About Your Bravo Capsule Test

This information will help you prepare for your Bravo Capsule Test at Memorial Sloan Kettering (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 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

Ask about your medications

You will need to stop taking some medications 1 week before your procedure. We have included some common examples are:

  • Proton pump inhibitors, such as rabeprazole (Aciphex®), omeprazole (Prilosec®), lansoprazole (Prevacid®), pantoprazole (Protonix®), and esomeprazole (Nexium®)
  • Histamine2blockers, such as nizatidine (Axid®), famotidine (Pepcid®), cimetidine (Tagamet®), and ranitidine (Zantac®)

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

Get a letter from your doctor, if necessary

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 18 years or older take you home after your procedure. If you don’t have anyone, call one of the agencies below. They will provide someone to accompany you home, however there is usually a charge for this service and you will also need to provide transportation.

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

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3 Days Before Your Procedure

You will receive a telephone call from an endoscopy nurse. They 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.

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The Day Before Your Procedure

Note the time of your procedure

A clerk 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 you are scheduled for your procedure on 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.

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The Day of Your Procedure

Between midnight and up until 4 hours before your scheduled arrival time, you may drink a total of 12 ounces of clear liquids (see Figure 1).

Figure 1. 12 ounces of clear liquid

Examples of clear liquids include:

  • Water
  • Clear broth, bouillon, or consommé (no particles of dried food or seasonings)
  • Gelatin, such as Jell-O®
  • Clear fruit juices (no pulp), such as white cranberry, white grape, or apple
  • Soda, such as 7-Up®, Sprite®, ginger ale, seltzer, or Gatorade®
  • Coffee or tea, without milk or cream

Do not eat or drink anything, or suck on hard candy after this.

Things to remember

  • 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 surgery can cause burns if it touches metal.
  • Don’t put on any lotion, cream, deodorant, makeup, powder, or perfume.
  • Leave all valuables, such as credit cards, jewelry, and your checkbook, at home.
  • If you wear contacts, wear your glasses instead.

What to bring with you

  • 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.
  • Only the money you may need for a newspaper, bus, taxi, or parking.
  • Your Health Care Proxy form, if you have completed one.

Where to park

MSK’s parking garage is located on East 66thStreet between York and First Avenues. To reach the garage, enter East 66thStreet 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 you can walk through that connects the garage to the hospital. For questions about prices, call 212-639-2338.

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.

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 2ndfloor.

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. 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.

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 are asleep, your doctor will place the capsule into your esophagus.

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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.

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.

At home

For 48 hours after your procedure, make sure you record the following in your diary:

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

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
  • Snacking between meals

Keep the receiver on your waistband or belt within 3 feet of your body all the times. When you shower, keep the receiver near you in the bathroom. 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, which will be 48 hours after your procedure.

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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
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