Bravo pH Study
What is the Bravo pH study?
This is a new technology that allows us to accurately measure acid reflux for 48 hrs in the esophagus and to correlate the pH (acid level) with your symptoms. First an upper Endoscopy (EGD) is performed under sedation in the Endoscopy Suite to look at the esophagus, stomach and duodenum; the correct location for placement of the Bravo capsule is also determined. Then, the Bravo capsule is inserted through the mouth (while you are still sedated) and placed with a tiny pin into the esophageal wall at the correct location; you do not have tubes or wires coming out of your nose or mouth afterwards. This device can then measure acid reflux over 48 hours while you carry on with normal activities. The capsule will come loose and fall off on its own and is disposable (will come out with a bowel movement).
What preparation is required?
In order for the EGD study to be done you need to have nothing to eat or drink after midnight as directed in the upper Endoscopy directions*. That way, we can safely do the procedure and give you sedation for the scope and the insertion of the Bravo capsule.
What should you expect during and after the procedure?
You will be sedated during the procedure and may not remember much of it. Afterwards you may be slightly groggy and should therefore have a driver to take you home. Some people have an awareness of “something” in the esophagus (feeding tube in the chest where the capsule is temporarily attached) especially during eating but patients generally tolerate it very well and do not usually have pain from the capsule.
How does it work?
You will carry a recording device with you; the messages from the capsule (acid reflux etc) are sent to the recording device and stored. After the study is completed you bring the recorder back to the Endoscopy suite and it is connected to a computer that downloads the information for the doctor to review. The capsule simply falls off and is lost in your bowel movements (you may or may not see it).
What will you need to do?
We encourage you to carry on with a normal day including eating and drinking normally as well as participating in all your usual activities. We do not want you to avoid things that make your reflux symptoms worse during this time. You will receive an instruction sheet when you are here for the study which will explain more of these things to you. You should not take over-the-counter antacids during the study but you need to decide with your doctor in advance if the test is to be done ON or OFF acid suppressive medications (such as Prilosec, Nexium etc). You should anticipate that you can NOT have an MRI after the capsule has been placed and for 30 days afterwards or until you are sure that the capsule has passed in your stools.