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Patient Guide to the Bravo Capsule Test

This information will help you prepare for your Bravo Capsule Test at Memorial Sloan Kettering Cancer Center (MSK).

The 48-hour Bravo Capsule test determines the amount of acid that comes back into your esophagus (food pipe) from your stomach. It can tell the doctor the amount of acid reflux you have and length of time you experience it as you go about your normal activities.

Before Your Procedure

Ask about your medications

You will need to stop taking some medicines 1 week before your procedure. Some common examples are

  • Proton pump inhibitors, such as rabeprazole (Aciphex®), omeprazole (Prilosec®), lansoprazole (Prevacid®), pantoprazole (Protonix®), and esomeprazole (Nexium®)
  • Histamine2 blockers, such as nizatidine (Axid®), famotidine (Pepcid®), cimetidine (Tagamet®), and ranitidine (Zantac®)

If you take insulin or other medication for diabetes, you may need to change the dose on the day of your procedure. Ask the doctor who prescribes this medicine for you what you should do the day before and the morning of your procedure.

Medical devices

If you have an automated implanted cardioverter-defibrillator (AICD), you will need to get a clearance letter from your cardiologist before your procedure.

Arrange for someone to take you home

You must have someone who is 18 years or older take you home after your procedure. Please call one of the agencies below if you do not have someone who can do this. They will help find someone to take you home.

In New York:

Partners in Care (888) 735-8913

Prime Care (212) 944-0244

In New York or New Jersey:

Caring People (877) 227-4649

3 Days Before Your Procedure

A few days before your procedure you will receive a telephone call from an endoscopy nurse. He or she will review the instructions in this guide with you and ask you questions about your medical history. The nurse will also review your medications and tell you which to take the morning of your procedure. Use the space below to write them down.

The Day Before Your Procedure

Time of your procedure

A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. He or she will tell you what time you should arrive at the hospital for your procedure. If your procedure is scheduled for a Monday, you will be called on the Friday before. If you do not receive a call by 7:00 pm, please call (212) 639-5014.

If you need to cancel your procedure for any reason, please call the doctor who scheduled it for you.

The Evening Before Your Procedure

Do not eat or drink anything after midnight the night before your procedure. This includes water, gum, and hard candy.

The Day of Your Procedure

Things to remember

  • Do not eat or drink anything the morning of your procedure. This includes water, gum, and hard candy.
  • Take only the medications your doctor told you to take the morning of your procedure. You may have written them down on the first page of this guide. Take them with a few sips of water.
  • Do not put on any lotion, cream, powder, deodorant, makeup, or perfume.
  • Remove all jewelry, including jewelry in body piercings.
  • Leave all valuables, such as credit cards and jewelry, at home.
  • If you usually wear contact lenses, wear your glasses instead.

What to bring with you

  • A list of the medications you take at home
  • Your rescue inhaler (such as albuterol for asthma), if you have one
  • Only the money you may need
  • A case for your glasses
  • Your Health Care Proxy form, if you have completed one

Where to park

Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that goes from the garage into the hospital. For questions about prices, call (212) 639-2338. There are also commercial garages nearby, on East 69th Street between First and Second Avenues and on East 65th Street between First and Second Avenues.

Where to go

Your procedure will take place in the Endoscopy Suite at the main hospital, which is located at 1275 York Avenue. Take the M elevator to the 2nd floor.

What to expect

Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. Patients with the same or similar names may be having procedures on the same day.

After changing into a hospital gown, you will meet your nurse. He or she will place an intravenous (IV) catheter into a vein, usually in your hand or arm. At first, you will receive fluids through the IV, but it will be used later to give you anesthesia (medication to make you sleepy). Your nurse will also check your heart rate, breathing, and blood pressure.

Your doctor will explain the procedure to you and answer any questions you have. He or she will ask you to sign a consent form.

When it's time for your procedure, you will be taken to the procedure room and helped onto an exam table. You will receive anesthesia through your IV, which will make you sleepy. You will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose. Your doctor will place the capsule into your esophagus while you are asleep.

After Your Procedure

In the recovery room

You will wake up in the recovery room. Your nurse will continue to monitor your heart rate, breathing, and blood pressure. Once you are fully awake, your nurse will remove your IV. If you have someone waiting with you, your nurse will explain your discharge instructions to both of you before you go home.

At home

It is important that you eat, drink, work, and exercise as you normally would. However, avoid the following because they will affect your test results:

  • Foods high in acid, such as coffee, orange juice, cranberry juice, and soda
  • Gum and throat lozenges
  • Between-meal snacks

You will be given a diary the day of your procedure. It is important that you keep accurate records in the diary. This will help the doctor decide how best to help you. Be sure to write down the following:

  • All symptoms you have, such as coughing, heartburn, and burping food into your mouth
  • All medicine you take
  • Everything you eat and drink
  • The time you eat and drink
  • When you lie down

You will be given a receiver to wear on your waistband or belt. Keep the receiver within 3 feet of your body all the times. If it is too far away, it will beep. Do not let the receiver get wet.

You may have some discomfort in your chest after your procedure. You can take acetaminophen (Tylenol®) to relieve this discomfort.

The capsule will pass through your system and come out during a bowel movement, but you might not see it.

Do not have magnetic resonance imaging (MRI) for 30 days after the capsule is placed.

Follow-up

You will need to return the receiver and your diary to your doctor during your follow-up appointment.

Call your doctor if you have

  • A temperature of 101° F (38.3° C) or higher
  • Severe or constant stomach pain, hardness, or bloating
  • Severe or constant pain in your chest
  • Difficulty swallowing
  • Nausea or vomiting
  • Severe or constant bleeding from your nose
  • Any unexplained or unexpected problems