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. It is not commonly done anymore.

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 rarely 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 to keep your symptoms from getting worse. It can also prevent more problems. If GERD is not treated for a long time, it may cause damage to 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?

There is a risk of gagging or vomiting during the Bernstein test. You may have other risks, based on your overall health. Be sure to talk with your healthcare provider about any concerns you have before your 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 healthcare provider will insert a thin, flexible tube (nasogastric tube) through your nose into your esophagus. This may cause some choking and coughing.

• A saltwater solution (mixture) and a mild acid solution (like stomach acid) will be passed through the tube at different times.

• Your healthcare provider will ask you when you feel symptoms of heartburn or pain.

• If you don't have symptoms from these solutions, the test is negative, and you probably don't 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 and muscle contractions 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.

• Esophageal impedance testing. This is combined with the 24-hour acid test. It checks for reflux of acid and other contents that flow into your esophagus from your stomach.

• Upper GI endoscopic exam. This procedure examines your esophagus using a thin, lighted tube and camera.

What happens after the Bernstein test?

If you have GERD, your healthcare provider may give you medicine to lower your stomach acid level. They may also ask you to stop eating 3 hours before going to bed. And they may advise raising 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. There are pros and cons to surgery. Be sure to discuss this with your healthcare provider.

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.

• Don't have too much alcohol and caffeine.

• Don't eat foods that give you heartburn.

• Don't wear tight clothes around your belly.

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how \you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure