Dr. Horhay Rodriguez: Hey Jacob! How are you doing?
Jacob: Good.
Dr. Horhay Rodriguez: Are you nervous for today?
Jacob: Yes.
Dr. Horhay Rodriguez: A little bit. We are going to be passing the tube down into your stomach and then I am going to suction a little chip around the size of the bean into the esophagus. There we are in the esophagus, and you can tell, see this area here in the esophagus, you can have, you see lines going up. So he has got esophagitis.
So he definitely has reflux, something that's burning that esophagus. Alright, that stomach is a little bit irritated; it should be nice and pink, and probably that's not normal. Okay, so now we are moving to small intestine.
Now we are going to take some samples to make sure he doesn't have the bacteria, open, close, that's what a biopsy is like. Patient doesn't feel that at all. There is a little nerve bending growing on inside of the stomach, and we are ready to insert the Bravo Chip. If you notice, the Bravo Chip is this little metallic thing right here. That's the dispenser. That's basically what shoots it out. This launches it, and then it hooks into the patient's esophagus.
So we are going to do this blindly which means that we don't look at it through a scope. Swallow, perfect! Alright, so it's gone down. So now that it is safely in place, we take the safety cup off, and press down for 5 seconds and then we'll just watch, done. There are the vocal chords and there is the Bravo Chip right there in front of us, that's beautiful placement. Alright, so that little microchip is going to be trying submitting pH information for the next 48 hours.
Male Speaker: Jacob is here with his Gastroenterologist Dr. Horhay Rodriguez. Welcome to you both.
Dr. Horhay Rodriguez: Thank you, thank you.
Male Speaker: Thanks for sharing your esophagus with all of us. This is really fun technology because this Bravo Chip gives you a look in real-time what is going on with the acidity basically in your lower esophagus.
Dr. Horhay Rodriguez: Yeah, it is amazing technology. We like to call it the Hubble of Inner Space in the GI because you can sort of see for 2 days what is going on in there, what his pH is. And like you mentioned Travis, gastro reflux, gastro-esophageal reflux is such a huge problem, and a lot of people don't even know what it is.
Male Speaker: And pH is a measure of the acidity for people who don't know that at home.
Dr. Horhay Rodriguez: Exactly, the stomach makes acid and the pH of the esophagus should be only around 6. So when acid abnormally comes up to the esophagus, it is not supposed to be there. So it obviously burns the esophagus. Here we have our little reproduction of a stomach, and the stomach has contents on it. Some people here we go have a little bit of reflux, some people have it all the way up. The problem is that it can come so far up that it can burn your throat, for some people it can go into your lungs, it can cause asthma, coughing and poor Jacob. I mean he had it all the time, really all the time.
Male Speaker: And you are not -- clap your hands if you've ever had that sensation what we call heart burn. You'd even clapped, you get everyday.
Dr. Horhay Rodriguez: I have it now.
Male Speaker: So this was in his esophagus, what were his results like?
Dr. Horhay Rodriguez: Well, his results were actually surprising because he is young kid, he is slim, so we can have the graphic up there of the result, we are going to show you two basic graphs when we put the results up.
There we go; the first graph on top is what a normal pH monitor is. So you see that it doesn't vary very much. The bottom one has all those spikes. I have never seen this many spikes. Jacob in 48 hours had 172 bouts of reflux. I mean significant reflux. And what was odd about it, is that he had the majority of them while he was standing up. Most people have it while they are lying down. So he really has a big issue and so now I believe everything is --
Male Speaker: Which is so unusual with someone whose body frame is thin, active, healthy. So we know that he has got reflux, what are his options now?
Dr. Horhay Rodriguez: Well, his options are is that, since he is not responding to treatment, I mean he has been on every medication and even on the medications the acid still comes up. You may need some surgical intervention and so he may need some other tests that are actually going to perhaps tighten this area here where the stomach meets the esophagus, so that it doesn't reflux all the way up. So that should give us a lot of information.
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