To prepare for a Bravo PH study, you need to stop medications that block stomach acid and have no food after midnight. The test lasts 48 or 96 hours depending on the doctor’s preference.
What is a Bravo PH?
The Bravo PH study is a wireless way to assess and monitor acid reflux. During the procedure, a camera is attached to the esophagus. The camera sends information to a recorder that will be given to you. The camera records the PH (acid level) in your esophagus.
The stomach produces acid but the esophagus does not. The esophagus does not tolerate significant acid exposure. Acid in the esophagus leads to heartburn, non-cardiac chest pain, cough, hoarse voice, Barrett’s esophagus and esophageal cancer.
Before the test, you will be given a diary. During the test, you will record your symptoms and activities such as eating, sleeping, lying down.
Who should not do the Bravo PH test
- Patients with severe inflammation or blockage in the esophagus.
- Those with esophageal varices.
- Patients with severe bleeding disorders.
- Those with pacemakers or implantable cardiac defibrillators.
What are the risks of Bravo PH test
The Bravo PH camera is usually placed during an upper endoscopy (EGD). Therefore, it also carries the risks associated with an EGD. In addition, the capsule may not attach or prematurely detach. Other risks include bleeding, perforation, aspiration of the capsule and failure of the capsule to pass. The capsule does not perform well with electromagnetic interference. Don’t get an MRI test within 30 days of the study.
How long does the study lasts
Most Bravo PH studies are for 48 hours. Some are for 96 hours.
How do I prepare for the Bravo PH test
The test can be done on therapy or off therapy. On therapy means that you will continue to use your acid blocking medications such as prilosec, protonix, prevacid, nexium and dexilant. Off therapy means the test will be done when you are off acid blocking medications. On therapy test is used to assess whether you still have acid reflux despite treatment. Off therapy test is used to confirm if you have acid reflux to begin with.
How to prepare for off therapy Bravo PH test
Stop 1 week prior to test
Proton pump inhibitors. These are Dexilant (dexlansoprazole), Prilosec (omeprazole), Prevacid (lansoprazole), Nexium (esomeprazole), Aciphex (rabeprazole), Protonix (pantoprazole).
Stop 72 hours prior to test
Histamine 2 receptor antagonists (H2RA). These are Tagamet (cimetidine), Zantac (ranitidine), Pepcid (famotidine), Axid (nizatidine).
Stop 24 hours prior to test
Antacids. These are Gaviscon, Maalox, Mylanta, Tums, Gelusil, Rolaids, Alternagel, Amphogel, Alka-Seltzer, Milk of magnesia, Pepto-Bismol.
What to expect during the procedure
The Bravo PH study can be done after an upper endoscopy or manometry. Most gastroenterologists confirm placement of the capsule in the esophagus with an endoscope.
What to expect after the procedure
After the capsule has been placed in the esophagus, the capsule begins to communicate with the receiver you will be given. The communication is wireless. No tubes or wires. Eat the foods that normally give you symptoms of acid reflux. Use the diary you were given to document when you eat, lie down or have symptoms of acid reflux like heartburn, regurgitation, chest pain and cough.
In addition, you can press buttons on the receiver to record when you eat, lie down and have symptoms. Keep the receiver within 3 feet of your self. Do not get the receiver wet. The capsule in your esophagus eventually dislodges and is eliminated with stool.
After you return the Bravo recorder, the data is downloaded to a computer. The result should be available to you after your doctor has reviewed and interpreted the result.
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