Bravo Esophageal pH Test
The Bravo esophageal pH test measures the frequency and times of stomach acid refluxing into the esophagus, aiding the diagnosis of gastroesophageal reflux disease (GERD).
What is a Bravo esophageal pH test?
It is a wireless pH test involving a small capsule placed in the esophagus. The capsule has a tiny battery, an acid (pH) sensor, and a transmitter to measure and send data regarding the acidity level and frequency of the acid refluxes. During the test, you will wear a receiver on a belt to record the data sent from the capsule over 96 hours. If you have heartburn, chest pain, coughing, sore throat, or hoarseness, the common symptoms of GERD, your doctor may recommend this test.
What is the normal pH in the esophagus?
The usual pH in the esophagus is about 7.0. If the pH after 30 seconds of reading is lower, such as 4.0, it indicates you have increased acidity in the esophagus due to a reflux of stomach acid.
What are the procedural steps of a Bravo esophageal pH test?
The doctor will perform an endoscopy under anesthesia to attach a small capsule to the lower esophageal wall with a clip. This capsule will measure the pH levels of the esophagus and transmit the readings to the portable receiver. You will have to push a button on the receiver when you have symptoms such as heartburn, chest pain, and coughs; write down your activity when activating the recorder, such as when you start and stop your meal or the time you lie down and get up, and list all symptoms while you are under the pH monitoring.
Is the Bravo pH monitoring test painful?
You can experience a sore throat or irritation post-endoscopy with the sensation of chest pressure at the site of the capsule attachment.
Preparation for the Bravo pH test
Before the test:
- Inform your physician if you have a pacemaker or implantable heart defibrillator, a history of bleeding disorders, dilated blood vessels, or any other pre-existing issues with your esophagus.
- Stop taking proton pump inhibitors such as omeprazole, lansoprazole, rabeprazole, pantoprazole, or esomeprazole at least seven days before the test.
- Stop H2 blockers such as famotidine or motility drugs 48 hours before the test.
- Do not take antacids 6 hours before the test.
- Refrain from eating or drinking 4-6 hours before your appointment.
On the day of the test:
- Wear comfortable clothes. Do not wear any jewelry. The doctor will ask you to remove glasses and dentures before the procedure.
- The doctor will spray local anesthetic on the back of your throat before the endoscopy.
- After attachment to the esophageal lining, the doctor will evaluate the capsule's functionality.
After the test:
- You may feel a mild sore throat. Nevertheless, you can resume your diet, medications, and daily life. Do not alter your routine, as it can affect test results.
- Press the designated button on the receiver every time symptoms occur.
- Keep a journal of when you start and stop eating and when you lie down and get up.
- The monitoring period lasts 24-48 hours, and hospital staff will remove the receivers.
- It takes 7-10 days before the Bravo capsule detaches and passes through the digestive tract.
- Due to safety concerns, you should avoid MRI scans for 30 days following capsule attachment.
What are the risks and benefits of the Bravo esophageal pH test?
- Benefits: The Bravo esophageal pH test can determine if your symptoms are related to acid reflux and confirm if you have GERD. If there is no acid reflux when you have the symptoms, further diagnosis is necessary.
- Risks: Possible risks of the Bravo esophageal pH test include the capsule not staying in place or not detaching when it is supposed to, damage to the esophageal or intestinal tissues, bleeding, aspiration of the capsule, or experiencing sore throat or chest or back pain, but these abovementioned risks are rare.
