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 25 February 2018

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News

Esophageal acid sensitivity detected by pH monitoring and Bernstein testing

Physicians, in the latest issue of the American Journal of Gastroenterology, find that heartburn following acid perfusion and spontaneous heartburn are induced by different stimuli.

News image

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Heartburn 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.

In addition, there is a temporal correlation between heartburn and pH drop in the esophagus from endogenous acid, which results in a positive symptom index (SI).

In this study, physicians from the San Diego, California, tested the relationship between heartburn and acid in the esophagus by determining the SI and Bernstein test results in the same individual.

A total of 93 patients with heartburn underwent 24-h pH monitoring and Bernstein testing.

The team calculated a Bernstein score which included the severity of heartburn and the time of heartburn onset during Bernstein testing. The team then determined the relationship between the SI, Bernstein test, and Bernstein score.

The physicians found that 58 patients reported symptoms during the prolonged pH recording.
There was no correlation between the symptom index and Bernstein score.
American Journal of Gastroenterology

A positive SI was detected in 27 patients, and 49 patients had a positive Bernstein test.

The team was unable to identify any correlation between the patients with a positive SI and positive Bernstein test results.

There was also no correlation between SI and Bernstein score.

They determined that a positive Bernstein test within 5 min of acid infusion did not predict heartburn during spontaneous reflux episodes of 5 min.

Dr Barbara Jung and colleagues concluded, "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".

Am J Gastroenterol 2004; 99(3): 410-15
19 March 2004

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