Bravo pH Monitoring
Bravo pH Monitoring

BRAVO pH Monitoring at AGMG

Learn about BRAVO pH Monitoring from the doctors of Associated Gastroenterology

GERD is one of the most common diseases seen at AGMG. Many patients will have typical symptoms of heartburn and regurgitation. However there are cases where the presentation is atypical or treatment is not effective. In these cases, the doctors of AGMG can offer an exciting technology called BRAVO pH monitoring to our patients.

What is BRAVO pH Monitoring?

The BRAVO pH monitor is a way to objectively measure how frequently patients are experiencing acid reflux episodes. A small wireless catheter is attached to the esophagus at the time of endoscopy. Over the next 2-3 days, the catheter directly measures how much acidic fluid is in the esophagus. In addition, the patient is given a hand held device that is activated when they are having symptoms of chest pain, pressure, cough etc.. This data is then directly correlated with the acid levels to see if they are related.

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When should I have a BRAVO pH monitor?

BRAVO pH monitoring is performed for a wide variety of reasons:

  • Chronic cough
  • Chest pain
  • Sore throat or hoarse voice
  • When acid reflux medicines are not working
  • If acid reflux surgery is being considered

The BRAVO pH Procedure

The process for an BRAVO is very straight forward. At the time your procedure is scheduled, your doctor will discuss with you if the test is going to be done ON or OFF your acid medicines. Typically the procedure is done OFF all acid medicines.

See patient handout for full instructions.

7 DAYS BEFORE YOUR PROCEDURE

  • Do not take proton pump inhibitors such as omeprazole (Prilosec®), lansoprazole (Prevacid®), rabeprazole (Aciphex®), pantoprazole (Protonix®), esomeprazole (Nexium®)

2 DAYS BEFORE YOUR PROCEDURE

  • Do not take the H2 blockers ranitidine (Zantac®), cimetidine (Tagamet®), famotidine (Pepcid®), nizatidine (Axid®); or the promotility drug, metoclopramide (Reglan®)

6 HOURS BEFORE YOUR PROCEDURE

  • Do not take antacids (such as Alka-Seltzer®, Gaviscon®, Maalox®, Milk of Magnesia®, Mylanta®, Phillips®, Riopan®, Tums® or any other brands)

48 - 72 HOURS AFTER THE PROCEDURE

  • Do not take any acid medicines unless specifically told by your doctor that it is ok. The goal of the test is to measure acid reflux. These medicines can interfere with these measurements
  • Record eating, lying down and symptoms as discussed at your appointment
  • You must keep the receiver within 3 feet of you at all times
  • Return the receiver at the time scheduled

Frequently Asked Questions

Will the test restrict my diet and activities?

The test is catheter-free and the capsule is small so you may eat normally and go about your daily routine.

What happens when the Bravo test is complete?

After the test is completed, you return the diary and the Bravo Receiver to your doctor. The test data is uploaded to a computer and analyzed by your doctor.

Is the catheter painful?

The capsule device may cause a vague sensation in the chest or discomfort when swallowing. This may be due to food tugging on the capsule as the food passes, although discomfort occasionally can be felt when swallowing only saliva. In very rare instances, the Bravo capsule can cause chest pain requiring removal of the capsule with an endoscopy

What happens to the capsule after the test?

Several days after the test, the capsule naturally falls off the wall of the esophagus and passes through your digestive tract.