 |
 |
| Figure 1: Bravo probe in place in the esophagus. |
 |
| Figure 2: close-up of the Bravo probe next to a penny. |
The pH test is useful for evaluating patients with acid reflux. The test was originally designed to evaluate patients with gastroesophageal reflux disease. It has since been modified to evaluate patients with laryngopharyngeal reflux disease. The test is currently the best method available to monitor acid exposure within the esophagus and voice box. As opposed to most other tests looking at reflux, the pH test evaluates acid exposure over a 24-hour period.
The test involves placement of a catheter containing two tiny probes into the patient’s esophagus. The catheter is connected to a small recording computer which can be worn on the patient’s waist. Generally the catheter is well tolerated by most patients. When the catheter is removed (the day following insertion) the data from the recorder are analyzed. A diagnosis of reflux disease can be made from this information. Additionally the pattern of reflux can be analyzed. This may help to individualized therapy for each patient.
pH testing is used routinely in all patients believed to have severe acid reflux or complications related to acid reflux disease. Additionally, it is very useful in patients failing traditional acid reflux therapy and essential in evaluating patients prior to considering Nissen Fundoplication.
The latest advance in pH monitoring has been the introduction of the Bravo probe. This is a wireless capsule that is attached to the esophagus, and left in place. The capsule eventually falls off and is passed through the gastrointestinal tract. While it is in place, the capsule sends data on the amount and pattern of reflux occurring in the esophagus wirelessly to a device worn on the patient’s waist for 48 hours. The Bravo probe is felt to collect more reliable data than the catheter, though it may not be very useful in most patients with laryngopharyngeal reflux.
