How Bravo measures reflux
A small wireless sensor is attached to the oesophageal lining, usually during an endoscopy, and transmits readings to a portable receiver for a period set by the clinical team. You may be asked to note symptoms, meals and relevant activities so the doctor can compare them with the recorded acid levels. This can help assess whether acid reflux is associated with symptoms, or provide information when reflux remains a concern despite treatment. It answers a different question from gastroscopy: the camera assesses the appearance of the lining, while Bravo records acid exposure over time.
Benefits, risks and limitations
The sensor usually detaches by itself and passes through the digestive tract; you generally do not need to retrieve it. Some people feel temporary chest discomfort, a sensation when swallowing, or discomfort while the sensor is attached. Rarely, the capsule may detach earlier than expected or readings may be incomplete. Bravo measures acid, not every type of non-acid reflux, and it cannot show structural problems or take a biopsy; it does not replace endoscopy when the lining needs assessment. Results are interpreted alongside your symptoms and prior investigations, and a recording alone may not explain every cause of discomfort.
Preparation and follow-up
The planned monitoring period, diary instructions and whether the test is performed on or off acid-suppressing medicine depend on the clinical question and your history. Do not stop or change a prescribed medicine unless your doctor specifically instructs you to do so. Tell the team about swallowing difficulties, allergies, implanted devices and any planned MRI, so they can check the capsule and device instructions and advise you about any restrictions. Ask what to do if the receiver signals a problem, how to return it, how results will be discussed, and what recovery advice applies after the endoscopy and sedation, if used. The team may explain how to mark symptoms on the receiver and keep a diary; record symptoms when they happen rather than relying on memory at the end of the test. Ask whether the aim is to assess reflux while taking your usual treatment or without it, since these approaches answer different questions. Unless your team advises otherwise, ordinary meals and activities may make the recording more representative, but follow the specific protocol you are given. The sensor is temporary and does not need to be removed by you. Before any MRI, check with the team whether the capsule has passed and what restriction applies to the particular device. If placement was combined with gastroscopy, recovery precautions relate to that procedure and any sedative, not to the receiver alone; arrange transport and supervision only as directed by your care team. The tracing reflects only the monitoring window: symptoms may not occur during that period, and an episode of discomfort does not necessarily coincide with an acid event. A quiet or inconclusive study therefore has to be considered with your usual symptom pattern and other tests. Ask whether the receiver needs to be kept within a particular range or returned in person, and what to do if you miss a diary entry; the unit’s instructions take priority over generic advice. The sensor measures acidity rather than the amount of fluid moving upward, so a separate impedance-based test may be discussed when non-acid reflux is the concern.
Understanding your results
Results consider how much time the oesophagus was exposed to acid and whether recorded symptoms coincided with acid episodes. Acid exposure and symptom association answer related but different questions; neither alone explains every symptom. Ask how testing while taking, or temporarily withholding, acid-reducing medicine affects interpretation.
Professional references
Related conditions
A related condition does not mean this procedure is suitable; decisions require individual assessment.