Bravo esophageal pH monitoring is a minimally invasive test that evaluates whether acid from the stomach is refluxing into the esophagus and causing various symptoms. It requires attachment of a small monitoring device onto the esophageal wall during an endoscopic procedure called upper endoscopy or EGD.

Bravo PH Monitoring (Tubeless PH Test)

The Bravo PH monitor is a test to determine esophageal reflux and is performed over a 48-hour period. It is placed with an introducer tube that can be placed orally either with sedation or in an un-sedated fashion. If sedation is utilized, someone must accompany you to drive home. The probe is left on the esophageal wall, there it send signals to a receiver that you will wear on your belt. The probe then usually falls off and empties through your GI tract, usually over the course of three days.

The test can be done on or off medications. If your doctor decides that the test should be done off medications, we would like you to stop your proton pump inhibitor medicines (Prilosec, Nexium, Aciphex, Dexilant, and Prevacid) one week prior to the procedures.  H2-blockers (Tagamet, Zantac, Axid and Pepcid, including the generic and over-the-counter forms) must be stopped 3 days prior to the exam.  Antacids may be taken up to the night before the exam.

If you have had a stricture in any part of your GI tract (but particularly the esophagus), if you have had intestinal obstructions in the past, or if you have severe esophagitis, the test cannot be done in this fashion. Please notify your physician if you have a pacemaker or defibrillator.

The procedure may be performed by itself or in conjunction with an upper endoscopy, which is done to identify the location for probe placement. The upper endoscopy does require sedation. In some situations an esophageal manometry test will need to be performed, especially if you are in need of hiatal hernia surgery, (manometry test is done to determine the motor function of the esophagus.) This is done without sedation. For this test, an NG - like catheter is placed through the nose down into the stomach, and then is slowly removed while the patient swallows water in order to determine the pressures generated by the esophagus in response to a swallow. This test can be performed prior to doing the Bravo PH test.

The patient should not have an MRI within 30 days after the procedure.