Use and utility of the Bravo™ pH capsule

The single technological advancement that Bravo pH monitoring offers over conventional pH monitoring is the elimination of the transnasal catheter. This was not a trivial advance in terms of technologic achievement. Development of a delivery system that could temporarily place a wireless capsule on the esophageal mucosa was extremely difficult to envision given the fact that the esophageal body is not conducive to retaining a foreign body. Thus, the delivery system and the ability to attach the pH capsule to the wall are what make the Bravo system unique. This approach has the potential to improve tolerance and obtain pH studies for durations greater than 24 hours; however, it still lacks the ability to measure nonacid reflux and also the ability to distinguish swallow events from true reflux. This review will highlight the advantages of the Bravo system and how it should be used.