AIM: To evaluate the technical failures of the Bravo pH test in a population with nonerosive gastroesophageal reflux disease. METHODS: Over the course of a year, we prospectively studied a population of 66 nonerosive ...AIM: To evaluate the technical failures of the Bravo pH test in a population with nonerosive gastroesophageal reflux disease. METHODS: Over the course of a year, we prospectively studied a population of 66 nonerosive reflux disease patients who received a Bravo pH test. The number and frequency of all technical failures were documented, quantified and analyzed. RESULTS: A total of 66 patients, with a mean age of 41.7 years, were studied. Technical failures occurred in 15.15% of the sample. The most frequent failures were due to poor data reception (4.5%), early dislodgement (4.5%) and capsule removal (6.1%). CONCLUSION: The Bravo capsule pH test involves a low but non-negligible rate of technical problems, a fact that must always be considered by physicians.展开更多
AIM: To evaluate measurements of intragastric pH with the Bravo capsule system over a prolonged time.METHODS: A Bravo capsule was placed inside the rat gastric body and pH was studied for periods up to five consecutiv...AIM: To evaluate measurements of intragastric pH with the Bravo capsule system over a prolonged time.METHODS: A Bravo capsule was placed inside the rat gastric body and pH was studied for periods up to five consecutive days.For comparison,a gastric fistula model was used.Effects of ghrelin and esomeprazole,with or without pentagastrin,on gastric pH were studied.In addition,effects of esomeprazole on plasma ghrelin,gastrin and somatostatin were analyzed.RESULTS: All rats recovered after surgery.The average 24-h pH during free feeding was 2.3 ± 0.1 (n = 20) with a variation of 18% ± 6% over 5 d.Ghrelin,2400 pmol/kg,t.i.d.increased pH from 1.7 ± 0.1 to 3.1 ± 0.3 (P < 0.01) as recorded with the Bravo system.After esomeprazole (1 mg/kg,3 mg/kg and 5 mg/kg) there was a dose-dependent pH increase of maximally 3.4 ± 0.1,with day-to-day variation over the entire period of 8% ± 3%.The fistula and pH studies generated similar results.Acid inhibition with esomeprazole increased plasma ghrelin from 10 ± 2 pmol/L to 65 ± 26 pmol/L (P < 0.001),and somatostatin from 10 ± 2 pmol/L to 67 ± 18 pmol/L (P < 0.001).CONCLUSION: pH measurements with the Bravo capsule are reliable,and comparable to those of the gastric fistula model.The Bravo system optimizes accurate intragastric pH monitoring over prolonged periods and allows both short-and long-term evaluation of effects of drugs and hormones.展开更多
We report an unexpected, previously unreported complication of Bravo p H capsule dislodgement. During Bravo p H testing of a 44-year-old man with gastroesophageal reflux disease, we were unable to endoscopically visua...We report an unexpected, previously unreported complication of Bravo p H capsule dislodgement. During Bravo p H testing of a 44-year-old man with gastroesophageal reflux disease, we were unable to endoscopically visualize the capsule attached to the esophageal wall after deployment. After multiple attempts to detect the capsule, it was visualized in the left pyriform sinus. As there was significant risk for pulmonary dislodgement, ENT and pulmonary physicians were immediately consulted to review options for safe removal. Ultimately, ENT successfully retrieved the capsule with a foreign body removal forceps. The Bravo p H test is generally a well-tolerated diagnostic tool used to confirm the presence of abnormal esophageal acid reflux. While few complications have been reported, technical difficulties can occur, including poor data reception, misplacement, and early dislodgement. Rarely, more serious complications can occur, ranging from esophageal wall trauma to capsule aspiration. Gastroenterologists performing this procedure should be aware of the low, but nontrivial, risk of complications.展开更多
文摘AIM: To evaluate the technical failures of the Bravo pH test in a population with nonerosive gastroesophageal reflux disease. METHODS: Over the course of a year, we prospectively studied a population of 66 nonerosive reflux disease patients who received a Bravo pH test. The number and frequency of all technical failures were documented, quantified and analyzed. RESULTS: A total of 66 patients, with a mean age of 41.7 years, were studied. Technical failures occurred in 15.15% of the sample. The most frequent failures were due to poor data reception (4.5%), early dislodgement (4.5%) and capsule removal (6.1%). CONCLUSION: The Bravo capsule pH test involves a low but non-negligible rate of technical problems, a fact that must always be considered by physicians.
文摘AIM: To evaluate measurements of intragastric pH with the Bravo capsule system over a prolonged time.METHODS: A Bravo capsule was placed inside the rat gastric body and pH was studied for periods up to five consecutive days.For comparison,a gastric fistula model was used.Effects of ghrelin and esomeprazole,with or without pentagastrin,on gastric pH were studied.In addition,effects of esomeprazole on plasma ghrelin,gastrin and somatostatin were analyzed.RESULTS: All rats recovered after surgery.The average 24-h pH during free feeding was 2.3 ± 0.1 (n = 20) with a variation of 18% ± 6% over 5 d.Ghrelin,2400 pmol/kg,t.i.d.increased pH from 1.7 ± 0.1 to 3.1 ± 0.3 (P < 0.01) as recorded with the Bravo system.After esomeprazole (1 mg/kg,3 mg/kg and 5 mg/kg) there was a dose-dependent pH increase of maximally 3.4 ± 0.1,with day-to-day variation over the entire period of 8% ± 3%.The fistula and pH studies generated similar results.Acid inhibition with esomeprazole increased plasma ghrelin from 10 ± 2 pmol/L to 65 ± 26 pmol/L (P < 0.001),and somatostatin from 10 ± 2 pmol/L to 67 ± 18 pmol/L (P < 0.001).CONCLUSION: pH measurements with the Bravo capsule are reliable,and comparable to those of the gastric fistula model.The Bravo system optimizes accurate intragastric pH monitoring over prolonged periods and allows both short-and long-term evaluation of effects of drugs and hormones.
文摘We report an unexpected, previously unreported complication of Bravo p H capsule dislodgement. During Bravo p H testing of a 44-year-old man with gastroesophageal reflux disease, we were unable to endoscopically visualize the capsule attached to the esophageal wall after deployment. After multiple attempts to detect the capsule, it was visualized in the left pyriform sinus. As there was significant risk for pulmonary dislodgement, ENT and pulmonary physicians were immediately consulted to review options for safe removal. Ultimately, ENT successfully retrieved the capsule with a foreign body removal forceps. The Bravo p H test is generally a well-tolerated diagnostic tool used to confirm the presence of abnormal esophageal acid reflux. While few complications have been reported, technical difficulties can occur, including poor data reception, misplacement, and early dislodgement. Rarely, more serious complications can occur, ranging from esophageal wall trauma to capsule aspiration. Gastroenterologists performing this procedure should be aware of the low, but nontrivial, risk of complications.
