This information will help you get ready for your Bravo Capsule Test at Memorial Sloan Kettering (MSK).
The 48-hour Bravo Capsule test checks the amount of acid that comes back into your esophagus from your stomach. The esophagus is the tube that carries food and liquids from your mouth to your stomach (see Figure 1).
Your Bravo Capsule test can tell your doctor the amount of acid reflux you have and length of time you experience it as you go about your normal activities. This procedure is also used to determine if you have gastroesophageal reflux disease (GERD).
You will have your Bravo Capsule test during an upper endoscopy procedure. For the upper endoscopy, your doctor will use a flexible tube called an endoscope to see the inside of your esophagus on a video monitor. A small capsule will be placed temporarily on the wall of your esophagus. The capsule will measure the amount of acid reflux you have. This information will then be sent to a receiver that you will wear on your waistband or belt.
Before Your Procedure
You may need to stop taking some of your medications before your procedure. Talk with your doctor about which medications you should stop taking. 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 medications for diabetes, ask the doctor who prescribes the medication what you should do the morning of your procedure. You may need to change the dose before your procedure.
If you have an automated implanted cardioverter-defibrillator (AICD), you will need to get a clearance letter from your cardiologist (heart doctor) before your procedure.
You must have someone 18 years or older take you home after your procedure. If you don’t have someone to do this, call one of the agencies below. They will send someone to go home with you. There’s usually a charge for this service, and you will need to provide transportation.
|Agencies in New York||Agencies in New Jersey|
|Partners in Care: 888-735-8913||Caring People: 877-227-4649|
|Caring People: 877-227-4649|
3 Days Before Your Procedure
Your endoscopy nurse will call you 3 days before your procedure. They will review the instructions in this resource with you and ask you questions about your medical history. Your nurse will also review your medications and tell you which to take the morning of your procedure.Back to top
The Day Before Your Procedure
A staff member from the Admitting Office will call you after 2:00 pm the day before your procedure. They 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 don’t get a call by 7:00 pm, call 212-639-5014.
If you need to cancel your procedure for any reason, call the doctor who scheduled it for you.
- Do not eat anything after midnight the night before your procedure. This includes hard candy and gum.
- Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of water (see figure).
- Starting 2 hours before your scheduled arrival time, do not eat or drink anything. This includes water.
The Day of Your Procedure
- Take the medications you were instructed to take the morning of your procedure with a few sips of water.
- Remove all jewelry, including body piercings. The equipment used during your procedure can cause burns if it touches metal.
- Don’t put on any lotion, cream, deodorant, makeup, powder, cologne, or perfume.
- Leave all valuables, such as credit cards, jewelry, and your checkbook, at home.
- If you wear contacts, wear your glasses instead.
- A list of all the medications you take at home, including the dose.
- Your rescue inhaler (such as albuterol for asthma), if you have one.
- A case for your glasses.
- Your Health Care Proxy form, if you have completed one.
MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212-639-2338.
To reach the garage, turn onto 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’s a tunnel that you can walk through that connects the garage to the hospital.
There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.
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.
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. People 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. They 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, and answer any questions you have. They will also ask you to sign a consent form stating that you agree to the procedure.
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 fall asleep. You will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose. Once you’re asleep, your doctor will place the capsule into your esophagus.Back to top
After Your Procedure
You will wake up in the recovery room. Your nurse will continue to monitor your heart rate, breathing, and blood pressure. Once you’re fully awake, your nurse will remove your IV.
You will get a receiver to wear on your waistband or belt. This receiver shows the amount of acid reflux you have, which is measured by the capsule placed in your esophagus. You will also get a diary to fill out for 2 days. Your nurse will explain your discharge instructions to you and your caregiver before you go home.
For 48 hours (2 days) after your procedure, make sure you record the following in your diary:
- All the symptoms you have, such as coughing, heartburn, and burping food into your mouth
- All the medications you take
- Everything you eat and drink
- The time you eat and drink
- When you lie down
It’s important that you eat, drink, work, and exercise as you normally would. 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
- Snacking between meals
Keep the receiver on your waistband or belt at all times. When you shower, keep the receiver within 3 feet of your body in the bathroom. If it’s too far away, it will beep. Don’t 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 your capsule is placed
You will need to return the receiver and your diary to your doctor during your follow-up appointment, which will be 48 hours after your procedure.Back to top
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
- Trouble swallowing
- Nausea or vomiting
- Severe or constant bleeding from your nose
- Any unexplained or unexpected problems