Esophageal 24-hour pH Monitoring

Bravo® (catheter-free or wireless) esophageal pH monitoring study

Wireless esophageal pH monitoring measures the amount of acidic reflux in your esophagus during a 48-hour period, and assesses whether your symptoms are correlated with the presence of acid in the esophagus. The test is performed by a gastroenterologist with the aide of a technician.

How is a Bravo® (catheter-free or wireless) esophageal pH monitoring study performed?

During an upper endoscopy (EGD), a small capsule will be attached to the lining of your esophagus to measure and record acidity for 48 hours (two days). As soon as the capsule is attached, it begins measuring the acidity in your esophagus. The capsule sends these measurements wirelessly to a small receiver that you will wear at your waist level held by a strap over your shoulder.

You must not take any over-the-counter antacids at least 24 hours before the test.

Your doctor should give you instructions on whether he or she wants your testing done while taking or while holding acid reducing medications.  If your doctor wants the test done while holding those medications, you will need to stop proton pump inhibitors 7 days before (name brand/generic equivalent: Prilosec/Zegerid/omeprazole, Nexium/esomperazole,  Protonix/pantoprazole, Prevacid/lansoprazole, Dexilant/dexlansoprazole, Aciphex/rabeprazole), and stop histamine type 2 blockers 3 days before the procedure (namebrand/generic equivalent: Tagamet/cimetidine, Pepcid/famotidine, Zantac/ranitidine).    

You will be asked to keep a diary during the testing, including every time you eat, drink, or take medicines, and how long that lasts, when you lay down and get up, and each and every time you have a symptom of interest (like heartburn, regurgitation, cough, sore throat, etc.).

Why is a Bravo® (catheter-free or wireless) esophageal pH monitoring study performed?

Esophageal reflux monitoring is performed in order to determine whether reflux of acidic stomach contents into the esophagus is causing symptoms such as heartburn, regurgitation, cough or sore throat. 

What are the potential complications with a Bravo® (catheter-free or wireless) esophageal pH monitoring study?

Wireless esophageal acid reflux monitoring is very safe. Rarely, there could be chest pain from the capsule requiring an endoscopy to remove it. Extremely rarely, there could be a tear in the wall of the esophagus or a bowel obstruction from the capsule. People with pacemakers or implantable defibrillators cannot have a Bravo® pH study.

What happens after a Bravo® (catheter-free or wireless) esophageal pH monitoring study?

Because you will be sedated for the upper endoscopy (EGD), you will not be able to drive afterwards. You must arrange for a responsible adult (over 18 years old) who can drive or otherwise accompany you to and from the Medical Procedures Unit. Your procedure cannot begin until a responsible adult driver is in the unit. This person should remain in the unit during your entire visit so that they are available as soon as you are ready to be discharged. You will not be discharged unless that person is in the unit. Because your judgment may be impaired after this procedure, you will not be released to take public transportation, a taxicab, or even walk home without another responsible adult present to accompany you.

Two days after the capsule is placed, you will return to turn in the diary and the data receiver. WE MUST HAVE THE EQUIPMENT RETURNED AT THIS TIME SO OTHER PEOPLE CAN HAVE BRAVO pH MONITORING STUDIES. The capsule will naturally fall off the lining of your esophagus and pass through your digestive system a few days after the study period. Typically patients do not see the capsule in the stool. The capsule itself is not retrieved; it is flushed down the toilet with the rest of the stool. You cannot have an MRI (magnetic resonance imaging) study for 30 days after the Bravo® pH monitoring study.

Your doctor will receive the final results of the procedure in about 1 week, and will communicate the results to you.

Make an Appointment

To make an appointment for a Bravo® (catheter-free or wireless) esophageal pH monitoring study or other GI procedure, call the University of Michigan Medical Procedures Unit at 877-758-2626.