Bravo pH Monitoring

NCH gastroenterologists use the wireless Bravo pH monitoring system to measure acid levels in the esophagus over 48–96 hours — helping diagnose and manage GERD without an uncomfortable nasal catheter.

monitor 1

What Is Bravo pH Monitoring?

Bravo pH monitoring is a test that measures how often and how much stomach acid backs up into the esophagus. A small, wireless capsule — about the size of a gel cap — is temporarily attached to the lining of the lower esophagus during an upper endoscopy (EGD). The capsule contains a tiny battery, an acid sensor, and a transmitter.

Once placed, the capsule wirelessly sends pH readings to a small receiver you wear on your waistband. Because there’s no catheter running through the nose and throat, most patients find the Bravo test more comfortable than traditional 24-hour catheter-based pH monitoring — and it collects data for a longer period, typically 48 to 96 hours, giving your physician a fuller picture of your acid reflux pattern.

The capsule detaches on its own within about 7 to 10 days and passes naturally through the digestive tract, so no removal procedure is needed.

Why Is Bravo pH Monitoring Performed?

Your gastroenterologist may recommend Bravo pH monitoring to confirm a GERD diagnosis or evaluate ongoing reflux symptoms.

Persistent Heartburn or Regurgitation

Symptoms that continue despite taking acid-reducing medication as directed.

Confirming a GERD Diagnosis

Determining whether reflux is truly the cause of your symptoms before starting long-term treatment.

Evaluating Medication Effectiveness

Checking whether your current GERD treatment is adequately controlling acid exposure.

Atypical Reflux Symptoms

Chronic cough, throat clearing, hoarseness, or chest pain that may be related to acid reflux.

Pre-Surgical Evaluation

Confirming reflux before procedures such as anti-reflux surgery or incisionless fundoplication.

Ruling Out Acid Reflux

Helping determine that symptoms are due to a different cause when reflux is not found.

Not every patient with reflux symptoms needs pH monitoring. Your gastroenterologist will review your symptoms, prior testing, and treatment history to decide whether Bravo monitoring, another diagnostic test, or a change in treatment is the right next step for you.

Your Procedure Journey

From referral through results, here’s what to expect at each stage.

Consultation & Scheduling

Symptom and medication review; instructions sent ahead of your procedure.

Preparation

Fasting and medication hold instructions before sedation.

Capsule Placement

Brief endoscopy under sedation to attach the capsule to the esophagus.

Monitoring Period

Wear the receiver and log meals, symptoms, and activity for 48–96 hours.

Results & Follow-Up

Return the receiver; your physician reviews the data with you.

Contact your care team promptly for severe or worsening chest pain, difficulty swallowing, or if the capsule sensation does not improve. Avoid MRI scans for 30 days after capsule placement.

Is This the Right Test for You?

Bravo pH monitoring and traditional catheter pH testing both measure acid reflux, but differ in comfort, duration, and how they’re worn.

Bravo Wireless pH Monitoring Traditional Catheter pH Monitoring
Method Wireless capsule attached to the esophagus during endoscopy Thin catheter passed through the nose into the esophagus
Monitoring duration 48–96 hours Typically 24 hours
Comfort No external tube; most patients resume normal activity Catheter remains in the nose and throat throughout testing
Placement Requires a brief endoscopy under sedation Placed at the bedside without sedation

Risks & Safety

Bravo pH monitoring is generally safe. As with any endoscopic procedure, there are some risks to be aware of.

Capsule Attachment Issues

Rarely, the capsule may detach early or fail to detach on its own as expected.

Chest Discomfort

A sensation of pressure or discomfort at the attachment site, especially when swallowing, is common and usually mild.

Bleeding or Tissue Injury

Minor bleeding or injury to the esophageal lining is uncommon but possible with any endoscopic procedure.

Sedation-Related Risks

Standard sedation risks apply, as with any endoscopy; your team will review your health history beforehand.

Do not stop or adjust any medication without your physician’s guidance. Your care team will tell you exactly which medications to pause and for how long before your test.

Frequently Asked Questions

Bravo pH monitoring is a test that uses a small wireless capsule, placed in the esophagus during an endoscopy, to measure acid reflux over 48 to 96 hours and help diagnose or manage GERD.

The capsule is attached to the lining of the lower esophagus during a standard upper endoscopy performed under sedation. Placement typically adds only a few minutes to the procedure.

You won’t feel the capsule being placed, since you’re sedated. Afterward, some patients notice a mild pressure sensation in the chest, especially when swallowing, which is usually mild and temporary.

Typically 48 to 96 hours, depending on what your physician orders. You’ll log your meals, activity, and symptoms during this time.

The capsule detaches on its own within about 7 to 10 days and passes naturally through your digestive tract. No retrieval procedure is needed.

Yes, most patients continue their normal daily activities while wearing the receiver, though your physician may ask you to avoid certain activities like swimming.

Risks are uncommon and include chest discomfort, the capsule detaching earlier or later than expected, and rare bleeding or injury to the esophagus. Your physician will review your specific risks before the procedure.

After you return the receiver, your physician downloads and reviews the data, then discusses your results and next steps with you at a follow-up visit.

Location

Bravo pH monitoring is performed at NCH Gastroenterology outpatient locations.

Explore All Gastroenterology Services

Conditions, screenings, and advanced GI care at NCH.

Schedule Your Bravo pH Monitoring Consultation

Talk with an NCH gastroenterologist about whether Bravo pH monitoring is right for you.