BRAVO pH Test

What is the BRAVO pH test?

The BRAVO® pH test measures the amount of acidity (pH) in the esophagus. This helps doctors diagnose gastroesophageal reflux disease (GERD).

For this test, a clinician passes a long, thin, flexible tube through the mouth and esophagus, down to the stomach, a procedure known as an endoscopy. As the clinician passes the tube through the gastrointestinal tract, they may take small samples of tissue called biopsies. The doctor will then attach a small recording device called a BRAVO capsule to the esophagus to monitor how much acid is flowing backward from the stomach.

A child must have an empty stomach for this procedure, which takes about 30 minutes.

After the endoscopy, the child will wear a wireless monitor that receives signals about acid reflux from the capsule for the next 48 hours. The capsule typically detaches and leaves the body through the stool within two weeks.

How should I prepare my child for a BRAVO pH test?

A week before the test, contact your doctor and discuss what medications your child can and cannot take in the days leading up to the BRAVO pH test. Aspirin products and certain medications, both prescription and over-the-counter, can interfere with the test.

After midnight the night before the test, make sure your child has:

  • no solid food
  • no milk or milk products
  • no formula
  • no orange juice, pineapple juice, grapefruit juice or any other juice with pulp

If your child is older than 6 months, they may drink clear liquids until three hours before the test. Keep in mind that formula is not a clear liquid. The following liquids are fine:

  • breast milk
  • water
  • apple juice
  • cranberry juice
  • Pedialyte
  • Gatorade

What happens during a BRAVO pH Test?

A clinician will use an endoscope to attach a small capsule to the wall of your child's esophagus. This capsule will record symptoms of acid reflux for two days after the procedure.

  • Your child will be given medicine through an IV (intravenous) line, a tube connected a vein close to the surface of the skin, which will make them sleepy and relaxed.
  • The doctor will spray a numbing medicine in your child's mouth.
  • Throughout the procedure, your child will be attached to a heart monitor and an oxygen monitor so doctors can keep an eye on their vital signs.
  • When the test is complete, the doctor will speak with you and then a nurse will bring you to the recovery area to be with your child.
  • A nurse will observe your child throughout the entire recovery time. When your child is fully awake, they may have clear liquids to drink. Once they can keep liquids down, the IV will be removed.

What happens after a BRAVO pH Test?

Children are usually able to go home about one hour after the endoscopy is completed. A nurse will review all instructions with you and give you printed information sheets to take home.

Your child should not take certain medications after the procedure. Be sure to discuss this with the doctor before leaving the hospital.

  • Call your doctor if your child has severe or persistent abdominal pain or chest pain, fever, difficulty swallowing or begins vomiting after BRAVO pH test.
  • After a BRAVO pH test, a BRAVO receiver must be on or within three feet of your child. You will hear a beep for 30 seconds if the receiver is too far away and the display will flash.
  • Usually within 30 days of placement, the BRAVO capsule is passed naturally in a bowel movement. It can safely be flushed down the toilet. Most likely, you will be unaware of its passage.
  • Until the BRAVO capsule passes, all types of MRI must be avoided. If your child has an MRI examination scheduled, notify the radiologist. An X-ray may be needed to confirm passage of the capsule before an MRI can be done safely.
The results of the BRAVO pH test results will be available in about two weeks. If biopsies were obtained, it will take about five to seven days for results to be available.