Oesophageal pH monitoring using the Bravo catheter-free radio capsule

Eur J Gastroenterol Hepatol. 2007 Jan;19(1):57-63. doi: 10.1097/MEG.0b013e3280116eec.


Objectives: Oesophageal pH monitoring is the current standard for the diagnosis of gastro-oesophageal reflux disease. The Bravo capsule allows 48-h monitoring without the need for a naso-oesophageal catheter. Our aim was to assess the Bravo capsule in terms of patient discomfort and interference with daily activities, and to determine if 48-h Bravo pH studies facilitate the diagnosis of gastro-oesophageal reflux disease.

Methods: Ambulatory pH studies were performed at two hospitals using either the Bravo capsule (n=100) or a conventional naso-oesophageal catheter (n=100). Participants were selected either for investigation of symptoms suggestive of gastro-oesophageal reflux disease, or to follow-up antireflux surgery. All participants completed questionnaires to assess discomfort and interference with daily activities.

Results: Eighty-nine Bravo studies recorded at least 48 h of data, and 95 were diagnostic. Bravo participants reported significantly less discomfort during insertion (P<0.0001) and monitoring (P<0.0001), and less interference with daily activities (P<0.0001), eating (P<0.005), sleeping (P<0.0001) and work (P<0.0001). No significant difference was observed between day 1 and 2 median total time pH<4 (4.0 and 4.3%, P=0.64), erect time pH<4 (5.0 and 5.0%, P=0.56), supine time pH<4 (0.5 and 0.5%, P=0.23), and Johnson-DeMeester scores (15.9 and 16.2, P=0.90). Ten Bravo participants (10%) were diagnosed with gastro-oesophageal reflux disease using day 2 data after a normal day 1.

Conclusions: The Bravo capsule significantly reduces the patient discomfort and interference with normal daily activities during pH monitoring associated with a naso-oesophageal catheter. Moreover, 48-h Bravo studies offer an advantage over conventional 24-h studies in diagnosing gastro-oesophageal reflux disease.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Multicenter Study

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Aged
  • Esophageal pH Monitoring / adverse effects
  • Esophageal pH Monitoring / instrumentation*
  • Esophagoscopy
  • Female
  • Gastroesophageal Reflux / diagnosis*
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Middle Aged
  • Monitoring, Ambulatory / adverse effects
  • Monitoring, Ambulatory / instrumentation
  • Monitoring, Ambulatory / methods
  • Pain / etiology
  • Telemetry / adverse effects
  • Telemetry / instrumentation*
  • Telemetry / methods