The Bravo pH monitoring test measures the pH level of your esophagus. The pH level of a substance tells whether something is basic or acidic. Sometimes, stomach acid backs up into the esophagus which can increase the acidity level within your esophagus. Stomach acid isn’t the only thing that can back up into the esophagus. Food particles and other digestive juices can also splash back. When reflux occurs on a regular basis, it can cause permanent damage to the esophagus. The Bravo pH monitoring test reveals how often stomach contents reflux into the lower esophagus and how much acid the reflux contains by measuring changes by using a capsule attached to your esophagus. The capsule can be left to collect data for from 24 to 48 hours.
There are two options of pH monitoring available:
1. Digitrapper catheter-pH monitoring: a measurement tube is inserted through the patient’s nose into the esophagus to collect signals for 24 hours. The results are then analyzed by a Digitrapper computer.
2. Capsule Bravo pH monitoring: a capsule is inserted through an endoscope to be attached to the esophageal wall.
The Brave pH monitoring test is used to assess the patient if they have any Gastroesophageal reflex disease [GERD] as well as any other functional gastrointestinal disorders. It will help the doctor in diagnosing your condition. When you doctor suspects GERD, they might ask you to have a Bravo pH test. People who are diagnosed with GERD often experience; heartburn, chest pain, coughing, sore throat or hoarse voice.
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-The Bravo pH monitoring test is a great test to determine whether you have GERD or not. Many people are taking medication like PPIs that aren’t working. You don’t need to take medication that is not indicated. If you don’t have acid reflux, your doctor can then help you find out what is really causing your symptoms.
-The capsule may fail to stay in place for the full testing period, or it might not detaach when it is supposed to do so.
-Although rare, people having this test might feel some discomfort when they swallow, chest pain or back pain. You may have a sore throat from the endoscopy for a day or so.
A small capsule, about the size of a gel cap, is temporarily attached to the wall of the esophagus during an upper endoscopy. The capsule measures pH levels in the esophagus and transmits readings to a receiver (about the size of a pager) worn on your belt or waistband. The receiver has several buttons on it that you will press to record symptoms of GERD such as heartburn (a caregiver will tell you what symptoms to record). You will be asked to keep track of events like when you start and stop eating and drinking, when you lie down and when you get back up. This will be explained by your caregiver.
Your doctor will discuss with you to find out if you have a pacemaker or implantable heart defibrillator, a history of bleeding problems, dilated blood vessels, and any other previously known problems with your esophagus. He / she will then proceed to discussing with you about which medications you are allowed to be on leading up to the placement of the brave pH monitor. You will have to fast approximately 4 to 6 hours before your appointment.
After the Bravo pH monitor is placed, you may resume your normal diet, medications, and normal activities – such as swallowing, eating and drinking. You cannot have any MRI exams (magnetic resonance imaging) for 30 days after the capsule has been inserted. Your doctor will discuss when you should come to the hospital in order to retrieve your results and analyze your results.
Although the Bravo pH test is safe and only available by prescription, there are a few potential complications such as:
-Premature detachment of the pH capsule
-Failure of pH capsule to detach within several days after placement
-Discomfort with placement of the pH capsule
-Tearing in the lining of the esophagus, which may require surgery
-Perforation
Does the Bravo pH monitoring procedure hurt?
Typically, patients do not feel anything throughout the procedure. Very rarely a patient may experience vague chest discomfort, which usually subsides when the capsule falls off the esophageal wall.