What is the Bravo pH monitoring system?
The Bravo system is a pH test to help your doctor determine if you have acid reflux. A pH test measures the degree of acidity or alkalinity in your esophagus. The test period usually lasts 24 to 48 hours, and measures acidity in two ways:
- How often stomach acid flows into the lower esophagus
- Degree of acidity during the test period
Information from the pH test helps your doctor diagnose GERD (gastroesophageal reflux disease) and plan your treatment. Bravo system consists of a capsule, approximately the size of a gel cap that is temporarily attached to the wall of your esophagus. The capsule measures pH levels in you esophagus and transmits this information wirelessly to a portable receiver you wear on your waistband.
What should I expect during a Bravo test?
You will sit or lie back while your doctor inserts the pH capsule into the esophagus. After the capsule is in place, suction is applied, drawing a small amount of tissue into the capsule. The capsule is locked in place with typically little or no discomfort.
As soon as the capsule is attached, it begins measuring the pH levels in your esophagus. The capsule transmits these measurements wirelessly to a small receiver you wear on your waistband or belt. As long as the capsule and receiver are within 3 feet of each other, the system will measure and record your pH levels. This means you can place the receiver nearby when bathing or sleeping without interrupting the test.
The receiver is about the size of a standard pager, and has three symptom buttons. You will be instructed to press the appropriate button during the study when you experience heartburn, regurgitation, or chest pain. The Bravo Receiver is designed to prevent you from turning it off during the test period.
You will also be asked to record periods of eating and sleeping in a diary throughout the test. You can go about your daily routine without any restrictions.
Some people say they have a vague sensation that “something” is in their esophagus. Others say they feel the capsule when they eat or when food passes the capsule. Chewing food carefully and drinking liquids may minimize this sensation.
Please note: The capsule contains a tiny magnet, and you should not undergo an MRI study within 30 days of using the Bravo system.
What should I expect after the Bravo test?
When the pH study is complete, you will return the receiver and diary to your doctor’s office. The information stored in the receiver will be uploaded to a computer. Your doctor will analyze your results to determine if you have acid reflux and plan the best treatment for your heartburn symptoms.
The disposable capsule will spontaneously detach and pass through your digestive system a few days after the test period. Only a small area of esophageal tissue is affected by the capsule.
What are the possible complications of Bravo?
If you have a bleeding tendency, narrowing of the esophagus, severe irritation of the esophagus, varices, obstructions, a pacemaker, or an implantable cardiac defibrillator, you should not undergo a Bravo pH test. Additionally, because the capsule contains a small magnet, you should not have an MRI study within 30 days of undergoing the Bravo pH test.
Rare complications from using the Bravo pH Monitoring System include the following events:
- The capsule could detach from the esophagus before the test is completeThe capsule may fail to detach from the esophagus within several days after placement, or there may be discomfort associated with the pH capsule, requiring endoscopic removal
- Tears in the lining of the esophagus, causing bleeding and requiring possible medical intervention
To Ensure a Successful Exam Follow These Instructions
Several medications alter the pH level of the stomach and may affect the contractile pattern of the esophagus. Your doctor may choose to perform the test with or without stomach (acid-blocking) medications. Your doctor will let you know prior to the test if you should stop your medications or continue your medications.
pH Test Without Stomach Medications
Discontinue your stomach medications
7 Days Before Your Test
- Aciphex® (rabeprazole)
- Nexium® (esompeprazole)
- Prevacid® (lansoprazole)
- Kapidex® (dexlansoprazole)
- Prilosec® (omeproazole)
- Protonix® (pantoprazole)
- Zegerid® (omeprazole/ sodium bicarbonate)
2 Days Before Test
- Reglan® (metoclopramide)
- Pepcid® (famotidine)
- Tagament® (cimetidine)
- Zantac® (ranitdine)
- Axid® (nizatidine)
- Carafate® (sucralfate)
24 hours Before Test:
Stop any Over-the-Counter antacids
pH Test with Stomach Medications
If you doctor has instructed you to complete this test while you remain on stomach medications, continue all stomach medications (and any other medications) prior to the test.
The night before your exam
- Stop eating solid foods at midnight
- Clear liquids are okay to drink (examples: water, Gatorade, clear broth and apple juice).
- Do not drink red liquids or alcoholic beverages.
The day of your exam
- Stop drinking clear liquids 6 hours before your exam.