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48 Hour PH Testing (BRAVO)

The 48-hour BRAVO pH study system is used for monitoring and assessment of gastroesophageal acid reflux disease, or GERD.

What is GERD and how will this study help me?

In normal settings, the stomach produces digestive acid. The lower esophageal sphincter, or LES, acts as a barrier preventing the stomach acid from entering the esophagus. While some reflux is normal, too much can lead to damage of the esophagus. This can manifest in several ways, but most patients experience heartburn or even sore throat and cough.

The BRAVO pH system measures the acid exposure in the lower part of your esophagus. Your doctor will be able to use this information to decide if your symptoms are related to GERD.

Please note the device used in this test contains nickel. If you have a nickel allergy, you will not be able to have this test. Please call your doctor to discuss other options.

How is the test performed?

A small pH capsule device will be attached to the lower part of your esophagus. The device is approximately the size of a pencil eraser. You will wear a pager-sized receiver around your waist for 48 hours. The capsule transmits information to that receiver about the acid exposure it is sensing. During the study, you will be given a diary to write down the times that you experience symptoms as well as when you eat or lie down.

Once the study is complete, you will need to return the receiver. The pH capsule naturally falls off the wall of the esophagus, usually within several days, and passes through the digestive tract.

Patient participation is extremely important in order to obtain accurate results.

Will it hurt?

Typically, patients do not feel anything throughout the procedure. Very rarely a patient may experience vague chest discomfort, which usually subsides when the capsule falls off the esophageal wall.

What else do I need to do?

  1. Stop all medications used to treat acid reflux or that are known to interfere with gastric function, unless your doctor has told you to stay on your medications.

If advised to stop medications then:

  1. Stop 1 week prior to testing: Prilosec (omeprazole), Prevacid (lansoprazole), Nexium (esomeprazole), Aciphex (rabeprazole), Protonix (pantoprazole), Dexilant (dexlansoprazole)

  2. Stop 72 hours prior to testing: Zantac (ranitidine), Pepcid (famotidine), Axid (nizatidine), Tagamet (cimetidine)

  3. Stop 24 hours prior to testing: Maalox, Mylanta, Tums, Rolaids, Amphogel, Gaviscon

  4. You may NOT get an MRI study within 30 days after your procedure.


Please note that your procedure may be cancelled if you do not follow the instructions carefully. If you need to cancel or reschedule your procedure, please call at least 48 hours in advance.

This procedure may not be recommended if you have a pacemaker or a defibrillator. Please discuss other options with your health care provider. If you have an internal device such as a pain control device, insulin pump, or continuous glucose monitoring system (CGMS), these may interfere with your test.

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