For a tiny country, Israel has a very large impact on the world — be it for religious, political or technological reasons. Similarly, a new Israeli product — a miniscule medical device — could have huge implications for physicians and patients worldwide.

Known as “PillCam SB,” it is a camera so small it can travel through the small intestine as it takes pictures. It is marketed in the United States and more than 50 other countries; so far the device has been used on more than 230,000 patients worldwide.

Bay Area members of the American Academy of Family Practitioners recently gathered for an introduction to this camera — the size of a vitamin pill — that can examine their patients’ intestines.

“This is an easy way to examine the gut,” says Dr. Glenn Eisen, during a telephone interview following his late September presentation to doctors in San Francisco. Glenn is a consultant for Given Imaging, the Israeli company that markets the PillCam.

It was invented by Gavriel Iddan, an electro-optical engineer who previously worked at Israeli military manufacturer Rafael Israel Armament Development Authority, developing guided-missile technology.

During a sabbatical year in Boston, Iddan was challenged by a neighbor, an Israeli gastroenterologist, to invent an endoscope that could make its way through the entire gastrointestinal tract. It took about 20 years, but in 1997, Iddan signed a patent for capsule endoscopy.

Today, Iddan is CEO at Given Imaging, which received FDA clearance in 2001 and has been gaining recognition for its innovative work on small-intestine diagnosis since.

Marketing is key for a small Israeli company such as Iddan’s.

“Israel cannot be a market for 99 percent of the Israeli companies,” says Tzach Segal, director of business development at the Israeli Consulate in San Francisco.

Given Imaging is located in Yoqneam, Israel; it has direct sales and marketing operations in the United States, Germany and France, and local offices in Japan, Spain and Australia.

“Companies like Given Imaging, Check Point, Amdocs and Comvers have offices all over the world that sell Israeli technology products,” Segal adds. “Israeli companies are playing by the same rules as their global competitors.”

What distinguishes Israel from many of its competitors is the degree of technology exports relative to the country’s size. The PillCam is one more example of Israel’s contributions to military, medical and computing technology.

“The PillCam starts taking pictures immediately,” explains Eisen, associate professor of medicine and clinical director of Gastroenterology at Oregon Health and Science University in Portland. “After approximately 20 minutes, the PillCam passes naturally through the gastrointestinal tract and takes about seven hours to journey through one’s body and out the other end.”

Half the capsule is comprised of the twin battery packs, and takes two pictures every second for eight hours, according to Eisen.

He often travels around the country to instruct doctors on how to use the new PillCam technology, since it was most likely not part of their medical school education. He explains that many patients with digestive-tract problems are leery about having in-hospital endoscopy, in which a flexible tube must be inserted to view the esophagus, stomach and small bowel. Instead, patients simply swallow this vitamin-sized camera and it does the job.

“Patients can take the capsule in the morning and go off to work,” says Iddan in a press release.

Eisen adds that the PillCam is “a good noninvasive screening test” for people who have acid reflux and are reticent about an invasive procedure, like having tubes inserted into their bodies.

“The San Fran-

cisco Bay Area is a market with a huge potential for the PillCam and can be also a gateway for other markets in the U.S. and other places around the world,” adds local Israeli consul Segal.

“Any success of an Israeli company is a contribution to the development of the Israeli industry and is very influential to the economic situation in Israel. These kinds of success stories help us to promote Israel as a source for innovation and technology.”