Technical problems produced by the Bravo pH test in nonerosive reflux disease patients

Abstract

The Bravo capsule pH test involves a low but non-negligible rate of technical problems, a fact that must always be considered by physicians.

Evaluation of Gastroesophageal Reflux Disease Using the Bravo Capsule pH System

“…21 However, optimal threshold cut-off values are yet to be standardized. Penagini et al 11 in 2007, explained that a pH monitoring study is considered normal when esophageal acid exposure is in the normal range and the SI is less than 0.5.…”

“…23 The presence of an abnormal composite pH score in either the first or second 24-hour had a sensitivity of 93% but specificity and positive predictive value of 100% for a diagnosis of GERD. 21 On the other hand, there is limited data on normal pH thresholds from Asia compared to the West. In a recent study by Ang et al, 7 they determined the following data in a cohort of Singaporeans (age range 22-50, with two-thirds males and two-thirds of Chinese ethnicity): total percentage time pH < 4 at 24 hours was 7.4%, at 48 hours was 6.3% and overall 48 hours study was 5.8% (Table 1).…”

“…8,15 Technical failures may occur in up to 15% of cases. 21 These include poor data transmission (4.5%), attachment failure (3.4%), early capsule dislodgement (4.5%), and detachment failure (1.5% to 6.8 %). 12,21 The need for capsule removal was seen in 6% of cases, and it may be indicated in patients with intolerable and persistent chest discomfort.…”

“…21 These include poor data transmission (4.5%), attachment failure (3.4%), early capsule dislodgement (4.5%), and detachment failure (1.5% to 6.8 %). 12,21 The need for capsule removal was seen in 6% of cases, and it may be indicated in patients with intolerable and persistent chest discomfort. 21 Complications, such as GI bleeding and perforations, although rare, have been reported.…”

“…12,21 The need for capsule removal was seen in 6% of cases, and it may be indicated in patients with intolerable and persistent chest discomfort. 21 Complications, such as GI bleeding and perforations, although rare, have been reported. 6 A capsule is considered to be detached from the esophagus when the pH suddenly drops below 2 followed by a sudden increase in pH > 6 which corresponds to capsule passage through the bowel.…”