Bravo pH Monitoring

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Overview (basics)

Bravo pH Monitoring collects 48 hours of pH data, twice the data of conventional catheter-based tests, increasing the ability to document relationships between atypical and reflux events. The 48 hours of data, allows your physician to evaluate your reflux symptoms and determine the best course of treatment for you.

How the Procedure Works

When you are ready for your procedure, you will be asked to sit or lie back while the physician places the capsule into the esophagus. After the capsule is in place, suction is applied, drawing a small amount of tissue into the capsule. The capsule is then locked into place. The placement procedure is simple to perform and well tolerated by most patients.
The capsule begins measuring the pH levels of the esophagus immediately, transmitting pH measurements wirelessly to a small receiver worn on your waistband or belt. The receiver houses three symptom buttons, and you will be asked to press the corresponding button when you experience heartburn, regurgitation, or chest pain during the procedure. You also will be asked to keep a diary and record periods of sleeping and eating during the procedure.
Upon completion of the procedure,you will return the recording device and diary to your physician, who will upload the data and analyze the results to determine the appropriate diagnosis. The disposable capsule will spontaneously detach and pass naturally through a bowel movement a few days after the test.

Who should be tested?

  • Refractory Heartburn/GERD (GastroEsophageal Reflux Disease)
  • Atypical chest pain (after cardiac evaluation)
  • To document abnormal esophageal acid exposure in an endoscopy-negative member being considered for surgical anti-reflux repair
  • To document concomitant gastroesophageal reflux disease in an adult onset, non-allergic asthmatic suspected of having reflux-induced asthma
  • To evaluate a patient with suspected otolaryngologic manifestations (laryngitis, pharyngitis, chronic cough) of gastroesophageal reflux disease
  • To evaluate a patient with either normal or equivocal endoscopic findings and reflux symptoms that are refractory to proton pump inhibitor therapy or NERD (Non-Erosive Reflux Disease)

Benefits

The world’s first catheter-free pH test, Bravo provides a more tolerable and convenient way to evaluate your heartburn symptoms when compared to catheter-based pH monitoring systems.1
The capsule is temporarily attached to the wall of your esophagus. The capsule transmits pH information wirelessly to a small receiver worn on your belt or waistband. Data can be transmitted approximately 3 feet, which means you can take the receiver off to shower and sleep without interrupting the test.
Most importantly, a catheter-free test allows you to engage in your usual activities during the test period:

  • Eat normally
  • Bathe and sleep comfortably
  • Maintain your daily life

The Bravo System allows you to perform your normal activities during the pH test, which has the potential to provide a more accurate picture of your acid exposure compared to data collected using catheter-based systems.2

Risks

The Bravo pH test is not for everyone. If you have bleeding diathesis, strictures, severe esophagitis, varices, obstructions, a pacemaker, or an implantable cardiac defibrillator, you should not undergo a Bravo pH test. Additionally, because the capsule contains a small magnet, you should not have an MRI study within 30 days of undergoing the Bravo pH test.
Potential complications associated with gastrointestinal endoscopy include perforation, hemorrhage, aspiration, fever, infection, hypertension, respiratory arrest, and cardiac arrhythmia or arrest.
Potential complications for using the Bravo pH Monitoring System include the following events:

  • Premature detachment of the pH capsule
  • Failure of the pH capsule to detach from the esophagus within several days after placement, or discomfort associated with the pH capsule, requiring endoscopic removal
  • Tears in the mucosal and submucosal layers of the esophagus, causing bleeding and requiring possible medical intervention
  • Perforation

Potential complications associated with nasal intubation include: sore throat, discomfort, and nasopharyngeal damage resulting in bleeding and soft tissue damage.
All pH-testing procedures carry some risks. Talk to your doctor about your concerns and testing options.