The Bravo pH Monitoring System for Diagnosing GERD

By Dr. Akram Ismail

As a specialist in internal medicine and gastroenterology, I have taken pride in utilizing the most effective and innovative technologies over the years. In 2003, I was one of the first physicians to offer the Bravo pH Monitoring System from Medtronic. The system is specifically optimized for testing gastroesophageal reflux disease (GERD), which involves stomach contents leaking back into the esophagus, often resulting in symptoms such as heartburn.

GERD has traditionally been diagnosed through treating patients with medications that suppress stomach acid production. Unfortunately, this approach alone is not enough to identify the disease positively. Conditions such as gastric ulcers effectively mimic GERD in responding to prescription drug treatment. In addition, the placebo effect inherent in patients’ response to medications must be taken into consideration.

Esophageal acid testing is a much more effective GERD diagnostic approach, as it measures the amount of time, over a 24- to 48-hour period, that the esophagus contains acid. The esophageal pH test generally involves a small tube or catheter that is positioned in the esophagus via the nose. The catheter’s tip holds an acid-sensing sensor, while the external end is attached to a recorder that tracks episodes of acid reflux.

Catheter free, the Bravo pH Monitoring System represents an improvement in this widely accepted GERD diagnostic approach. With the Bravo System, a capsule (similar in size to a small gelcap) is attached temporarily to the esophageal wall. Utilizing wireless telemetry, the capsule transmits pH data to a portable receiver worn by the patient over a period of 24 to 48 hours.

The primary benefits of this system are exceptional accuracy and minimal discomfort to the patient compared to a trans-nasal catheter. In addition to the Bravo System diagnostics, I have introduced a number of new techniques at my practice over the years, including the incision-free, EsophyX trans-oral surgery approach to GERD treatment.

About the Author: Dr. Akram Ismail served for nearly two decades as the President and Medical Director of Professional Gastroenterology & Surgery Associates in Leesburg, Florida.


Dr. Akram Ismail Describes Epic Teleradiology

For the past several years, I have acted as the President of Epic Teleradiology. Based out of Leesburg, Florida, my company offers cost-effective radiology services from American Board of Radiology-certified professionals. Additionally, I serve as Medical Director for Epic’s two affiliated facilities: Lake Surgery & Endoscopy Center and Endosurg Outpatient Center, LLC. Both of these firms hold Joint Commission accreditation, and they were the first in Florida’s Lake County to obtain this honor. Furthermore, Epic earned a Joint Commission Gold Seal of Approval in recognition of its high-quality care and skilled employees.

On behalf of Epic, I regularly visit the Middle East to maintain connections and fulfill our contracts with organizations in Cairo and Dubai, such as the Saudi Arabian Oil Co. and the King Faisal Specialist Hospital & Research Centre. However, Epic makes its services available to any group in need of imaging analysis. With a 24-hour turnaround for final diagnosis and a rush option, the facility reads data from ultrasounds, PET scans, and nuclear medicine. Soon, Epic will provide cardiovascular imaging to its clients. Compliant with the Health Insurance Portability and Accountability Act and DICOM (Digital Imaging and Communications in Medicine), Epic can receive and interpret documents 24 hours a day, 7 days a week.

To contact Epic Teleradiology, visit or call 1-888-EPICRAD. Patients with after-hour emergencies should dial (352) 323-0938.

About the Author:

A specialist in gastroenterology and internal medicine with credentials from institutions in Egypt, Saudi Arabia, New York, and New Jersey, Akram Ismail, MD, has performed diagnostic, therapeutic, and upper endoscopies and used the Medtronic Bravo pH Monitoring System to treat gastroesophageal reflux disease, viral hepatitis, liver disease, and other digestive disorders. Along with heading Epic, Dr. Akram Ismail functions as President and founder of Alani Medical Spa and belongs to the residential development firm Tri-County Professional Management, Inc.

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