Motility and Gastrointestinal Disorders Center
What is a BRAVO placement with upper endoscopy?
A BRAVO placement with upper endoscopy is done so doctors can look inside the esophagus (food pipe), stomach and beginning of the small intestine (bowel). A BRAVO can determine if acid from the stomach is coming up into the esophagus.
In this procedure, the doctor passes a long, thin, flexible tube with a light on the end through the mouth and esophagus. The tube goes down into the stomach and small intestine. As the doctor passes the tube, he or she looks at these areas and may take small samples of tissues called biopsies. The doctor will then attach a small recording device called a BRAVO capsule to the esophagus to record what the acid does inside the body.
What happens before BRAVO placement?
Your child must have an empty stomach for an upper endoscopy. After midnight, do not give your child:
- any solid food
- milk or milk products
- juices with pulp, such as orange, pineapple or grapefruit juice.
If your child is younger than 6 months, he/she may drink clear liquids until two hours before the scheduled test time. Breast milk is considered a clear liquid.
- If your child is older than 6 months, he/she may drink clear liquids until three hours before the scheduled test time.
Examples of clear liquids are:
- breast milk
- apple juice
- cranberry juice
**Note: Formula is not a clear liquid
- Your child should not take aspirin products for one week prior to the procedure. Certain medications, both prescription and over-the-counter, can interfere with BRAVO placement.
- A week before your child's visit, please contact your doctor and discuss what medications can and cannot be taken in the days leading up to BRAVO placement.
What happens during BRAVO placement?
- Your child will have an IV (intravenous) placed. Your child will then be given medicine through the IV. This will make your child sleepy and very relaxed.
- The doctor will spray a numbing medicine in the mouth to make the test more comfortable. This does not hurt, but some children do not like the taste.
- Throughout the procedure, your child will be attached to a heart monitor by wires connected to three stickers on the chest. He or she will also have a small-lighted sticker on a finger or toe attached to an oxygen monitor.
- The test usually takes about 30 minutes to complete.
What happens after BRAVO placement?
Immediately after the test:
- When the test is complete, the doctor will speak with you. From there, a nurse will bring you to the recovery area to be with your child.
- In the recovery area, a nurse will be with your child and carefully observe him or her during the entire recovery time. When your child is fully awake, he or she may have clear liquids to drink. Once your child is able to keep liquids down, the IV will be removed.
- Your child will have a small pouch with a recording device within three feet of him that will be recording data from the BRAVO. You will be asked to record events on a log while the BRAVO is recording. The nurse will review all of the instructions with you and your child and give you an additional education sheet that will be attached to the BRAVO log.
- Children are usually able to go home about one hour after the test is done. The nurse will review all instructions with you and give you information sheets.
- Please call your doctor if your child has severe or persistent abdominal pain or chest pain, fever, difficulty swallowing or if he or she begins vomiting after BRAVO placement.
- Certain medications are not recommended after BRAVO placement, please discuss this with your doctor before leaving the hospital.
- After BRAVO placement, a BRAVO receiver must be on or within three feet of your child. If the receiver is too far from the BRAVO capsule, a beep will be heard for 30 seconds and the display will flash C1 or C2. Move the receiver to your breastbone until the beep stops and the C1 or C2 is no longer visible. Always keep the BRAVO receiver in a safe, dry place.
- Usually within 30 days of placement the BRAVO capsule is passed naturally in a bowel movement. Most likely, you will be unaware of its passage. It does not need to be retrieved and can safely be flushed down the toilet.
- Until the BRAVO capsule passes, all types of MRI must be avoided. If you have an MRI examination scheduled notify the radiologist. An x-ray may be needed to confirm passage of the capsule before the MRI can be done safely.
How will we be informed of the results?
Your doctor will speak with you as soon as the procedure is done. If biopsies were obtained, it will take about five to seven days for results. The results of the BRAVO will take about two weeks.