Lack of Association Between Esophageal Acid Sensitivity Detected by Prolonged pH Monitoring and Bernstein Testing

Jung, Barbara; Steinbach, Joseph; Beaumont, Cheryl; Mittal, Ravinder K.
March 2004
American Journal of Gastroenterology;Mar2004, Vol. 99 Issue 3, p410
Academic Journal
OBJECTIVES: Heartburn, a common medical symptom, is thought to be the result of acid reflux into the esophagus. Perfusion of the esophagus with exogenous acid (Bernstein test) in susceptible individuals causes heartburn. Temporal correlation between heartburn and pH drop in the esophagus from endogenous acid, as reflected by a positive symptom index (SI), provides further evidence of a correlation between acid in the esophagus and heartburn. We tested the relationship between heartburn and acid in the esophagus by determining the SI and Bernstein test results in the same individual.METHODS: Ninety-three patients with heartburn underwent 24-h pH monitoring and Bernstein testing. A Bernstein score that included the severity of heartburn and the time of heartburn onset during Bernstein test was calculated. The relationship between SI, Bernstein test, and Bernstein score was determined.RESULTS: Fifty-eight patients reported symptoms during the prolonged pH recording. A positive SI was detected in 27 patients. Forty-nine patients had a positive Bernstein test. There was no correlation between the patients with a positive SI and positive Bernstein test results. There was no correlation between SI and Bernstein score. A positive Bernstein test within 5 min of acid infusion did not predict heartburn during spontaneous reflux episodes of≥5 min.CONCLUSIONS: The lack of association between symptoms induced by acid perfusion of the esophagus compared with symptoms following spontaneous reflux in the same individual suggests that the heartburn following acid perfusion and spontaneous heartburn are induced by different stimuli.


Related Articles

  • Acid Reflux Immediately Above the Squamocolumnar Junction and in the Distal Esophagus: Simultaneous pH Monitoring Using the Wireless Capsule pH System. Wenner, Jörgen; Johnsson, Folke; Johansson, Jan; Öberg, Stefan // American Journal of Gastroenterology;Aug2006, Vol. 101 Issue 8, p1734 

    OBJECTIVES: The pattern of reflux in the most distal esophagus of asymptomatic individuals is largely unknown. Using a wireless technique we compared the degree and the pattern of acid reflux just above the squamocolumnar junction (SCJ) with that measured at the conventional level for pH...

  • Lack of Correlation Between a Self-Administered Subjective GERD Questionnaire and Pathologic GERD Diagnosed by 24-h Esophageal pH Monitoring. Chan, Kevin; Liu, Geoffrey; Miller, Linda; Ma, Clement; Xu, Wei; Schlachta, Christopher M.; Darling, Gail // Journal of Gastrointestinal Surgery;Mar2010, Vol. 14 Issue 3, p427 

    Self-reported reflux symptoms do not always correspond to pathologic gastroesophageal reflux disease (GERD). We evaluated whether GERD-related symptoms in the self-reported Mayo-GERD questionnaire (GERDQ) were correlated with current gold standard definitions of pathologic GERD. Three hundred...

  • Esophageal mucosal acid sensitivity can coexist with normal pH recording in healthy adult volunteers. Ho, Khek Yu; Kang, Jin Yong // Journal of Gastroenterology;2000, Vol. 35 Issue 4, p261 

    Abstract: We aimed to determine whether healthy volunteers with normal pH monitoring study results experienced heartburn or discomfort during an esophageal acid perfusion test. We performed an esophageal acid perfusion test, followed by ambulatory esophageal pH monitoring, in 15 healthy and...

  • Esophagitis Symptoms May Not Match Severity of Disease. Sadovsky, Richard // American Family Physician;11/1/2004, Vol. 70 Issue 9, p1782 

    Discusses research being done on heartburn severity that underestimated erosive esophagitis severity in elderly patients with gastroesophageal reflux disease. Reference to a study by D. A. Johnson and M. B. Fennerty published in the March 2004 issue of "Gastroenterology"; Reason behind the...

  • Metoclopramide in Gastroesophageal Reflux Disease: Rationale for its Use and Results of a Double-Blind Trial. McCallum, Richard W.; Fink, Steven M.; Winnan, Gerald R.; Avella, Jerold; Callachan, Cynthia // American Journal of Gastroenterology;Mar1984, Vol. 79 Issue 3, p165 

    We investigated the acute effect of metoclopramide on lower esophageal sphincter pressure, esophageal contraction amplitude, and gastric emptying and compared metoclopramide, 10 mg four times a day, to placebo in improving the symptoms and objective parameters of reflux esophagitis in 19...

  • American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection. Chey, William D.; Wong, Benjamin C. Y. // American Journal of Gastroenterology;Aug2007, Vol. 102 Issue 8, p1808 

    Helicobacter pylori ( H. pylori) remains a prevalent, worldwide, chronic infection. Though the prevalence of this infection appears to be decreasing in many parts of the world, H. pylori remains an important factor linked to the development of peptic ulcer disease, gastric malignanc and...

  • “Refractory GERD”: Acid, Nonacid, or Not GERD? Vaezi, Michael F. // American Journal of Gastroenterology;Jun2004, Vol. 99 Issue 6, p989 

    Gastroesophageal reflux disease (GERD) is a common condition with 44% of Americans surveyed reporting heartburn at least once a month and 20% once a week (). However, despite major advances in our understanding of this disease, management of GERD is still a challenge. Proton pump inhibitors...

  • The Impact of Prolonged pH Measurements on the Diagnosis of Gastroesophageal Reflux Disease: 4-Day Wireless pH Studies. Scarpulla, Giuseppe; Camilleri, Salvatore; Galante, Pietro; Manganaro, Miohele; Fox, Mark // American Journal of Gastroenterology;Dec2007, Vol. 102 Issue 12, p2642 

    INTRODUCTION: Prolonged, 4-day (96 h) measurement by the wireless Bravo® system provides an opportunity to assess the variance, diagnostic reproducibility, and yield of 24- and 48-h pH and symptom association studies. METHOD: Retrospective analysis of 83 patients with suspected reflux...

  • Reproducibility of Multichannel Intraluminal Electrical Impedance Monitoring of Gastroesophageal Reflux. Bredenoord, Albert J.; Weusten, Bas L.A.M.; Timmer, Robin; Smout, Andre J. P. M. // American Journal of Gastroenterology;Feb2005, Vol. 100 Issue 2, p265 

    OBJECTIVE: Esophageal impedance measurement is a novel method for gastroesophageal reflux monitoring. Reproducibility is an important aspect of every biomedical test. The aim of this study was therefore to asses the reproducibility of gastroesophageal reflux monitoring using impedance...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics