If you’re like me, you might be hopeful that the EGD with Bravo test will finally shed light on your reflux symptoms. Afterall, it’s considered the gold standard in traditional medicine for diagnosing reflux. But there is a hard truth you should be aware of: while the test can detect acid exposure and spot visible damage, it’s focus is squarely on the symptoms—not the root causes behind them.
As with much of traditional medicine, these tools are excellent at labeling symptoms—but not no hot at explaining why those symptoms exist in the first place. And without understanding the root cause, long-term relief can remain out of reach. But don’t worry. The answers you’re seeking do exist. I’m here to help you answer them, starting with what this test actually shows—and what it doesn’t.
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Esophagogastroduodenoscopy Meaning
An EGD, or esophagogastroduodenoscopy, is a procedure that uses a thin, flexible tube with a camera to examine your esophagus, stomach, and the first part of your small intestine. It’s designed to detect visible signs of inflammation, ulcers, polyps, or tissue damage.
These can be precursors to gastritis, esophagitis, cancers, or Barrett’s Esophagus which are more advanced symptoms of these issues.
The Esophagoduodenoscopy Procedure
When I had my EGD, it revealed a hiatal hernia and multiple polyps in my stomach. The polyps, I later learned, were a known side effect of taking acid-blocking medications long-term. At that point, I had been on them for seven years. Thankfully, the polyps were benign.
But the experience opened my eyes. The super brief consultation I had with my doctor after the procedure gave me a snapshot of what was happening—but not why it was happening. I walked in hopeful that I’d finally get answers, but left feeling more confused than ever.
I didn’t do the Bravo test, but when the EGD is paired with the Bravo capsule, it goes a step further. A tiny wireless capsule is attached to the wall of your esophagus and records pH levels for 48 to 96 hours. This helps doctors measure how often acid enters your esophagus and how long it stays there.
What does a positive Bravo test mean?
A positive Bravo test generally means your esophagus is exposed to more acid than what’s considered “normal.” But seriously—you already know that. You can feel it. The burning, the pressure, the throat irritation. The real question is: why is this happening?
Spoiler alert: the chances that your problem is “too much acid” are vanishingly small.
There are three medical terms used to describe stomach acid levels:
- Achlorhydria – no stomach acid production
- Hypochlorhydria – too little acid
- Hyperchlorhydria – too much acid
If most reflux sufferers heard those definitions, they’d assume they fall into the third category: hyperchlorhydria. But that’s almost never the case.
Here’s why: hyperchlorhydria is incredibly rare. So rare that if you try googling it, you’ll find barely any case studies, treatment protocols, or clinical literature. The term exists—but it’s hardly discussed because it’s hardly ever diagnosed. That’s not just a coincidence. You’ve probably never heard of it because even your doctor doesn’t use the term.
Consider this. If your stomach acid was too high, your food would digest quickly and you would never have indigestion! Also, the pharmaceutical ads for reflux would just come out and say it, but to avoid legal trouble they imply it through clever marketing.
That said, there are a couple of known cases where excess acid production truly does occur. The main one is a rare condition called Zollinger-Ellison Syndrome (ZES), where tumors in the pancreas or duodenum secrete excess gastrin, a hormone that causes the stomach to produce extreme amounts of acid.
The other situation—is rebound acid hypersecretion after long-term PPI use. When you stop taking acid blockers abruptly, the body can temporarily overproduce acid. But this usually resolves within a few weeks. It’s not considered a permanent state.
So if you’ve been told your reflux is due to “too much acid,” but you’ve never been tested for stomach acid levels, it may be time to question that assumption. Because in most cases, it’s not about too much acid—it’s about acid in the wrong place.
What an EGD with Bravo Can & Can’t Tell You
By now, you’ve probably picked up on the pattern: the EGD with Bravo can show what’s happening on the surface—acid exposure, tissue damage, and sometimes how frequently reflux events occur.
But what it can’t tell you is why those things are happening. It doesn’t explain the dysfunction behind the symptoms, and it doesn’t explore what’s going on in your digestive system before that acid ends up in the wrong place.
Even worse, many people are told their results are normal—their esophagus looks fine, their acid exposure is within limits—and they’re sent home without answers, still battling daily symptoms. That’s one of the most frustrating parts of this whole process.
If you’ve been there, I want you to know: you’re not crazy, and you’re definitely not alone.
To truly get better, we have to go beyond surface-level diagnostics. Let’s look at the deeper root causes the EGD with Bravo often misses—and what tools can actually help uncover them.
The Root Causes EGD and Bravo Tests Miss
1 Indigestion and Slow Motility
One major driver of reflux is poor digestion. When stomach acid is too low or motility is sluggish, food lingers too long in the stomach. This causes fermentation, gas, and pressure that pushes upward on the lower esophageal sphincter (LES).
Oftentimes with the EGD, the stomach appears normal. And the Bravo test might detect acid in the throat—but not the impaired digestion that led to it.
Better diagnostic: The Heidelberg pH test offers a precise way to measure your stomach’s acid production. Unlike Bravo, which looks at acid in the esophagus, Heidelberg uses a similar technique to measure acid in the stomach—which is often the root issue. If the Heidelberg test is not available in your area, consider the Betaine HCl Test instead.
2 Bacterial Overgrowth and Gut Imbalance
Another hidden cause of reflux is bacterial overgrowth. When stomach acid is too low and gut motility slows down, it creates the perfect environment for microbes to grow where they don’t belong. This imbalance can delay digestion, increase inflammation, and trigger reflux symptoms.
Doctors are generally aware of two specific overgrowths—H. pylori, which is commonly tested for, and candida, which is occasionally discussed. When my reflux symptoms started to take a turn for the worse, I took a H. pylori breath test. It came back negative—which, at the time, left me both relieved and confused. But beyond those two, traditional medicine rarely acknowledges or tests for other strains that might be contributing to symptoms.
Unfortunately, esophagoduodenoscopy procedures and Bravo testing don’t detect these kinds of microbial imbalances either.
Better diagnostic: A comprehensive microbiome test can evaluate your bacterial balance. These results are often far more revealing than what shows up on an endoscopy. Use my discount code REFLUXRELIEF at checkout for +15% off.
3 Chronic Inflammation and Irritation
Chronic inflammation is incredibly common in reflux sufferers. It can come from repeated acid exposure and food sensitivities. But the thing is, you don’t always need an EGD to confirm this. If you have heartburn, globus sensation, or throat discomfort—you have inflammation.
That said, EGD can be useful in detecting mor advanced progressions of the disease, such as erosive esophagitis or Barrett’s esophagus. But for most people with reflux symptoms already know something’s wrong without needing a scope to tell them.
Helpful diagnostic: Symptoms themselves are often the best indicator of inflammation. However, in some cases, EGD with biopsy can be helpful for identifying more serious or long-term damage.
Common EGD and Bravo Test Questions
Is stomach hurting after endoscopy normal?
Discomfort is common but if pain is sharp, persistent, or worsening, contact your provider.
Why do I have a painful Throat After Endoscopy?
A sore throat after endoscopy is typically due to irritation from the tube. It usually resolves in a few days. However, ongoing throat pain or difficulty swallowing is a cause to contact your provider.
What should I expect after an EGD and Bravo?
You may be asked to avoid acidic foods and keep a symptom diary while the Bravo capsule records your pH levels. Some people feel pressure in the chest or mild discomfort until the capsule falls off naturally. Results are typically reviewed a few days later.
Where to Go From Here
If you’re serious about resolving reflux, you need to dig deeper than measurements of acidity in the throat. Real progress comes from identifying and addressing the root cause:
- Indigestion: Try an at home Betaine HCl Test to assess stomach acid production accurately.
- Infection or imbalance: Take an at home microbiome test to evaluate bacterial balance and inflammation.
- Inflammation: If you’re experiencing ongoing symptoms like sore throat, burning, globus, or food sensitivities—you likely have inflammation. EGD can sometimes help identify damage, but your body may already be telling you what you need to know.
When you match your testing approach to your symptoms, you get better answers—and more effective treatment strategies and I’m here to help you find them.
If you found value in this article, be sure and check out my other diagnostics articles here.
This content is for informational purposes only and is not medical advice. Consult your physician for personalized care.
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