Imagine a monitoring system the size of a pencil eraser that can help diagnose acid reflux disease without the inconvenience or discomfort of traditional monitoring tests. In the Institute for Digestive Disorders at Winthrop-University Hospital, patients can now benefit from the use of the catheter-free Medtronic Bravo™ pH Monitoring System in diagnosing acid reflux disease.
The Bravo™ is a small capsule equipped with a pH sensor that is temporarily attached to the wall of the esophagus to measure gastroesophageal acid levels (pH) in the evaluation of gastroesophageal reflux disease or GERD.
GERD is a leading cause of chronic heartburn and in severe cases, can cause damage to the esophagus, chronic discomfort and even chest pain not associated with cardiac problems.
Traditionally, acid levels in the esophagus were measured by placing a catheter, connected to a monitoring device, down the nose and into the esophagus for a 24-hour period. This procedure often causes nasal and throat discomfort and limits the activities a patient can do. The new minimally invasive monitoring system collects pH data over a 48-hour period for a more accurate assessment of a patient's condition.
Winthrop is one of only a few regional hospitals to utilize the new catheter-free pH monitoring system, which has been making a world of difference in the diagnosis of acid reflux disease since it was introduced at Winthrop in July of 2003.
Kavita Kongara, MD, (right) Director of the Motility Center at Winthrop analyzes pH data received from a patient's Bravo™
sensor with colleague Chris Demetriou, MD (left).
In most cases, the capsule is placed through a routine endoscopy procedure where it is attached to the wall of the esophagus. It transmits real-life data to a pager-sized receiver worn on the patient's belt or waistband. Patients are also asked to keep a daily diary of reflux symptoms. This diary, along with the transmitted data from the Bravo™ capsule, is then analyzed and a report is generated for the patient's referring physician. Several days after the pH test, the capsule naturally falls off the esophagus wall and safely passes through the digestive tract.
One of the leading benefits of the new system is the ability of the patient to go about their daily activities without restriction. In addition, the 48-hour study provides physicians with more true-to-life information on pH levels.
"The fact that our patients can go about their normal daily routines with this new monitoring technique is key in receiving more real-life data and more accurate results," explained Kavita Kongara, MD, Director of the Diagnostic Motility Center in the Institute for Digestive Disorders at Winthrop.
In addition, the monitoring system allows for more precise diagnosis of GERD in cases that may not present with typical symptoms (chronic cough, laryngitis, hoarseness, chest pain). Dr. Kongara added, "We have already diagnosed a few cases of GERD with the two-day Bravo™ study. The traditional 24-hour study might not have picked up the elevated pH levels and may not have been as well tolerated by the patient."
Utilizing the most advanced technology available, including the new Bravo™ pH Monitoring System to effectively manage problems of the digestive tract, Winthrop's Institute for Digestive Disorders has helped restore quality of life to hundreds of patients.
For more information, call the Institute for Digestive Disorders at