Want to know the exact cause of your heartburn and acid reflux? (Bravo Esophageal pH Test)

Do you also often feel a burning sensation in your chest and a sour taste in your throat? Sometimes this discomfort after eating is very annoying, isn't it? Some people also call it gastritis. So what is the real cause of this, and today we are going to talk about a test that can accurately determine whether the acid in your stomach is actually coming up into your throat. This is called the Bravo™ pH monitoring test.

What is the Bravo™ pH test? Why do I need to do this?

Simply put, this Bravo pH test measures the pH of your esophagus. Now you may be wondering what this pH value means. pH is a measure of how acidic or basic/alkaline something is. Our stomachs contain something called stomach acid. This is what helps us digest the food we eat. However, sometimes this stomach acid flows back up into the esophagus, the tube that carries food from the throat to the stomach. Then the acidity of the esophagus increases.

Not only stomach acid, but sometimes undigested food particles and other digestive juices can also come back up. This constant reflux of stomach contents is called "reflux." When this happens continuously, it can damage the esophagus. So, this Bravo pH test can find out exactly how often stomach contents come up into the lower esophagus, and how acidic they are.

If your doctor suspects that you have gastroesophageal reflux disease (GERD) , or the acid reflux disease we talked about, he or she may recommend this Bravo pH test. People with GERD may typically have symptoms like these:

• Heartburn
• Chest pain
• Coughing
• Sore throat or hoarse voice

How does the Bravo pH test work?

The Bravo pH monitoring test works as a system. It has three main parts:

1. A small wireless capsule that measures pH (pH-sensing wireless capsule): This is what measures pH by attaching it to the tissues of the esophagus.

2. A recorder: You need to wear this. It records the data sent from the capsule.

3. A software system that helps make all this work.

Think of it like a small capsule, about the size of a gel cap. It's temporarily attached to the wall of your esophagus. This is done during a procedure called an upper endoscopy . The capsule measures the pH of your esophagus and transmits that information to a recorder (about the size of a pager) that you carry on your belt or in your pocket.

This recorder has several buttons. When you have symptoms of GERD, such as heartburn, you press the corresponding button (the nurse will tell you what symptoms to record). You will also be asked to keep a diary. In it, you will record things like when you start eating, when you finish eating, when you drink, when you lie down, and when you get up again. All of this will be explained to you.

Who performs the Bravo pH monitoring test?

This capsule is inserted by a gastroenterologist, a doctor trained in gastrointestinal endoscopy . During this procedure, a thin tube with a camera attached is inserted through your mouth and passed down your esophagus to your stomach. This procedure can examine your digestive system and treat some conditions.

How do you prepare for the Bravo pH test?

This is something to be a little careful about.

• If you have a pacemaker or implantable heart defibrillator , have had previous bleeding problems, have dilated blood vessels, or have any other known problems with your blood vessels, you should definitely inform your doctor.

Next, some medications will need to be stopped a few days before this test.

• Seven (7) days prior to the test: Do not take medications called Proton Pump Inhibitors (PPIs), such as Omeprazole (Prilosec®), Lansoprazole (Previcid®), Rabeprazole (Aciphex®), Pantoprazole (Protonix®), Esomeprazole (Nexium®).
• Two days (48 hours) before the test: Do not take H2 blockers, such as Ranitidine (Zantac®), Cimetidine (Tagamet®), Famotidine (Pepcid®), Nizatidine (Axid®). Also, stop taking Metoclopramide (Reglan®).
• Six (6) hours before the test: Do not take antacids, i.e. liquid medicines or tablets used to treat gas (such as Alka-Seltzer®, Gaviscon®, Maalox®, Milk of Magnesia®, Mylanta®, Phillips®, Riopan®, Tums®).
• Four to six hours before your test: Do not eat or drink anything.

Important: Sometimes, your doctor may ask you to continue taking a medication you are currently taking during this test period. This is to see how well the medication is working for you. So follow your doctor's instructions exactly.

What happens on the day of the Bravo pH test?

• Wear as light and comfortable clothing as possible. The hospital or outpatient treatment center may give you a different gown to wear.
• Leave your jewelry, credit cards, etc. at home. You cannot wear glasses or dentures during the test.
• You should definitely have someone responsible take you back home, because you will be given medication to make you a little intoxicated.
• Your medical team will explain the procedure to you again and explain what to expect. This is done by putting you in a state called "twilight sleep," which means you are given medication to make you feel like you are in a light sleep. They will also talk to you about any possible complications or side effects.
• A local anesthetic will be applied to the back of your throat.
• The doctor will then insert the endoscope through your mouth and pass it down your esophagus to your stomach. Don't worry, this won't interfere with your breathing.
• The doctor attaches the capsule to tissue in the esophagus and checks to see if the signal is being received properly by the recorder.
• This entire process only takes a few minutes.

Does the Bravo pH monitoring test hurt?

You may be wondering what this experience will be like. To be honest, your throat may hurt a little. It may feel like something is stuck in your throat. However, if you experience unbearable pain or any symptoms that make you feel anxious, inform your doctor immediately.

What happens during the Bravo pH monitoring test after inserting the capsule?

Okay, now inside the capsule. How are you supposed to be for the next 48 hours (about two days)?

• Activity: Continue your usual daily activities. Do not reduce or change your activities during the test period. Doing so may reduce the accuracy of the test results. Important: Do not let the recorder get wet. It is not waterproof.
• Eating: Eat your normal meals at your usual times. If you don't eat during the test, your stomach won't produce acid as it normally does. This can give you false test results. Eat at least two meals a day. Eat foods that make your symptoms worse (but not too difficult for you to handle). Avoid snacking. Don't suck on candy, toffee, lozenges, or chew gum during the test.
• Lying down: Stay as upright as possible throughout the day. Don't lie down until you go to bed at night (unless napping or lying down is part of your daily routine).
• Medications: Continue to take any medications that your doctor has advised you to stop during the test period.
• Recording symptoms: When you have a symptom, press the appropriate button on the recorder (your nurse will have told you about this). Record the time you start and stop eating and drinking anything other than water. Record the time you lie down (even if it's just to rest) and the time you get up again. One of your medical team will explain all of this to you.
• Unusual symptoms or side effects: If you think you are experiencing any unusual symptoms or side effects, call your doctor immediately.

When the test period is over, you must return the recorder and diary. The information in the recorder and diary is entered into a computer and the results are analyzed.

What are the risks and benefits of the Bravo pH monitoring test?

It's important to know for sure if you really have acid reflux. Because if you really have a serious condition like GERD, it can damage your esophagus. If that happens, you could end up with serious problems like Barrett's esophagus or esophageal cancer later on.

It's also important to know that you don't really have a heartburn condition. Many people use medications like PPIs, but they don't help. So, unless you really have a problem, you don't need to take medication for nothing. If you don't have a heartburn condition, your medical team can help you find the real cause of your symptoms.

There are risks with any medical procedure. However, complications with the Bravo test have been reported very rarely. Sometimes, equipment errors can make the results unreliable. The capsule may not be released throughout the entire test. Or, it may not be released when it should be.

Very rarely, people who have this test may experience difficulty swallowing, chest pain, or back pain. The endoscopy may also cause a sore throat for a day or two.

There are other, less likely, risks that can occur, such as damage to the tissues of the esophagus or intestines, bleeding, or aspiration of the capsule into the windpipe.

What happens after the Bravo pH monitoring test?

After the test is finished:

• You can resume your usual diet, drinks, and medications .
• You can resume your normal activities – swallowing, eating, drinking, etc. When you do these things, the removable pH capsule will come off and will usually be passed out with your stool within seven to ten days.
• You cannot have an MRI (Magnetic Resonance Imaging - MRI) test for 30 days after the capsule is inserted.
• See your doctor and discuss the test results. He or she will help you develop a plan to manage your symptoms.

Finally, things to remember (Take-Home Message)

So, you probably understand what this Bravo pH test is and how it can help you find the cause of your chest pain and acid reflux.

Although this may seem like a bit of a hassle, it's worth it to know for sure whether you have a condition like GERD. Once you know, you can start the right treatment. Or, you can stop taking the medication and find the real cause of your symptoms.

If your doctor recommends this test, talk to him/her about it and ask any questions you may have. Take it easy and don't be afraid. Your medical team will explain everything to you and help you.

` Esophagus, pH, acid reflux, GERD, Bravo test, endoscopy, chest inflammation