed within the capsule body interior and configured to generate a driver signal sent to the second electrode and receive the signals from the first and second circuits, to generate a first output signal in response to the first input signal and a second output signal in response to the second input signal to determine a time of passage of the capsule between the stomach and the intestines based upon the first and second output signals, and to determine the gastric emptying parameter based on the time of passage;
a transmitter coupled to the controller for transmitting the first and second output signals;
a power source coupled to at least one of the controller, the first circuit or second circuits or the transmitter; and wherein when the capsule reaches the stomach, the first and second electrodes electrically couple with stomach fluids to allow current flow between the first and second electrodes to generate the first input signal and when the capsule reaches the small intestine the enteric coating degrades allowing the second and third electrodes to couple with fluid in the small intestine to allow current flow between the second and third electrodes to generate the second input signal.
37. The capsule of claim 36 , wherein the transmitter is an RF transmitter.
38. A system for measuring a gastric emptying parameter, the system comprising: the capsule of claim 36 ; and a receiver unit for receiving the transmitted first and second output signals.
39. The system of claim 38 , wherein the receiver unit is configured to be worn by the patient.
40. The system of claim 39 , further comprising a patch configured to be worn on the patient's abdomen, the receiver unit positioned on the patch.
41. The system of claim 40 , wherein the patch is configured to adhere to the patient's skin.
42. The system of claim 41 , wherein the patch is sufficiently flexible to bend and flex with movement of the patients abdomen and stay adhered to the skin with the receiver unit attached.
43. The system of claim 38 , further comprising a controller operatively coupled to the receiver unit, the controller configured to determine the gastric emptying parameter utilizing the first and second output signals.
44. The system of claim 38 , wherein the first and second output signals provide information on a location of the capsule in a GI tract at a moment in time.
45. The system of claim 38 , wherein determined gastric parameter is a gastric emptying time.