title: Performance, tolerability, and symptoms related to prolonged pH monitoring using the Bravo system in Mexico.
abstract: BACKGROUND
  The traditional system for esophageal 24-h pH monitoring requires transnasal introduction of the catheter with pH sensors; this technique produces discomfort, inconvenience, and interference with daily activity. Recently, a catheter-free pH monitoring system (Bravo) has been proposed as an alternative and promising method for 24-h pH.
  
  
  OBJECTIVE
  To evaluate performance, tolerability, and symptoms related to this new technology in our population.
  
  
  METHODS
  Consecutive patients with gastroesophageal reflux disease (GERD) with indication for 24-h pH were included. pH Bravo capsule was placed 6 cm above the squamocolumnar junction using endoscopic measurement. Symptoms associated were evaluated daily in a personal diary until 7 days after the capsule attachment. Severity of symptoms was assessed by a 5-point Likert scale. Capsule detachment was assessed by chest X-ray.
  
  
  RESULTS
  Eighty-four patients were included. Forty-nine were female (mean age 44 +/- 12 yr). Indications for pH monitoring were: nonresponse to proton pump inhibitor therapy in 38 (45%), preoperative evaluation for anti-reflux surgery in 36 (43%), previous failed transnasal 24-h pH monitoring in 6 (7%), and extra-esophageal manifestations of GERD in 4 (5%). The capsule was successfully attached in 95% of patients. At day 7, capsule detachment occurred spontaneously in all cases. Symptoms related to capsule attachment were: chest pain in 26 (33%), foreign body sensation in 11 (14%), nausea in 5 (6%), and 9 (11%) patients had more than one symptom. Severities of those symptoms were mild, and no patient required removal of the capsule. Women and younger patients had more symptoms related to the procedure (p < 0.05).
  
  
  CONCLUSIONS
  Esophageal pH monitoring with Bravo capsule is a safe, reliable, and tolerable method in patients with GERD.
authors.affiliation: Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico.
authors.forename: José María
authors.initials: JM
authors.lastname: Remes-Troche
authors.forename: Jorge
authors.initials: J
authors.lastname: Ibarra-Palomino
authors.forename: Ramon I
authors.initials: RI
authors.lastname: Carmona-Sánchez
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Valdovinos
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002408:Catheters, Indwelling; D002637:Chest Pain / Q000209:etiology; D020878:Device Removal; D004867:Equipment Design; D050782:Esophageal pH Monitoring / Q000009:adverse effects / Q000295:instrumentation*; D004945:Esophagoscopy; D005260:Female; D005547:Foreign Bodies / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D013677:Medical Laboratory Science / Q000295:instrumentation; D008499:Medical Records; D008800:Mexico; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D009325:Nausea / Q000209:etiology; D011300:Preoperative Care; D054328:Proton Pump Inhibitors; D012677:Sensation / Q000502:physiology; D012737:Sex Factors
chemical_list: D054328:Proton Pump Inhibitors