Highly accurate acidity monitoring for reflux diagnosis using a tubeless wireless capsule
Many suffer from heartburn, but to treat the root cause, it must be measured. In the past, the "Gold Standard" for diagnosing reflux required the patient to walk around for 24 hours with a tube (catheter) inserted through the nose into the esophagus and connected to an external recording device. This was an unpleasant experience that prevented many from getting tested.
The technological breakthrough Dr. Vosko offers is the Bravo Test: a completely wireless monitoring system. A tiny capsule is attached to the esophagus, continuously measuring acid levels for 48-96 hours, and transmitting the data to a small recorder worn on the belt. No tubes, no discomfort, and done while maintaining a normal routine.
Dr. Vosko interprets the data to determine if you are suitable for advanced treatments (such as TIF, Stretta, or surgery) or precise pharmaceutical treatment.
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Who is this pH Monitoring test for?
The Bravo test is designed for patients suffering from symptoms suspected as Reflux (GERD), where objective proof of the problem's severity is required.
Key Indications:
- Before Surgical/Therapeutic Decision: It is mandatory to perform monitoring before any anti-reflux procedure (such as TIF or Nissen Fundoplication) to verify that it is indeed acid reflux.
- Resistant Symptoms: Patients taking medications (PPIs) but still suffering from heartburn.
- Atypical Symptoms: Investigation of chronic cough, hoarseness, Non-Cardiac Chest Pain, or globus sensation (lump in throat), to rule out or confirm an acidic source.
- Follow-up: Assessing the efficacy of pharmaceutical or surgical treatment.
The difference lies primarily in the quality of life and data accuracy. When the patient feels comfortable, they eat normally, so the data reflects reality better.
Attaching the capsule is a simple action, but deciphering the data is the true expertise.
- Comprehensive View: Dr. Vosko is not just a "testing technician." As an expert who also performs the treatments themselves (TIF, Stretta), he analyzes the data with the goal of tailoring the best practical solution for you.
- Precise Positioning: Using preliminary gastroscopy to place the capsule exactly 6 cm above the stomach transition (Z-line), ensuring accurate readings without "noise."
- Personal Guidance: Detailed explanation on how to use the recorder and availability for questions in real-time if the device beeps or disconnects.
Stop guessing, start diagnosing.
Dr. Vosko invites you to the most advanced Bravo test in Israel.
How is the treatment carried out?
How is the consultation conducted?
- Attaching the Capsule: The action is performed during a short gastroscopy under sedation (about 10 minutes). The capsule is attached to the esophageal wall using a tiny vacuum mechanism and a small pin. You feel nothing as you are asleep.
- Monitoring Period: You are discharged home with a small recorder (smartphone size). Over the next few days, the capsule transmits data to the device. You must press buttons on the device when you eat, lie down to sleep, or feel heartburn.
- End of Test: After 48-96 hours, the capsule naturally detaches and is expelled from the digestive system (no need to remove it). You return the recorder to the clinic for analysis.
How should I prepare for treatment?
How should I prepare for the consultation?
Preparation and Medication Suspension
Proper preparation is critical for the reliability of results. The goal is to see the body's "natural" acidity:
- Fasting: Full fasting 6 hours before the gastroscopy.
- Stopping Antacids (PPI): In most cases, medications like Omeprazole/Nexium must be stopped 7 days before the test.
- Stopping H2 Blockers: Medications like Famotidine must be stopped 48 hours before.
Note: In some cases, the doctor will instruct to continue medications to test their efficacy. Follow personal instructions.
What to expect the day after? (Recovery and recuperation)
Instructions for Monitoring Days
For the test to succeed, you need to "challenge" the stomach:
- Eat Normally: Do not diet during these days. Eat foods that cause you heartburn (spicy, coffee, tomato paste). We want to catch the reflux "in the act."
- Routine: Continue work and regular activity (except MRI or airport metal detectors).
- Diary: Make sure to document events and meals in the diary in real-time.
Are there risks or side effects?
The test is very safe. Side effects are rare:
- Discomfort: Some patients report a slight "scratching" sensation or dull chest pain while eating, which usually passes within a day.
- Technical Issues: Rarely, the capsule does not transmit or falls off too early.
- Complications: Minimal risk of bleeding or perforation at the attachment point (less than 0.1%).
Information for patients from abroad (medical tourism)
The unit is equipped to receive international patients and collaborates with agents for a full logistical envelope.Direct inquiries are also welcomed for rapid and efficient coordination.
For non-residents, we offer a concentrated diagnostic package: Landing, performance of Gastroscopy and Bravo attachment, and receipt of full analysis and recommendations for further treatment (including surgical) within just a few days, before returning home.
For your convenience, Dr. Vosko is fluent in Hebrew, English, and Russian.
Does the external device beep?
The device (the recorder) is quiet and discreet. It can be concealed under clothing. It will only beep if you move too far away from it (the device must remain with you at all times) to remind you to return closer.
How will I know that the capsule has exited?
The capsule is expelled in the stool, and most people do not notice it in the toilet. If five days have passed and you are unsure, and you are scheduled for an MRI scan, a simple X-ray can be performed to confirm that the capsule has exited.
What happens if I do not eat the foods that cause me heartburn during the test?
This will reduce the reliability of the test. The goal is to "capture" the heartburn. We encourage you to challenge your stomach during these days - eat spicy foods, drink coffee, and do what usually brings on your symptoms. Only this way can we obtain an accurate picture.
Is it allowed to undergo an MRI scan with the capsule?
No. As long as the capsule is in your body (approximately 4 days), you must not enter an MRI machine because it contains a small metallic and magnetic component. After the capsule has passed, there are no restrictions.
Will I feel the capsule when I swallow food?
In the vast majority of cases - no. The capsule is very small and is attached in an area of the esophagus where sensation is minimal. Rarely, you may experience a mild "scratching" sensation or become aware of its presence when swallowing large food items, but this passes.
We are with you - from the very first call, we understand that on the other end of the line is a person who may be concerned or in pain, waiting for answers. Therefore, we have built a service system that truly sees you:
- High Availability: A live service center is active Sunday-Thursday from 09:00 AM to 07:00 PM and on Fridays from 09:00 AM to 02:00 PM. In urgent cases, we are available beyond these hours.
- Direct WhatsApp Line: Do you have a question about fasting? Did you forget to ask something about your medications? Our customer service is available via WhatsApp for a quick response.
- Peace of Mind from Bureaucracy: Our team is highly experienced in working with insurance companies and supplemental health plans. We will assist you in preparing the necessary paperwork and authorizations so that you can focus entirely on your health.
Bravo pH Monitoring Pricing
★ The test takes about 40 minutes.
★ Attaching a capsule to the esophagus using a gastroscopy test, the capsule is tiny in size, and includes an acidity monitoring sensor that transmits the data to a wireless receiver. It is required to keep an eating and drinking diary for 48 hours.
★ Detection and identification of gastrointestinal pathologic findings, including inflammation, precancerous and cancerous growths, sections and lesions.
★ Using advanced optics technology (HD, Virtual Chromoendoscopy).
★ Removal of polyps, biopsy and patological evaluation - at an additional cost and in accordance with the findings.
★ If there are any pathologic findings, a biopsy is sent to an external laboratory at an additional charge of 350₪.
★ THE PRICE INCLUDES DECODING OF RECEIVER RESULTS BY A CERTIFIED DECODER.
The test is not suitable for patients who have undergone intestinal surgery, or alternatively for patients who have had a pacemaker implanted in their bodies.
Bravo pH Monitoring - Wireless Acid Reflux Test
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