Bravo pH Monitoring

Reasons for Bravo pH monitoring

Your physician may recommend Bravo pH monitoring for the following reasons:

• Persistent heartburn
• Suspected gastroesophageal reflux disease (GERD)
• Chest pain not related to heart disease
• Chronic cough
• Hoarseness or voice changes
• Chronic throat clearing
• Regurgitation of stomach contents
• Difficulty swallowing associated with reflux symptoms
• Evaluation of symptoms despite acid-suppressing medications
• Assessment before anti-reflux surgery
• Evaluation of recurrent symptoms after anti-reflux procedures

Benefits of Bravo pH monitoring

Bravo pH monitoring provides objective information about acid exposure in the esophagus and can help guide treatment decisions. Benefits include:

• Accurate measurement of acid reflux
• An extended monitoring period compared with traditional catheter-based testing
• No nasal catheter during the monitoring period
• Improved patient comfort
• Correlation of symptoms with reflux events
• Assistance in diagnosing GERD
• Guidance for medical or surgical treatment decisions

How to prepare

Please inform your healthcare team if you have heart disease, lung disease, bleeding disorders, esophageal disorders, implanted cardiac devices, allergies to medications, or any other significant medical condition.

• Do not eat or drink anything for at least 8 hours before the procedure.
• Inform your physician of all medications you are taking.
• Certain acid-reducing medications may need to be stopped before the study, as instructed by your physician.
• Arrange for a responsible adult to drive you home if sedation is used during the endoscopy.

What to expect during the procedure

• An upper endoscopy is typically performed to place the Bravo capsule.
• An intravenous (IV) line may be started if sedation is administered.
• You will receive medications to help you relax and remain comfortable.
• The physician examines the esophagus and positions the capsule at the appropriate location.
• The capsule is temporarily attached to the lining of the esophagus.
• The procedure generally takes approximately 15 to 30 minutes, and the capsule begins recording acid levels immediately.

During the monitoring period

• You will carry a small recording device that receives information from the capsule.
• You will be asked to maintain a diary of meals, activities, medications, and symptoms.
• You should continue normal daily activities unless instructed otherwise.
• Follow your physician's instructions regarding diet and medications during this time.
• The monitoring period typically lasts 48 to 96 hours, depending on the study protocol.

After the procedure

• Mild throat discomfort may occur temporarily following the endoscopy.
• Some patients feel a mild sensation of the capsule in the chest while swallowing.
• The capsule usually detaches naturally within several days and passes through the digestive tract on its own, so retrieval is not required.
• The recorded information is analyzed by your physician, with results typically available within several days after the study.

Important instructions after the procedure

• Follow all instructions regarding use of the recorder and symptom diary, and return the recording device as instructed.
• Avoid MRI examinations until your physician confirms the capsule has passed.

Risks and possible complications

Bravo pH monitoring is generally very safe and well tolerated. Possible complications include:

• Mild throat discomfort
• Temporary chest discomfort
• Sensation of the capsule during swallowing
• Difficulty swallowing (rare)
• Bleeding (rare)
• Capsule detachment failure (rare)
• Esophageal injury (very rare)
• Adverse reactions related to sedation used during endoscopy

Most patients complete the study without significant complications. The findings help your physician determine whether acid reflux is contributing to your symptoms and develop an individualized treatment plan.