Esophageal acid reflux can be measured either by gently placing a tube into the nose or by placing a chip in the esophagus while asleep. Each of these tests has an advantage. Wireless BRAVO pH testing allows patients to lead normal lifestyle while having the test. There are no tubes to interfere with eating or working. The impedance pH test with the tube in the nose can measure both acid and non-acidic reflux, which is a great advantage to someone who needs a test while on acid suppressing medication to see if the treatment is effective. Bravo has the advantage of 48 hours of acid testing giving a higher yield than the 24 hour nasal Impedance pH.
BRAVO Wireless Acid pH Testing
Dr. Gutman is pleased to be among the first to offer the convenience of the wireless Bravo capsule. Having performed thousands of BRAVO tests since 2003, he has the largest experience on Long Island. The miniature capsule is placed into your esophagus while you are comfortably asleep during an endoscopy exam of your esophagus. Without discomfort, you can enjoy your normal routine, without being aware of having the capsule attached to the lower esophagus. The capsule comes off on its own in a few days. You do not return the capsule, only the monitor that you wear or carry like a beeper.
Keys to Success with BRAVO
Dr.Gutman will work with your Cardiologist, Internist, and Gastroenterologist to effectively diagnose the cause of your chest pain and assess if Acid Reflux requires treatment. Analysis of your symptoms and test results are given to you and sent to all of your physicians. During the 48 hour test period you will keep a diary of when you eat and sleep. Symptoms of Chest Pain, Heartburn, Cough, and Regurgitation are recorded on the diary with the time, in addition to pressing a button on the pager-like monitor. The diary is key to creating the symptom index and evaluating whether episodes of reflux correlate to symptoms. The test is easy, painless, and safe. You will bring back the monitor 2 days after the endoscopy, with the diary and make an appointment to meet with Dr. Gutman the following week to discuss the findings and recommendations.
Preparing for BRAVO
The BRAVO test is generally performed painlessly, and in just a few minutes in the comfort of Dr. Gutman’s fully accredited, in office endoscopy suite. We ask that you not eat for 8 hours before the test and no drinking or smoking for 4 hours. If you have ever had a heart attack or stroke or have had a stent placed in your arteries, continue aspirin up to the day before the procedure. Otherwise, please refrain from aspirin, ibuprofen and similar pain relievers for one week before the test. Also, refrain from herbal medications unless specifically discussed. If you take heart pills, blood pressure medication or inhalers in the morning, please take them when you arise that morning. If you take Diabetes medications, discuss them with Dr. Gutman. Discuss with Dr. Gutman any blood thinners including Coumadin/Warfarin, Plavix, Pradaxa, Effient, etc. as these need adjustment. You may not drive or drink alcohol on the day of the test, so someone will need to escort you home. The following day you may go to work, dine, be active, and enjoy your normal routine. Discontinue all acid blockers (including Prilosec, omeprazole, Zegerid, Nexium, Aciphex, rabeprazole, Dexilant, Prevacid, lansoprazole, Protonix, pantoprazole, Zantac, Ranitidine, Tagamet, Pepcid, Axid, and antacids) in order to diagnose whether there is acid present in the esophagus. The test may also be done on your treatment to assess effectiveness of the therapy.