Samuel N. Marcus M.D., Ph.D.

EL CAMINO MEDICAL ASSOCIATES

CROHN'S & COLITIS MEDICAL CLINIC

Bravo® pH Monitoring Means Accurate GERD Diagnosis

Prior to the innovative Bravo® pH Monitoring system, doctors had to either make an educated guess or use fairly invasive procedures – like a full upper endoscopy – to determine whether or not a patient suffered from gastro-esophageal reflux disease, or GERD.

The last thing we want to do is to prescribe unnecessary medicines or procedures, or not prescribe them when they’re needed, because this interferes with patient health and comfort. Bravo® pH monitoring allows us to get real-time readings of the acid levels in your esophagus over a 48-hour period. This information is crucial in making an accurate diagnosis so we can get you the treatment you need.

Here’s How Bravo® pH Monitoring Works

The Bravo® Monitoring systems uses a small, pH capsule (just a little larger than a standard pencil eraser) that is attached painlessly to esophageal tissue using an endoscope. You’ll be mildly sedated to remain relaxed during the procedure.

The capsule is wirelessly connected to a receiver, that dutifully records the acid levels in your esophagus. Within about four to five days, the gel capsule will simply dissolve and the contents will pass through your digestive tract, so there is no need to have it removed.

You will, however, return to the office with the receiver so we can upload its findings into the Bravo® software program, where the results are analyzed and Dr. Marcus can make an accurate diagnosis.

For the most accurate readings, we recommend that you:

  1. Stop taking reflux meds. If you currently take prescription meds for acid reflux, we ask that you stop taking them at least two weeks prior to Bravo® Monitoring. In most cases, this means being more uncomfortable than normal, so you can take Tums or Rolaids for the time being since they don’t interfere with the test results.
  2. Live your life as usual. We want to get accurate readings that reflect pH levels during your typical, day-to-day life. Go about your daily routine – work, exercise, etc. – as if nothing is different. This isn’t a chance to put on your best eating habits, just eat normally. In fact, we want to see what the readings are after a few meals, a couple of snacks and a fatty meal each day if that is your norm. If you typically drink beer, wine or cocktails, we want to see the readings after you drink those beverages as well.
  3. Maintain your Patient Diary. You’ll be given a Patient Diary in which you can record eating and sleeping habits as well as any acid reflux symptoms you might have. You will also document stop/start times for any periods spent lying down and/or sleeping.
  4. Keep the wireless receiver close. The receiver can be connected to your waistband or to your waist by an elastic band that is provided. While showering, the receiver should remain no more than three feet away from your body. Failure to keep the receiver close means it can’t accurately record consistent pH levels – and that means we can’t make an accurate diagnosis. The receiver is easy to use – you press the meal button once when you start and once again when the meal is complete. You’ll also use coded buttons to record certain symptoms. The bed button is pressed before and after you lie down.
  5. Show up to your follow up appointment. Return the receiver and your Patient Diary when scheduled, typically two days after the Bravo® Monitoring begins.

It’s that simple!

A few things to note:

  • Bravo® capsules rarely cause any problems, but patients may feel like there is a little something in their throat – since there is. This sensation will fade within five days, as soon as the capsule falls off.
  • The capsule contains a small piece of metal. This will be shed by your body through the digestive tract without issue. However, this means that you should avoid having an MRI for 30 days after the procedure, just to make sure the metal has exited your body.
  • We’ll want to see you one more time to discuss the monitoring results, so schedule a follow-up appointment with our office staff as soon as possible.

Interested in taking advantage of Bravo® pH Monitoring to learn more about what’s going on in your esophagus? Contact us here in Dr. Marcus’s office to schedule an appointment.