BRAVO Placement – Pediatric

The Bravo placement is a procedure used to measure acidity in the esophagus. The doctor inserts a small capsule (about the size of a gel cap) into the patient’s esophagus, and the capsule collects data on acidity over the next 24-48 hours. This procedure is typically used for patients with heartburn and acid reflux.

What is it?

Bravo capsules are the first catheter-free pH measuring tool. Doctors attach the capsule to the upper esophagus. From there, the capsule measures the acidity of the upper esophagus. The Bravo capsule transmits data to a receiver that can be up to three feet away. This allows the patient to have freedom and perform daily tasks. After a couple of days, the capsule will detach itself from the esophagus and is eliminated in the stool.

What should I do to prepare

Individuals should stop taking acid suppression medications ten days prior to the procedure. Individuals should also avoid consuming food and drinking eight hours prior to the procedure. After midnight the day before the procedure, no solid food, milk products, formula, or pulp juices should be ingested. Patients should tell their doctor if they have had an MRI at least 30 days after the procedure because the magnet in the Bravo capsule may interfere with the results. Conditions like esophagitis, strictures, or having a pacemaker placed should be shared with the patient’s doctor before the Bravo capsule is placed.

What happens during the process?

The doctor will ask the patient to lie on their back and will place the capsule in his or her esophagus. This process is quick and relatively easy. The patient should not feel the capsule, but there have been some cases where the capsule is felt. Once the capsule has been placed and the capsule has sucked some of the surrounding tissue from inside, the pH measurements will begin.

The patient is then given a receiver about the size of a pager and is asked to keep a food and sleep diary. On the receiver,there are symptom buttons, and the patient presses a button when they are feeling a particular symptom. For example, if the patient is feeling heartburn, they will press the heartburn button. Once the test is complete, the patient returns the receiver to the doctor along with the diary. The capsule, barring any unusual circumstances, should release itself and be eliminated through the patient’s stool.

What are the risks and potential complications?

Risks of Bravo placement include bleeding, perforation, premature capsule release, fever, hemorrhages, infection, and hypertension. In rare cases, the capsule may not release itself, in which case an endoscopic removal is necessary.


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