IS Case 582: Bravo pH device
Imaging Sciences URMC 2010
Publication Date: 2011-11-17
History
Patient is a 62-year-old male with history of peptic ulcer disease presenting for an upper GI study to evaluate for reflux and ulcers.
Findings
Lateral and oblique views of the distal esophagus demonstrated the Bravo pH device in the distal esophagus.
Diagnosis
Bravo pH device
Discussion
The diagnosis of gastroesophageal reflux disease can be made using pH monitoring to determine the presence of acid in the esophagus. The most commonly used pH monitoring device is the naso-esophageal pH catheter. The pH catheter is usually left in place for 24-48 hours to record the pH. The major drawback associated with the pH catheter is the discomfort to the patient associated with having a nasal catheter for 24 hours.
The Bravo pH capsule is another way being used recently for monitoring pH in patients with GERD. It is a small device that is attached to the esophageal wall using a small pin by endoscopy. The device monitors pH and sends information to a wireless recorder that is carried in the patient’s pocket. The capsule breaks off the esophageal wall in 48 hours and is passed through a bowel movement.
The primary advantage of the Bravo pH capsule over the traditionally used pH catheter is the capability of monitoring pH without the patient’s need to have a nasal catheter for 24-48 hours. The main problems associated with the Bravo pH capsule are failure of data transmission to the recorder and early detachment of the capsule from the esophagus. However, these technical problems seem to occur at a low percentage based on a study done by de Hoyos et al.
References
- de Hoyos A, Esparza EA. Technical problems produced by the Bravo pH test in nonerosive reflux disease patients. World J Gastroenterol. 2010 Jul 7;16(25):3183-6. PMID: 20593504
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