Harmony Chandler
The Bravo capsule is a device used to detect acid exposure in the oesophagus, which is often used to help diagnose gastroesophageal reflux disease (GERD). The capsule is placed in the oesophagus during an upper endoscopy procedure and measures the amount of acid reflux the patient experiences. The Bravo capsule test can cause some discomfort, and patients are advised to avoid certain foods and drinks that can affect the results, such as coffee, orange juice, cranberry juice, and soda. It is not clear whether beer should also be avoided, but it is recommended that patients follow their regular diet during the test.
| Characteristics | Values |
|---|---|
| Purpose | To check the amount of acid that comes back into your oesophagus from your stomach (acid reflux) and determine if you have gastroesophageal reflux disease (GERD) |
| Procedure | A small capsule is attached to the wall of the oesophagus during an upper endoscopy and measures pH levels. |
| Duration | 48 hours (2 days) |
| Preparation | Stop taking certain medications up to 14 days before the procedure. Do not eat or drink 4-6 hours before the procedure. |
| Aftercare | Resume normal activities, diet, and medications. The capsule will detach and pass through the digestive tract in 7-10 days. Avoid MRI exams for 30 days after the procedure. |
| Risks | Discomfort when swallowing, chest pain, back pain, sore throat. Rare risks include damage to the oesophagus or intestines, bleeding, or aspiration of the capsule. |
What You'll Learn
What is the Bravo capsule?
The Bravo capsule is a noninvasive test used to evaluate heartburn or reflux symptoms related to gastroesophageal reflux disease (GERD). The test involves inserting a small capsule (about the size of a long gel cap or a pencil eraser) into the oesophagus to measure the pH level. Higher levels of pH in the oesophagus indicate the presence of acid reflux. The test can be used to determine the cause of symptoms and to prescribe the appropriate treatment.
The Bravo pH monitoring system is suitable for children as young as four years old. However, it is not recommended for patients with pacemakers, cardiac defibrillators, or diagnosed gastrointestinal obstructions or strictures. The test procedure involves attaching the Bravo capsule to a catheter and inserting it through the mouth into the oesophagus using an endoscope. The capsule is then attached to the wall of the oesophagus, and the catheter is removed. The capsule measures the pH in the oesophagus and transmits this information wirelessly to a small receiver device worn on the waistband or belt. The test period typically lasts between 48 and 96 hours.
Before the procedure, patients are advised to fast and refrain from eating or drinking anything for about six hours. They may also need to stop taking certain medications, such as proton pump inhibitors, H2 blockers, or antacids, as directed by their doctor. After the procedure, the capsule naturally detaches from the oesophageal wall within a few days and passes through the digestive tract. During the test period, patients are instructed to maintain a diary to record their symptoms, meals, sleep, and other activities.
The Bravo pH monitoring system offers several advantages over traditional catheter-based pH monitoring methods. It is more comfortable and convenient for patients, allowing them to resume their normal diet and activities during the test period. It also provides prolonged pH monitoring, enabling more comprehensive data collection.
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How is the capsule administered?
The Bravo capsule is administered during an upper endoscopy procedure. A flexible tube called an endoscope is inserted into the patient's mouth and down their oesophagus to allow the healthcare provider to see the inside of the oesophagus on a video monitor. The patient is usually put under twilight sleep during the procedure.
The Bravo capsule is then placed temporarily on the wall of the oesophagus, where it measures the amount of acid reflux the patient experiences. The patient will then wear a receiver on their waistband or belt, which collects information from the capsule. The procedure typically lasts a few minutes.
Before the procedure, patients may need to stop taking certain medications, such as proton pump inhibitors and histamine type 2 blockers. They will also need to fast for a certain period, typically for about six hours.
After the procedure, patients may experience some discomfort in their chest and throat, and may feel like there is something in their throat. The capsule will pass through the patient's system in a bowel movement within about seven to ten days.
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What are the side effects?
The Bravo capsule is a small wireless device that is attached to the wall of the oesophagus to measure acid reflux. The procedure is often carried out to determine if a patient has gastroesophageal reflux disease (GERD). While the procedure is considered safe, there are some side effects that patients can experience.
Some patients may experience discomfort in their chest, throat, or back, as well as pain when swallowing. This is considered normal and usually goes away within a day or two. However, in rare cases, patients have reported severe odynophagia (pain when swallowing) and chest pain, which may indicate a more serious complication such as perforation.
There is also a risk of the capsule becoming dislodged too early or failing to detach when it is supposed to. In some cases, the capsule may need to be removed endoscopically if it does not detach within five days.
Other potential, but very rare, risks include damage to the tissue of the oesophagus or intestines, bleeding, and aspiration (breathing in) of the capsule.
It is important to note that these side effects are uncommon, and the Bravo capsule has been shown to be well-tolerated by most patients. However, if you experience any unusual symptoms or side effects, it is important to contact your healthcare provider.
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How long does the capsule stay in place?
The Bravo capsule is typically attached to the wall of the oesophagus during an upper endoscopy. The procedure is carried out by a healthcare provider and lasts a few minutes. The Bravo capsule is a small wireless device, about the size of a gel capsule, that measures the pH level of the oesophagus.
The Bravo capsule is designed to stay in place for 48 hours (2 days) to check the amount of acid that comes back into the oesophagus from the stomach, known as acid reflux. This procedure is used to determine if a patient has gastroesophageal reflux disease (GERD).
The average battery life of a Bravo capsule is up to 14 days. However, the capsule usually detaches within 5 days. In rare cases, if the capsule does not detach within 5 days, endoscopic retrieval may be required.
After the 48-hour testing period, the disposable pH capsule will detach and pass through the digestive tract in 7 to 10 days on average.
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What are the benefits of the Bravo capsule?
The Bravo capsule is a diagnostic tool used to measure the pH level of the esophagus. It is placed temporarily on the wall of the esophagus during an upper endoscopy procedure. The Bravo capsule is beneficial in several ways:
- It can help determine the amount of acid reflux coming from the stomach into the esophagus, which is a tube that carries food and liquids from the mouth to the stomach.
- It can assist in diagnosing gastroesophageal reflux disease (GERD) by measuring the level of acid reflux and the length of time it occurs.
- The Bravo capsule is user-friendly and has an advantage of prolonged pH monitoring compared to traditional 24-hour catheter-based pH monitoring.
- It is well-tolerated by patients, with minor impacts on diet and daily activities.
- The system includes a wireless capsule, a recorder to capture data, and software to process the information.
- The procedure is relatively safe, although there is a small risk of technical failures, such as poor data transmission or early capsule dislodgement.
- It can be used to evaluate the effectiveness of proton pump inhibitor (PPI) therapy and to assess atypical symptoms unresponsive to PPI therapy.
- The Bravo capsule can also be used to monitor treatment responses while on histamine receptor blockers.
- It provides valuable information for healthcare providers to develop a plan to manage a patient's symptoms.
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Frequently asked questions
It is not recommended to drink beer or any other alcoholic beverage while the Bravo capsule is attached. Alcohol can irritate the oesophagus and interfere with the accuracy of the test results.
You should only drink clear juices (apple, grape, or cranberry), Gatorade or Powerade, and black coffee or plain tea (with sugar, if desired). Avoid adding milk, creamer, or flavoured syrup to your coffee or tea.
The Bravo capsule test typically lasts for 48 hours (2 days). During this time, it is important to follow the instructions provided by your healthcare provider to ensure accurate test results.
Some people may experience a sore throat or discomfort in the chest and throat during and after the procedure. In rare cases, there is a risk of damage to the oesophageal tissue, bleeding, or aspiration of the capsule.
Once the monitoring period is over, you can resume your normal diet and medications. The capsule will detach and pass through your digestive tract within 7 to 10 days on average. It is important to note that you cannot undergo an MRI exam (magnetic resonance imaging) for 30 days after the capsule has been inserted.
