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The Bravo pH monitor is a small wireless capsule that is temporarily attached to the esophagus during an upper endoscopy (EGD). The Bravo capsule measures the pH (acid levels) in the esophagus and transmits data to a wearable receiver.
Purpose of the Study
The purpose of this study is to monitor the frequency and duration of gastroesophageal reflux and to analyze whether reflux events are related to patient symptoms. It helps diagnose gastroesophageal reflux disease (GERD) and assesses the effectiveness of GERD treatment.
How Long Does the Capsule Stay in Place?
The capsule can collect data for up to 96 hours. It should fall off and pass naturally with a bowel movement after 3 to 7 days.
Who Might Need This Test?
A Bravo pH study may be recommended if you experience:
- Persistent heartburn or acid reflux that has not responded to treatment
- Frequent regurgitation (food or liquid coming back up into the throat)
- Chronic cough, hoarseness, or throat clearing that may be related to acid reflux
- Chest discomfort that has not been explained by other causes
- Symptoms that are unclear or difficult to diagnose
Your doctor may also recommend this test to find out whether your current GERD medication is working as it should. If your symptoms have continued despite treatment, the Bravo pH study can help your care team understand whether acid is still reaching the esophagus and adjust your plan accordingly.
Preparing for Your Bravo pH Study
Before your procedure, your physician will give you specific instructions based on your health history. In general, you should be prepared to do the following:
Medications: You may be asked to stop taking proton pump inhibitors (PPIs), antacids, or other acid-reducing medications for a period of time before the study. This allows the test to capture your natural acid levels. Do not stop any medications without first talking to your doctor.
Fasting: Because the Bravo capsule is placed during an upper endoscopy, you will need to fast before the procedure. This typically means nothing to eat or drink for at least 6 to 8 hours beforehand. Your care team will confirm the exact timeframe when your appointment is scheduled.
What to bring: Wear comfortable clothing to your appointment. Bring a list of your current medications and your insurance card. A responsible adult will need to drive you home after the procedure due to the sedation used during the EGD.
If you have any questions about how to prepare, contact our office before your appointment.
What to Expect During the Procedure
The Bravo capsule is placed during a standard upper endoscopy (EGD), which is performed while you are under light sedation. Placing the capsule adds only a few minutes to the overall procedure time.
During the EGD, your physician will attach the small Bravo capsule to the lining of your esophagus using a delivery system. Once it is in place, you will be given a small wearable receiver to take home.
Most patients do not remember the procedure and are comfortable when they wake up.
After the Procedure
Once you leave our office, you will wear the receiver for up to 96 hours. During this time, you will:
- Log your symptoms using the receiver, including heartburn, regurgitation, chest discomfort, or other symptoms you notice
- Record your activities, such as mealtimes, when you lie down, and when you go to sleep
- Go about your normal daily routine, eating, drinking, and sleeping as you usually would (see the FAQ below for more details)
- Return the receiver to our office at the end of the monitoring period
The Bravo capsule does not need to be removed. It will detach on its own and pass naturally through your digestive system, typically within 3 to 7 days.
Risks and Considerations
The Bravo pH study is generally safe and well-tolerated. Most patients complete the monitoring period without any significant problems. As with any procedure, there are some things to be aware of:
- Mild chest discomfort or a sensation of something in the chest is the most common complaint and typically resolves on its own
- Early capsule detachment is uncommon but possible; if this happens, the study may need to be repeated
- Difficulty swallowing is rarely reported and is usually temporary
Certain patients may not be candidates for the Bravo pH study. Let your physician know if you have a pacemaker, implantable defibrillator, or neurostimulator, as the capsule transmitter may interfere with these devices. Patients with known narrowing of the esophagus, bleeding disorders, or severe esophageal disease should also discuss whether this test is appropriate.
If you experience severe chest pain, difficulty swallowing, or vomiting after the procedure, contact our office or go to the nearest emergency room.
Frequently Asked Questions
Will I feel the capsule?
Some patients notice a mild sensation of pressure or a feeling of something being stuck in the chest, especially when swallowing. This is normal and usually fades within a day or two. If you experience significant pain or difficulty swallowing, contact our office.
Can I eat and drink normally during the study?
Yes. In fact, eating and drinking as you normally would is encouraged so that the data collected reflects your everyday acid exposure. You do not need to follow a special diet during the monitoring period. Just be sure to log your mealtimes using the receiver.
What if the capsule does not pass?
The capsule is designed to detach and pass on its own within 3 to 7 days. In rare cases, it may take a bit longer. If you have not passed the capsule within two weeks, or if you develop any concerning symptoms, contact our office. Retained capsules are uncommon and can be evaluated with imaging if needed.
Is the Bravo pH study covered by insurance?
The Bravo pH study is a recognized diagnostic procedure and is covered by many insurance plans when ordered for appropriate medical reasons. Coverage varies depending on your plan and individual circumstances. We encourage you to contact your insurance provider before the procedure to confirm your benefits. Our team is also happy to assist with any questions about billing.
How will I get my results?
After you return the receiver, the recorded data will be analyzed by your physician. Results are typically reviewed within a few days. Your doctor will go over the findings with you and discuss what they mean for your diagnosis and treatment plan. You may receive your results during a follow-up visit or through our patient portal.
Contact Us Today
Centers for Gastroenterology serves patients throughout Fort Collins, Loveland, Greeley, and Steamboat Springs, Colorado. To schedule a Bravo pH study or to learn whether this test is right for you, please contact our office.
Contact Us Today to Schedule Your Appointment
Centers for Gastroenterology is devoted to providing professional and compassionate digestive care to patients of all ages. Using cutting-edge and innovative treatment and screening techniques, you can rest assured that you are in good hands. Our team of skilled providers has the knowledge and expertise to help you achieve optimal health.
