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Bravo pH Monitoring
Bravo pH Monitoring
(by Given Imaging – www.givenimaging.com)
Why test for GERD?
Do you have frequent indigestion or a burning sensation in the center of your chest? Do you regularly get sour or bitter-tasting fluids in your throat or mouth? Do you avoid lying flat or bending over to prevent acid from backing up into your throat?
If you answered “yes” to any of these questions, you might have chronic (more than twice per week) heartburn or GERD (gastroesophageal reflux disease). The heartburn may be so severe that it interferes with your daily routine.
Frequent or chronic heartburn may be associated with a more serious problem known as GERD. Damage caused by GERD can lead to more serious medical problems such as difficulty in swallowing (dysphagia), narrowing of the esophagus (strictures), and Barrett’s esophagus.
Bravo pH monitoring is a minimally invasive test for evaluation of heartburn or related symptoms. Your doctor will analyze results from this test to determine what is causing your symptoms and the treatment to prescribe for you.
How it works
After administering a local anesthesia, your doctor will place a Bravo capsule into your esophagus using a delivery device. The test involves a miniature pH capsule, approximately the size of a gelcap, which is temporarily attached to the wall of your esophagus.
Throughout the test period, the Bravo pH capsule will measure the pH in the esophagus and transmit this information to a small recorder worn on your belt or waistband just like a mobile phone. Once the Bravo capsule has been placed and you have been instructed how to use the recorder, you can leave the doctor’s office and go about your normal activities.
Once the test has been completed, you will need to return the recorder to your doctor and the test data will be uploaded to a computer. The information will be analyzed by your doctor to diagnose your condition.
What to expect
The capsule takes only moments to place in the esophagus. Then, the test period lasts 48 to 96 hours, depending on what your doctor requests. The test is catheter-free (meaning no tube or wire remains in your nose or mouth) after placement of the capsule.
Some patients say they have a vague sensation that “something” is in their esophagus. Some patients say they can feel the capsule when they eat or when food passes the capsule. Should you experience this, chewing food carefully and drinking liquids may minimize this sensation.
Your doctor will instruct you how to use the recorder and when to return the equipment. You will be given a diary to write down the times when you have reflux symptoms (coughing, heartburn, regurgitation), when you eat and when you lie down.
Answers to your questions
What are the benefits of the Bravo pH monitoring procedure?
The Bravo pH monitoring procedure is catheter-free so you are free to move about as long as you stay within three feet or approximately one meter of the recorder. You can bathe and get a restful night’s sleep because you can place the recorder outside the shower or on your nightstand, and the test will not be interrupted.
The test also allows for evaluation of acid reflux and symptoms both on or off reflux medication, depending on your doctor’s recommendation.
Will the test restrict my diet and activities?
No. One of the added benefits of the capsule is that it is so small that you may eat normally and go about your daily routine.
What happens after the test?
After the test is complete, the disposable capsule falls off the wall of the esophagus and passes naturally with your bowel movement through your digestive tract. The data capture on the recorder during the procedure will be downloaded to a computer and your doctor will view the test results.
The risks of Bravo pH monitoring include premature detachment, discomfort, failure to detach, failure to attach, capsule aspiration, capsule retention, tears in the mucosa, bleeding and perforation. Endoscopic placement may present additional risks. Medical, endoscopic or surgical intervention may be necessary to address any of these complications should they occur. Because the capsule contains a small magnet, patients should not have an MRI study within 30 days of undergoing to Bravo pH test. Please consult your physician or refer to givenimaging.com for detailed information.
Please see the last 2 pages of the endoscopy information sheet for information on the billing for this.
The BRAVO capsule and placement device attracts an out of pocket expense of $650. This is NOT claimable through Medicare as this does not have an item number attached to it as it is a disposable item. An account for this will be sent to you for payment.