What is the Bernstein test?

The Bernstein test (esophageal acid perfusion test) is part of a test called esophageal pH testing. It's used to see if you have gastroesophageal reflux disease (GERD), or to check to see if your symptoms are coming from the esophagus.

The most common symptom of GERD is heartburn. Heartburn can feel like a burning in your chest. You may have GERD if you have heartburn more than 2 times a week. Your healthcare provider may do a Bernstein test and other tests to be sure. However, the Bernstein test is not commonly done.

Why might I need the Bernstein test?

Some symptoms of GERD may also be signs of other diseases. Your healthcare provider may use the Bernstein test and other tests to find out what is causing your symptoms. Besides heartburn, other signs of GERD may include:

• Coughing
• Having a rough or raspy voice (hoarseness)
• Chest pain
• Sore throat
• Choking
• Regurgitation
• Asthma or wheezing

It’s important to know if you have GERD and how to control it. That can keep your symptoms from getting worse. It can also prevent more problems. If GERD is not treated for a long time it may change the lining of your food pipe (esophagus). This is known as Barrett's esophagus. It can raise your risk of getting esophageal cancer. It can also lead to inflammation in the esophagus, called erosive esophagitis.

What are the risks of the Bernstein test?

How do I get ready for the Bernstein test?

You must not eat anything for at least 8 hours before the test. This often means no food or drink after midnight.

Ask your healthcare provider to tell you what else you should do before your Bernstein test.

What happens during the Bernstein test?

Talk with your healthcare provider about what will happen and how you may feel during your Bernstein test. In general, you can expect the following:

• The doctor will insert a thin, flexible tube (nasogastric tube) through your nose into your esophagus. This may cause some choking and coughing.
• A salt water solution (mixture) and a mild acid solution (like stomach acid) will be passed through the tube at different times.
• Your doctor will ask you when you feel symptoms of heartburn or pain.
• If you do not have symptoms from these solutions, the test is negative, and you probably do not have GERD.
• If you have symptoms only from the acid solution, the test is positive, and you may have GERD.

After the test, you can go back to your normal diet. You may have a sore throat for a short while. In most cases the Bernstein test can tell if you have the disease.

The Bernstein test may be done along with other tests, such as:

• Esophageal manometry. This measures the pressure inside your esophagus.
• 24-hour esophageal acid testing. This measures the amount of acid that flows into your esophagus from your stomach over 24 hours.
• Endoscopic exam. This checks your esophagus using a thin, lighted tube.

What happens after the Bernstein test?

If you have GERD, your healthcare provider may give you medicine to lower your stomach acid level. He or she may also ask you to stop eating 3 hours before going to bed. You may also be told to raise the head of your bed. These things will help reduce your GERD symptoms.

If you have a very bad case of GERD, you may need surgery to tighten your lower esophageal sphincter (LES). This will keep stomach contents from moving up into your esophagus.

Here are some things you can do to help control GERD:

• Stop smoking.
• Lose weight if you need to and stay at a healthy weight.
• Not have too much alcohol and caffeine.
• Not eat foods that give you heartburn.
• Not wear tight clothes around your belly.

Next steps

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