Bravo™ pH Monitoring System Effective to Treatment GERD or Acid Reflux

What is the Bravo™ pH Monitoring System?

The Bravo pH Monitoring System is a catheter-free way to measure pH.



The Bravo system involves a pH capsule, about the size of a gel cap, that is temporarily attached to the wall of the esophagus. The Bravo™ pH Capsule measures pH levels in the esophagus and transmits readings via radio telemetry to the Bravo™ Receiver worn on the patient’s belt or waistband. The patient also records symptoms he or she experiences in a diary by pressing buttons on the receiver. The Bravo pH capsule collects pH measurements for up to 48 hours. After the study, data from the receiver is uploaded to a computer and diary information is entered for analysis to aid in the diagnosis and plan treatment. Normal patient activities such as swallowing, eating and drinking should cause the disposable pH capsule to detach and pass through the digestive tract in 5-7 days on average.

How is the Bravo pH capsule attached to the esophagus?

The doctor uses the Bravo Delivery System to insert the pH capsule through the mouth or nose and position it above the lower esophageal sphincter. Once the pH capsule is in place, suction is applied, drawing a small amount of esophageal tissue into the capsule and locking it in place. The delivery system is then withdrawn and the pH capsule can begin measuring pH levels.

How is the Bravo pH capsule attached to the esophagus?



The doctor uses the Bravo™ Delivery System to insert the pH capsule through the mouth or nose and position it above the lower esophageal sphincter. Once the pH capsule is in place, suction is applied, drawing a small amount of esophageal tissue into the capsule and locking it in place. The delivery system is then withdrawn and the pH capsule can begin measuring pH levels.

Study and Research

The study enrolled 23 consecutive patients who had symptoms suggestive of reflux but who previously had shown normal acid exposure and negative symptom association when evaluated with traditional, catheter-based pH monitoring systems. Researchers used standard esophageal acid measurements to analyze total reflux, upright reflux and supine reflux. Acid exposure over 24 hours was the primary outcome of the study. Key findings included:

- More than 1 in 4 patients with a negative pH catheter study had pathological acid exposure during a 48-hour period of wireless pH monitoring.

- Nearly one in two patients had at least one day of pathological exposure during a 96-hour period of wireless pH monitoring (total, upright or supine).

- Prolonged monitoring also increased the number of patients with a significant association between reflux episodes and symptoms.

- Follow-up showed that 6 of 7 patients with positive findings (acid exposure or symptom association) did well after anti-reflux surgery; whereas 6 of 7 patients with entirely negative findings failed to respond to medical therapy.

Researchers indicated that it is unclear as to whether average pH measurement or the single-worst-day measurement is more clinically relevant, noting that either approach increased the diagnostic yield in this study.

Source:
- esophyxny.com