Using a simple 'test' to diagnose
gastro-oesophageal reflux disease is difficult because accurately measuring gastric refluxate and correlating reflux events with symptom episodes is complex. This paper reviews the safety, tolerability and diagnostic accuracy of
Bravo (Medtronic, Shoreview, MN, USA), ambulatory oesophageal pH monitoring technology.
Catheter-based pH
electrodes inhibit patients' normal activity, and can yield erroneous results because of placement or subsequent migration of the probe or errors in the thermal compensation algorithm that is requisite for
antimony pH
electrodes.
Bravo pH studies reliably discriminated oesophagitis patients from controls, but are less discriminatory in endoscopy-negative
gastro-oesophageal reflux disease patients. The
Bravo system can be accurately placed using endoscopic landmarks and pH studies demonstrated more accurate in vivo pH recording than with a
catheter-based system. The
Bravo system detected fewer reflux events of short duration compared with a
catheter-based system. Studies examining the correlation between reflux events and symptoms have not yet been conducted using the
Bravo system. In conclusion, the
Bravo system offers a more user-friendly ambulatory pH monitoring technique that more accurately records pH compared with a
catheter-based system. More research is needed to determine whether the detection of reflux events with
Bravo will provide a good correlation with symptom episodes.