Bravo Probe (48 Hour pH Testing)
The doctors of Gastroenterology of Southern Indiana must often perform routine procedures for the evaluation and treatment of many digestive tract problems. For detailed information regarding a specific procedure, simply click on the procedure listed below. The information about the following procedures is meant as a reference only and should not be used as diagnostic treatment.
The Bravo pH Monitoring System is a catheter-free way to measure pH.
The Bravo system involves a pH capsule, about the size of a gel cap, that is temporarily attached to the wall of the esophagus. The Bravo pH Capsule measures pH levels in the esophagus and transmits readings via radio telemetry to the Bravo Receiver worn on the patient's belt or waistband. The patient also records symptoms he or she experiences in a diary by pressing buttons on the receiver. The Bravo pH capsule collects pH measurements for up to 48 hours. After the study, data from the receiver is uploaded to a computer and diary information is entered for analysis to aid in the diagnosis and plan treatment. Normal patient activities such as swallowing, eating and drinking should cause the disposable pH capsule to detach and pass through the digestive tract in 5-7 days on average.
The pH test is useful for evaluating patients with acid reflux. The test was originally designed to evaluate patients with gastroesophageal reflux disease. It has since been modified to evaluate patients with laryngopharyngeal reflux disease. The test is currently the best method available to monitor acid exposure within the esophagus and voice box.
Once in the procedure room, you will be asked to lie on an exam table. One of the nostrils will be numbed with lidocaine. The nurse will then place a thin catheter into the nostril. As the catheter is advanced into the esophagus, you will be asked to swallow to help open up the esophagus. Once the catheter is in the appropriate position, it will be connected to the recorder. Overall, the exam will take approximately 15-30 minutes.
Because there is no sedation for the exam, you will be allowed to leave the endoscopy unit as soon as you are finished. Most patients are able to eat and drink normally after their discharge from the endoscopy unit, however, specific instructions regarding activity, eating, and medications will be given to the patient prior to discharge.
Because the probe measures the pH of the esophagus for 24 hours, you will need to return to the endoscopy unit the following day to have the pH probe removed.
The doctor uses the Bravo Delivery System to insert the pH capsule through the mouth or nose and position it above the lower esophageal sphincter. Once the pH capsule is in place, suction is applied, drawing a small amount of esophageal tissue into the capsule and locking it in place. The delivery system is then withdrawn and the pH capsule can begin measuring pH levels.
The Bravo pH system is convenient and provides comfort. The data is recorded when the capsule and receiver are within 9 feet of each other. You can bathe and sleep without the receiver interrupting your daily routine.
The 48 hour pH probe is a very safe procedure. Complications occur in less than 1% of patients. Most complications are not life-threatening, however, if a complication occurs, it may require hospitalization and surgery. Prior to the exam, a consent form will be reviewed with the patient by the nursing staff.
Perforation or puncture of the esophagus is a very uncommon complication, but can occur. This may be recognized at the time of the exam, or it may not be apparent until later in the day. In most cases, a perforation will require surgery and hospitalization.
Patients can develop chest pain after the monitor is attached. This does not occur in the majority of patients, but if it does, pain medications will be provided.