Bravo™ Reflux Capsule

The Bravo™ capsule test is a noninvasive test for evaluating heartburn or reflux symptoms related to gastroesophageal reflux disease (GERD). Damage caused by GERD can lead to more serious medical problems such as difficulty swallowing (dysphagia), narrowing of the esophagus (strictures), and Barrett’s esophagus.

This test involves inserting a capsule the size of a long gel cap into the esophagus to measure the pH environment. Higher levels of pH in the esophagus indicate the presence of acid reflux. Your doctor will analyze results from the Bravo test to determine what is causing your symptoms and which treatment to prescribe for you.

The Bravo pH monitoring system can be used in children as young as 4 years old. However, patients with pacemakers, cardiac defibrillators, or diagnosed gastrointestinal obstructions or strictures are not candidates for this procedure.

How to Prepare for the Bravo Capsule Test

You should not eat or drink anything for 6 hours prior to the procedure. Your doctor will let you know if or when you should adjust or stop any medications you take, such as proton pump inhibitors, H2 blockers, or antacids. Because you will be sedated, you will need someone you know to drive you home after the procedure.

What to Expect

You will lie on your left side for the procedure and receive sedation through an IV line to relax you and make you feel drowsy. A mouth guard will be placed to protect your teeth and gums. After administering sedation, your gastroenterologist will attach the Bravo capsule to a catheter and insert it through the mouth into the esophagus using an endoscope. Once positioned, the capsule is attached to the wall of the esophagus and the catheter is removed. This usually takes 60 seconds.

Throughout the test period, which lasts 48 to 96 hours, the Bravo capsule will measure the pH in your esophagus and transmit this information to the Bravo reflux recorder, a small device that you will wear on your belt or waistband as you would a mobile phone. The capsule communicates with the recorder wirelessly, meaning that no tube or wire remains in your nose or throat.

The Bravo capsule not only measures the degree of acidity during the test period but also how often stomach acid flows into the lower esophagus.

After the capsule has been placed, you will be taken to the recovery room while the sedative wears off. Unless otherwise directed by your doctor, you may immediately resume your normal diet and medications. Some patients can feel the presence of the capsule, some do not. You will also be given a diary to note when you have reflux symptoms, when you eat and drink, and when you sleep or lie down.

Once the test has been completed, you will return the recorder and diary to your doctor’s office. The data is then downloaded to a computer program, which provides a comprehensive report. Your GI doctor will analyze the information and your symptoms to determining if you have acid reflux.

A day or two after the test is completed, the disposable capsule falls off the wall of your esophagus, harmlessly passes through your digestive tract, and is eliminated from your body through a bowel movement.