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A Novel Placement Method of the Bravo Wireless pH Monitoring Capsule for Measuring Intragastric pH

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Abstract

Purpose The delivery system of the Bravo capsule was designed for placement on the esophagus. We evaluated the feasibility of our novel placement method of the Bravo capsule using a clip to monitor intragastric pH and to compare the accuracy of the Bravo wireless system to the traditionally used Slimline catheter-Mark III Digitrapper pH monitoring system. Methods The Bravo capsule was placed by clip or conventional delivery system using suction on the gastric wall in 20 fasted subjects. A separate group of ten healthy volunteers underwent simultaneous intragastric pH monitoring for comparison of the two systems with meals. Results Early dislodgment rate of the capsules was lower when placed using clipping (20%) than using conventional delivery system (70%) within 48 h after placement. We observed prominent movement of one catheter in the stomach during the study. Post-test calibration drifts of the catheters at pH 7.01 were significantly greater than those of the Bravo capsules (P = 0.02). Conclusion Our novel clipping method of the Bravo pH capsule placement provided accurate monitoring of intragastric pH with merits of tolerability, acid stability, and fixing position.

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References

  1. van Rensburg CJ, Hartmann M, Thorpe A, Venter L, Theron I, Lühmann R et al (2003) Intragastric pH during continuous infusion with pantoprazole in patients with bleeding peptic ulcer. Am J Gastroenterol 98:2635–2641. doi:10.1111/j.1572-0241.2003.08723.x

    Article  PubMed  Google Scholar 

  2. Hsieh YH, Lin HJ, Tseng GY, Perng CL, Wang K, Lo WC et al (2004) Poor responders to intravenous omeprazole in patients with peptic ulcer bleeding. Hepatogastroenterology 51:316–319

    PubMed  Google Scholar 

  3. Green FW Jr, Kaplan MM, Curtis LE, Levine PH (1978) Effect of acid and pepsin on blood coagulation and platelet aggregation. A possible contributor prolonged gastroduodenal mucosal hemorrhage. Gastroenterology 74:38–43

    PubMed  CAS  Google Scholar 

  4. Brunner G, Luna P, Hartmann M, Wurst W (1996) Optimizing the intragastric pH as a supportive therapy in upper GI bleeding. Yale J Biol Med 69:225–231

    PubMed  CAS  Google Scholar 

  5. Udd M, Toyry J, Miettinen P, Vanninen E, Mustonen H, Julkunen R (2005) The effect of regular and high doses of omeprazole on the intragastric acidity in patients with bleeding peptic ulcer treated endoscopically: a clinical trial with continuous intragastric pH monitoring. Eur J Gastroenterol Hepatol 17:1351–1356. doi:10.1097/00042737-200512000-00014

    Article  PubMed  CAS  Google Scholar 

  6. Kahrilas PJ, Quigley EM (1996) Clinical esophageal pH recording: a technical review for practice guideline development. Gastroenterology 110:1982–1996. doi:10.1053/gast.1996.1101982

    Article  PubMed  CAS  Google Scholar 

  7. Fass R, Hell R, Sampliner RE, Pulliam G, Graver E, Hartz V et al (1999) Effect of ambulatory 24-hour esophageal pH monitoring on reflux-provoking activities. Dig Dis Sci 44:2263–2269. doi:10.1023/A:1026608804938

    Article  PubMed  CAS  Google Scholar 

  8. Aksglaede K, Funch-Jensen P, Thommesen P (2003) Intra-esophageal pH probe movement during eating and talking. A videoradiographic study. Acta Radiol 44:131–135. doi:10.1034/j.1600-0455.2003.00033.x

    Article  PubMed  CAS  Google Scholar 

  9. Pandolfino JE, Richter JE, Ours T, Guardino JM, Chapman J, Kahrilas PJ (2003) Ambulatory esophageal pH monitoring using a wireless system. Am J Gastroenterol 98:740–749. doi:10.1111/j.1572-0241.2003.07398.x

    Article  PubMed  Google Scholar 

  10. Gillies R, Stratford J, Booth M, Dehn T (2007) Oesophageal pH monitoring using the Bravo catheter-free radio capsule. Eur J Gastroenterol Hepatol 19:57–63. doi:10.1097/MEG.0b013e3280116eec

    Article  PubMed  Google Scholar 

  11. Remes-Troche JM, Ibarra-Palomino J, Carmona-Sánchez RI, Valdovinos M (2005) Performance, tolerability, and symptoms related to prolonged pH monitoring using the Bravo system in Mexico. Am J Gastroenterol 100:2382–2386. doi:10.1111/j.1572-0241.2005.00292.x

    Article  PubMed  Google Scholar 

  12. Ward EM, Devault KR, Bouras EP, Stark ME, Wolfsen HC, Davis DM et al (2004) Successful oesophageal pH monitoring with a catheter-free system. Aliment Pharmacol Ther 19:449–454. doi:10.1111/j.1365-2036.2004.01868.x

    Article  PubMed  CAS  Google Scholar 

  13. Bothwell M, Phillips J, Bauer S (2004) Upper esophageal pH monitoring of children with the Bravo pH capsule. Laryngoscope 114:786–788. doi:10.1097/00005537-200404000-00039

    Article  PubMed  Google Scholar 

  14. Pandolfino JE, Kahrilas PJ (2005) Prolonged pH monitoring: Bravo capsule. Gastrointest Endosc Clin N Am 15:307–318. doi:10.1016/j.giec.2004.10.005

    Article  PubMed  Google Scholar 

  15. Suzuki T, Yamaguchi T, Odaka T, Kobayashi M, Seza A, Kouzu T et al (2008) Four-day continuous gastric pH monitoring following anti-acid secretory drug administration: cross-over test to assess the early effects. Aliment Pharmacol Ther 27:66–71

    Article  PubMed  CAS  Google Scholar 

  16. Yamaguchi T, Seza A, Odaka T, Shishido T, Ai M, Gen S et al (2006) Placement of the Bravo wireless pH monitoring capsule onto the gastric wall under endoscopic guidance. Gastrointest Endosc 63:1046–1050. doi:10.1016/j.gie.2005.10.028

    Article  PubMed  Google Scholar 

  17. Mori M, Suzuki H, Masaoka T, Imaeda H, Nomoto Y, Hosoda H et al (2006) Intravenous ghrelin administration enhances gastric acid secretion—evaluation using wireless pH capsule. Aliment Pharmacol Ther 24(Suppl):96–103

    Google Scholar 

  18. Chen EP, Mahar Doan KM, Portelli S, Coatney R, Vaden V, Shi W (2008) Gastric pH and gastric residence time in fasted and fed conscious cynomolgus monkeys using the Bravo(R) pH system. Pharm Res 25:123–134. doi:10.1007/s11095-007-9358-5

    Article  PubMed  CAS  Google Scholar 

  19. Ono S, Kato M, Ono Y, Asaka M (2007) New method for long-term monitoring of intragastric pH. World J Gastroenterol 13:6410–6413. doi:10.3748/wjg.13.6410

    Article  PubMed  Google Scholar 

  20. Pandolfino JE, Schreiner MA, Lee TJ, Zhang Q, Boniquit C, Kahrilas PJ (2005) Comparison of the Bravo wireless and Digitrapper catheter-based pH monitoring systems for measuring esophageal acid exposure. Am J Gastroenterol 100:1466–1476. doi:10.1111/j.1572-0241.2005.41719.x

    Article  PubMed  Google Scholar 

  21. Maton PN (1991) Omeprazole. N Engl J Med 324:965–975

    PubMed  CAS  Google Scholar 

  22. Wise JL, Kammer PK, Murray JA (2004) Post-test calibration of single-use, antimony, 24-hour ambulatory esophageal pH probes is necessary. Dig Dis Sci 49:688–692. doi:10.1023/B:DDAS.0000026319.79368.b8

    Article  PubMed  Google Scholar 

  23. McLauchlan G, Rawlings JM, Lucas ML, McCloy RF, Crean GP, McColl KE (1987) Electrodes for 24 hours pH monitoring—a comparative study. Gut 28:935–939. doi:10.1136/gut.28.8.935

    Article  PubMed  CAS  Google Scholar 

  24. Geus WP, Smout AJ, Kooiman JC, Lamers CB, Gues JW (1995) Glass and antimony electrodes for long-term pH monitoring: a dynamic in vitro comparison. Eur J Gastroenterol Hepatol 7:29–35

    PubMed  CAS  Google Scholar 

  25. Pandolfino JE, Zhang Q, Schreiner MA, Ghosh S, Roth MP, Kahrilas PJ (2005) Acid reflux event detection using the Bravo wireless versus the Catheter pH systems: why are the numbers so different? Gut 54:1687–1692. doi:10.1136/gut.2005.064691

    Article  PubMed  CAS  Google Scholar 

  26. Aksglaede K, Thommesen P (2003) Positioning of the pH-probe by manometry or radiography for monitoring of the esophagus. Influence on diagnostic results? Acta Radiol 44:360–362. doi:10.1034/j.1600-0455.2003.00093.x

  27. des Varannes SB, Mion F, Ducrotté P, Zerbib F, Denis P, Ponchon T et al (2005) Simultaneous recordings of oesophageal acid exposure with conventional pH monitoring and a wireless system (Bravo). Gut 54:1682–1686. doi:10.1136/gut.2005.066274

    Article  PubMed  Google Scholar 

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Acknowledgment

This study was supported by a grant from the Korea Health 21 R and D Project (A060093), Ministry of Health and Welfare, Republic of Korea.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Kangnam St. Mary’s Hospital, The Catholic University of Korea, No. 505, Banpo-Dong, Seocho-Gu, Seoul, 137-040, South Korea

    Jae Hyuck Chang, Myung Gyu Choi, Yu Kyung Cho, Jae Myung Park, In Seok Lee, Sang Woo Kim & In Sik Chung

  2. Department of Clinical Pharmacology, College of Medicine, The Catholic University of Korea, Seoul, South Korea

    Dong-Seok Yim

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  1. Jae Hyuck Chang
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  2. Myung Gyu Choi
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Correspondence to Myung Gyu Choi.

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Chang, J.H., Choi, M.G., Yim, DS. et al. A Novel Placement Method of the Bravo Wireless pH Monitoring Capsule for Measuring Intragastric pH. Dig Dis Sci 54, 578–585 (2009). https://doi.org/10.1007/s10620-008-0399-3

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  • DOI: https://doi.org/10.1007/s10620-008-0399-3

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