BRAVO Prep

BRAVO Prep Explained

BRAVO esophageal pH monitoring measures acid exposure in the esophagus over several days using a small capsule placed during a sedated endoscopy. The capsule transmits data to a wearable recorder while you go about normal activities. The results help your provider understand reflux patterns and guide treatment decisions.

Important Things to Know

Let your doctor know if you have an implanted electronic device such as a pacemaker or implantable cardiac defibrillator (ICD), a history of bleeding problems, dilated blood vessels, a nickel allergy, or any other previously known problems with your esophagus.

Hold PPI for 7 days prior to your procedure or as directed by your physician. Omeprazole, Prilosec, Esomeprazole, Nexium, Lansoprazole, Prevacid, Rabeprazole, AcipHex, Pantoprazole, Protonix, Dexlansoprazole, Dexilant
Hold H2 Blockers for 2 days prior to your procedure unless otherwise directed by your physician. Famotidine, Pepcid AC, Zantac 360, Cimetidine, Tagamet HB, Nizatidine, Axid AR
Continue all aspirin and anti-inflammatory medications including ibuprofen, Motrin, Aleve, naproxen, Naprosyn, sulindac, piroxicam, Feldene, indomethacin, diclofenac, and Voltaren. Tylenol (acetaminophen) is also safe to continue unless otherwise specified by our office.

If you have diabetes or are taking medications for weight loss, use the following instructions:

Fasting (going without food) is required for this procedure. Please monitor your blood sugar.
GLP-1 - STOP 7 days prior to your procedure. (ex: Ozempic, Wegovy, Mounjaro, Zepbound, Trulicity, Semaglutide, Tirzepatide)
SGLT2 - Stop 3 days prior to procedure (ex: Jardiance, Farxiga, Invokana, Steglatro, Brenzavvy, Glyxambi, Synjardy, Xigduo, Qtern)
Other oral diabetic medication: do not take the morning of your procedure.
Insulin Pump: Leave on, if you have questions refer to your endocrinologist.
Long-acting Insulin: Do not take the morning of your procedure.
Short-acting insulin: dose as necessary with blood sugar monitoring.
If you are concerned about your blood sugar dropping, consider purchasing glucose tablets.

Timing & Schedule

Preparation involves medication planning and fasting before capsule placement, followed by several days of monitoring. You’ll wear the recorder, track symptoms in a diary, and return the equipment after the study is complete. Detailed instructions and exact timing are provided below.

Instructions:

Step 1.

If You Take GLP-1 of SGLT2 Medications

If you take GLP-1 medications (Ozempic (Semaglutide), Mounjaro (Trizepatide) or ANY GLP-1) - DO NOT TAKE 7-DAYS PRIOR TO YOUR PROCEDURE

If you take SGLT2 medications (Jardiance, Farxiga, Invokana, Steglatro, Brenzavvy, Glyxambi, Synjardy, Xigduo, Qtern) - DO NOT TAKE 3 DAYS PRIOR TO YOUR PROCEDURE. If you are taking any of these medications, use the following instructions.

THE DAY BEFORE YOUR PROCEDURE

24 hours prior to procedure, BEGIN A CLEAR LIQUID DIET. Do not eat any solid foods. You may consume clear fluids including juice (apple, grape, strained orange, strained lemonade), tea, coffee (no milk or creamer), soft drinks, sports drinks (Gatorade, Powerade), clear broth or bouillon, Jell-O, and popsicle only.

THE DAY OF YOUR PROCEDURE

4 hours prior to your procedure, STOP ALL LIQUIDS. This also means NO water other than to take your medications – this is very important. Drinking within 4 hours before your procedure may result in delay or cancellation of your procedure.

Step 2.

If You DO NOT Take GLP-1 of SGLT2 Medications

THE DAY OF YOUR PROCEDURE

8 hours prior to the procedure, BEGIN A CLEAR LIQUID DIET. Do not eat any solid foods. You may consume clear fluids including juice (apple, grape, strained orange, strained lemonade), tea, coffee (no milk or creamer), soft drinks, sports drinks (Gatorade, Powerade), clear broth or bouillon, Jell-O, and popsicles.
4 hours prior to your procedure, STOP ALL LIQUIDS. This also means NO water other than to take your medications – this is very important. Drinking less than 4 hours before your procedure may result in delay or cancellation of your procedure.

Step 3.

General Instructions For All Patients

Loose dentures may be removed prior to the procedure.
Please bring a list of your current medications and correct dosage to your appointment.
NO DRIVING –you cannot drive for the remainder of the day if you are sedated. You need to have a responsible driver to take you home after your procedure. If your driver wishes to discuss the results of your procedure with the doctor, please have them accompany you to your procedure and remain on site.
We do not recommend Uber, Lyft, or taking a taxi – these are not acceptable forms of transportation.
You will be sedated for your procedure. Please avoid alcohol and making legal decisions for the remainder of the day after your procedure.

Step 4.

After The Procedure

Follow instructions on Bravo Diary
After 96 hours the receiver will automatically turn off and the time display will be blank. The recording will be stored even when the recorder loses battery.
The Capsule should fall off the esophagus in 5 - 7 days. You do not need to retrieve the capsule. Please return the receiver and diary 96 hours after your testing is finished or as specified in your diary. *No longer than 5 days.
PLEASE BE SURE TO BRING YOUR DIARY WHEN YOU RETURN THE RECEIVER TO THE DEPARTMENT.
No MRI for 30 days. If you must have an MRI, we recommend an x-ray, to determine if the capsule is present. Unless the capsule was visually seen in the stool.

Take Aways

Additional Details

Medication:

STOP GLP-1 medications 7 days prior to your procedure
STOP SGLT2 medications 3 days prior to procedure
There are different instructions depending on the medications you take, please read all instructions carefully.
DO NOT DRINK water or anything while driving to your appointment or waiting for your appointment – we need your stomach empty to safely use sedation.
You may not remember your conversation with your doctor after your procedure – we STRONGLY recommend your driver stays IN our facility to speak with the doctor after your test.

Your procedure time will be approximately 90 minutes from the scheduled check-in time to discharge for procedures in the Meridian Endoscopy Center. Please coordinate with your driver to alleviate delays in discharge.
We cannot be responsible for your valuables (watches or various jewelry items). Please leave them at home.
Bring all insurance cards and a photo ID with you. Please check with your insurance company regarding prior-authorization.
Fee for services is required at time of check-in. Please be prepared to make a payment.
IGA recognizes that your time is valuable, and so is ours. If you need to cancel or reschedule an appointment, please do so more than 48 business hours prior to your scheduled appointment arrival time at 208-343-6458.
Late cancellations and no shows may be assessed a $200 fee.

These instructions summarize the Bravo pH preparation used at Idaho Gastroenterology Associates. Always follow the exact directions given by your provider and call our office if anything is unclear.

BRAVO Prep

BRAVO Prep Explained

Important Things to Know

Timing & Schedule

Supplies Needed

Download

Ayudando a Idaho a sentirse mejor desde 1976.

BRAVO Prep

BRAVO Prep Explained

Important Things to Know

Timing & Schedule

Supplies Needed

Download

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Ayudando a Idaho a sentirse mejor desde 1976.

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