BRAVO pH study

BRAVO pH study

pH is a measure of acidity or alkalinity.  Most people are familiar with pH tests done on soil or swimming pools.  As esophageal pH test measures how often stomach acid flows into the lower esophagus and the degree of acidity during a 12-24 hour period

What is Bravo pH monitoring?

Bravo pH monitoring is a test for identifying the cause of heartburn. This test allows your doctor to evaluate if you reflux acid into your esophagus, and for how long and how frequently. It also helps to see if acid reflux is the cause for symptoms such as heartburn, cough, or chest pain.
The test involves a miniature pH capsule, approximately the size of a gel cap that is attached to your esophagus. Throughout the test period, the Bravo pH capsule measures the pH in the esophagus and transmits this information to a small receiver worn on your belt or waistband.

What to expect during the procedure?

The capsule takes only moments to place in the esophagus. Then the test period lasts 48 hours or more, depending on what your doctor requests. A thin tube is used to pass the capsule over the tongue into the esophagus. A small amount of tissue is suctioned into the capsule and a small pin secures it. The catheter is then removed leaving the capsule inside.  The majority of patients tolerate this with very little discomfort. You will then be asked to keep a symptom diary and keep the receiver box close to you for the duration of the test. The usual test period lasts 48 hours.

How is the capsule placed?

The capsule can be placed during an endoscopy or at a later date to be determined by your physician. If the procedure is done at a later date you will not be sedated for the capsule placement. Your throat will be sprayed to assist you in swallowing the capsule. The capsule is small so you may eat normally and go about your daily routine.

Who should not undergo BRAVO testing?

The Bravo pH test is not for everyone. If you have a severe bleeding condition, blockages or narrowing of the esophagus, severe esophageal inflammation, varices, 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.

What are the potential risks of the test?

  • Premature detachment of the pH capsule
  • Failure of the pH capsule to detach from the esophagus within several days  or discomfort associated with the pH capsule, requiring another procedure to remove the capsule
  • Tears in the mucosal and sub mucosal layers of the esophagus, causing bleeding and requiring possible medical intervention
  • Perforation
  • Minor complications associated with capsule placement also include: sore throat, discomfort, and tissue damage resulting in bleeding.


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