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Data collected by an implanted oesophageal  capsule helps determine the best treatment.

What is BRAVO?

A small capsule, about the size of a gel cap, is temporarily attached to the wall of your oesophagus during an upper GI endoscopy. The capsule measures pH levels in your oesophagus, which are then transmitted wirelessly to a receiver (a box about the size of a pager) that’s carried on your body by a strap.

The BRAVO capsule checks the amount of acid that comes back into your oesophagus from your stomach over the duration of the study (at least 48–96 hours). You’ll go about your usual activities (eating, sleeping, working etc.), ensuring that the recorder is always within 3 feet of you. Within a week the capsule should detach naturally and pass through your digestive system. The capsule may cause a vague sensation in the chest or occasionally some discomfort when swallowing.

Preparation for the test

  1. Stop all your acid medication as instructed by your consultant. PPIs, such as Omeprazole, must be stopped one week prior to the procedure. H2 blockers, such as Ranitidine, must be stopped 3 days prior to the procedure.
  2. Fast for six hours prior to attending the hospital although you may have clear fluids until one hour prior to your admission time.
  3. You will be contacted by the hospital where your procedure is to be carried out to attend a preoperative appointment where they’ll ask about your past and current medical health.
  4. The procedure is usually carried out under sedation along with a local anaesthetic throat spray that numbs the back of your throat.
  5. Please inform us if you have a nickel allergy as the capsule contains a small amount of nickel.

On the day

  1. Please read the admission and discharge information that you have been sent regarding endoscopy. 
  2. An endoscopy will be performed to accurately locate and measure the correct position for the capsule.
  3. The endoscope will be removed and the capsule inserted using the manufacturer’s insertion device (a thin wire). A second endoscopy will be performed to check that the capsule has been deployed and is in the correct position.
  4. The procedure may be uncomfortable and you may feel a strange sensation between your ribs where the capsule is attached. If you experience this, chewing carefully and drinking liquids may help to minimise it (once you are awake and stable).

After the procedure

The recording box has several symbols on the front that you’ll need to press as and when your symptoms occur or when you lie down or eat. You’ll be shown how to use the device by the endoscopy staff who will also provide you with a sheet explaining the symbols and a diary sheet for recording information.

If the recording device is in sleep mode it won’t be back lit. Press any button to activate the back light before pressing the required button to record your activity or symptom. There’s a blue light on the front of the box that flashes to indicate that it’s recording. If you step too far away from the box a red/amber light comes on so you must pick the device up and hold it close to your chest until the C1 message disappears and the blue flashing light returns.

Please take note of the following: 

  • Stop your acid medication for the duration of the study unless otherwise instructed by your consultant
  • Don’t consume any carbonated fizzy drinks or alcohol during the study period
  • Don’t chew gum or suck too many boiled sweets
  • You may take a bath or shower, but don’t let the recording box get wet and keep it within 3 feet. Place it nearby so that it can continue to record data wirelessly
  • As the BRAVO capsule has a magnet in it you cannot have an MRI for 30 days following the procedure unless you have an x-ray to ensure that the capsule has passed through your digestive tract
  • You must return the recording box promptly as instructed, 96 hours after your procedure, so that we can download the data and generate a report (we may ask you for a deposit to ensure that the device is returned as instructed)
  • The report will be sent to you and your GP and discussed with the referring consultant