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.