Comparison of esophageal placement of Bravo capsule system under direct endoscopic guidance with conventional placement method

Sofi, Aijaz; Filipiak, Charles; Sodeman, Thomas; Ahmad, Usman; Bawany, Muhammad; Daboul, Isam

doi:10.4318/tjg.2011.0208

Cited by 3 publications

(5 citation statements)

References 8 publications

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“…The average EGD/patient was 2. [1][2][3][4][5][6][7][8][9][10] The average GERD-Health Related Quality of Life, Reflux Symptom Index, and GERD Symptom Score were 32 ± 18, 23 ± 14, and 25 ± 12, respectively. The Health Satisfaction Survey completed by 357/379 (94.2%) patients showed that 250/357 (70.0%) were dissatisfied with the control of their GERD symptoms ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Since the utilization of the direct visualization technique, we have not encountered any complications. 2 Placement of the Bravo capsule adds only 1 to 3 minutes to the EGD. The entry of patients' diary is straightforward, and the report is computed.…”

Section: Discussionmentioning

confidence: 99%

“…The catheter was then removed and the proper placement of the capsule was confirmed by the gastroscope, which was then removed. 2 All probes were placed in the early morning to ensure that breakfast, lunch, and dinner were captured in the study period. Patients were instructed to discontinue PPIs for 1 week and histamine (H2) blockers for 2 days prior to the study.…”

Section: Methodsmentioning

confidence: 99%

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Drawbacks of the Current Algorithm for Patients With Symptoms of Gastroesophageal Reflux Disease and the Impact of Adding Wireless pH Study to the Initial Diagnostic Endoscopy: Data From High-Volume Rural Antireflux Center

Fanous

Hughes

2020

The American Surgeon

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Background Patients with symptoms of gastroesophageal reflux disease (GERD) are often given a trial of proton pump inhibitors (PPIs). When they respond, patients usually continue PPI therapy. If this empiric treatment fails, esophagogastroduodenoscopy (EGD) is recommended. When EGD findings are equivocal, pH study is warranted. We hypothesize that this algorithm results in prolonged PPI therapy, repetition of EGDs and patient dissatisfaction. This study evaluates the impact of placing a pH probe at the time of the initial EGD. Methods IRB approval was obtained for retrospective chart review of patients who presented with GERD symptoms between August 2015 and March 2019. Patients were included if they underwent EGD with placement of wireless pH probe. Results A total of 379 patients (260 females, 119 males) with average age was 56.7±14.2 years. There were 253/379 (66.7%) patients who had previous EGDs (1-10). Health Satisfaction Survey was completed by 357/379 (94.2%) patients and 250/357 (70%) reported dissatisfaction with GERD control. PPI use was noted in 299/379 (78.8%) patients with average duration of 10.9±9.1 years. Testing off antisecretory medication was performed in 360/379 (94.9%). The average time interval between the clinic visit and performing EGD and pH study was 22±25 days. Conclusion The current GERD algorithm results in prolonged PPI therapy, repeated endoscopies and patient dissatisfaction. Placing a pH probe at the time of initial endoscopy is safe and expedient in a rural setting. Positive pH studies avoid repeating EGDs and negative pH studies warrant a search for potential alternative diagnosis.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Drawbacks of the Current Algorithm for Patients With Symptoms of Gastroesophageal Reflux Disease and the Impact of Adding Wireless pH Study to the Initial Diagnostic Endoscopy: Data From High-Volume Rural Antireflux Center

Fanous

Hughes

2020

The American Surgeon

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“…Die Platzierung unter zeitgleicher endoskopischer Darstellung ist sicher und vermeidet, sofern eine endoskopische Lagekontrolle angestrebt wird, eine wiederholte Intubation mit dem Endoskop. Darüber hinaus bietet die direkte visuelle Kontrolle der Applikation aber keine Vorteile [282,283]. Alternativ möglich ist auch eine transnasale Platzierung der Messkapsel nach transnasaler Ösophagusmanometrie.…”

Section: Erläuterungunclassified

Ösophageale Refluxdiagnostik – pH-Metrie, Impedanzmessung, Bilirubin-Messung: Empfehlungen der Deutschen Gesellschaft für Neurogastroenterologie und Motilität und der Arbeitsgruppe Neurogastroenterologie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten

Pehl¹,

Keller

Allescher

et al. 2012

Z Gastroenterol

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“…With direct endoscopic guidance, the endoscope is left in place within the esophagus while the Bravo delivery system is being deployed and capsule placed under direct view of the endoscope. 18 Direct-guidance has been shown to be equally effective as conventional-guidance with the added advantage of avoiding a second endoscopy to confirm the placement.…”

Section: Test Proceduresmentioning

confidence: 99%

Evaluation of Gastroesophageal Reflux Disease Using the Bravo Capsule pH System

Lawenko

Lee

2015

J Neurogastroenterol Motil

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Gastroesophageal reflux disease (GERD) is a disease predominantly seen in the West but there is a rising trend in Asia. Ambulatory 24-hour catheter-based pH monitoring has been the de facto gold standard test for GERD that correlates symptoms with acid reflux episodes. However, drawbacks such as patients' discomfort, and catheter displacement render the test as cumbersome and errorprone. The Bravo pH wireless system is designed to be user-friendly and has an added advantage of prolonged pH monitoring. The system is comparable to the catheter-based pH monitoring system in terms of diagnostic yield and symptom-reflux association. Indications include evaluation of patients with refractory GERD symptoms and prior to anti-reflux surgery. Bravo utilizes a wireless pH-sensing capsule with a complete prepackaged system, and a data processing software. The capsule may be positioned indirectly using endoscopic or manometric landmarks or under direct endoscopic guidance. Optimal threshold cut-off values are yet to be standardized but based on available studies, for the Asian population, it may be recommended for total % time pH < 4 of 5.8 over 48 hours. Cost is a limitation but capsule placement is relatively safe although technical failures may be seen in small percentage of cases.

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Comparison of esophageal placement of Bravo capsule system under direct endoscopic guidance with conventional placement method

Cited by 3 publications

References 8 publications

Drawbacks of the Current Algorithm for Patients With Symptoms of Gastroesophageal Reflux Disease and the Impact of Adding Wireless pH Study to the Initial Diagnostic Endoscopy: Data From High-Volume Rural Antireflux Center

Drawbacks of the Current Algorithm for Patients With Symptoms of Gastroesophageal Reflux Disease and the Impact of Adding Wireless pH Study to the Initial Diagnostic Endoscopy: Data From High-Volume Rural Antireflux Center

Ösophageale Refluxdiagnostik – pH-Metrie, Impedanzmessung, Bilirubin-Messung: Empfehlungen der Deutschen Gesellschaft für Neurogastroenterologie und Motilität und der Arbeitsgruppe Neurogastroenterologie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten

Evaluation of Gastroesophageal Reflux Disease Using the Bravo Capsule pH System

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