Ambulatory pH monitoring provides information about the duration, pattern and symptom correlation of distal esophageal acid exposure from gastroesophageal reflux (GERD). This information is very useful in diagnosing GERD in patients with atypical symptoms (chronic cough, laryngitis, chest pain among others) and assessing response to medications in patients with known GERD.
With older traditional pH monitoring systems, a catheter is inserted through the patient's nose and into the esophagus. Wires connect the catheter to a portable device that records pH levels. This method was cumbersome, inconvenient and interfered with usual daily activities. The Given Imaging catheter-free monitoring system utilizes a small pH capsule (about the size of a gel cap) that is temporarily attached to the wall of the esophagus during an endoscopy. The capsule transmits pH data wirelessly via radio frequency telemetry to a pager-sized receiver worn by the patient.
Ambulatory pH monitoring provides measures of the severity and frequency of acid reflux and allows correlation of reflux events with patient symptoms (both typical and atypical).
The test involves a miniature pH capsule, approximately the size of a gelcap that is attached to your esophagus. Throughout the test period, the Bravo capsule measures the pH in the esophagus and transmits this information to a pager-sized receiver worn on your belt or waistband just like a pager or mobile phone. You will be given a diary to write down the times when you have reflux symptoms (for example, coughing, heartburn, regurgitation), when eating or when lying down. After the test is completed, you return the diary and the Bravo Receiver to your doctor and the information is uploaded to a computer, which provides a comprehensive report so the physician can diagnosis your condition.
The Bravo pH system provides comfort and convenience. Data is recorded when the capsule and receiver are within 3 feet of each other. What this means is you can bathe and get a restful night’s sleep because you can place the receiver outside the shower or on your nightstand and the test will not be interrupted.
The capsule takes only moments to place in the esophagus. Then, the Bravo test lasts for 48-hours.
The test is catheter-free and the receiver is small so you may eat normally and go about your daily routine without any restrictions.
After the test period, you return the Bravo Receiver to your physician’s office. The test data is uploaded to a computer and analyzed by your doctor. Your physician will inform you of your results soon after the test.
Several days after the test, the capsule naturally falls off the wall of the esophagus and passes through your digestive tract and is eliminated from the body.
Patients are restricted from undergoing an MRI study within 30 days of the Bravo procedure.
Some patients say they have a vague sensation that “something” is in their esophagus. Some patients say they 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.
Unfortunately, it is not for everyone. Patients with pacemakers, implantable defibrillators or neurostimulators cannot use Bravo. Patients with a history of bleeding diatheses, strictures, severe esophagitis, varices and obstructions are not candidates for Bravo.
Bravo wireless pH monitoring is performed by BCGI physicians at St. Mary Medical Center in Langhorne, PA.
