In addition to acid reflux, alkaline (bile) reflux can cause chronic esophagitis, although chronic alkaline reflux is generally not associated with as much discomfort as is acid reflux.

The Bernstein test is rarely performed these days, but if your GI doctor strongly suspects acid GE reflux, then this test could be considered. However, the current standard of care is actually 24-hour esophageal pH monitoring (and which is also often combined with esophageal manometry testing, as well).

The barium swallow/UGI test is not perfect, and it doesn't always demonstrate reflux or esophageal spasm. (On the other hand, it often demonstrates clinically non-significant GE reflux in patients who are perfectly healthy.)


Sincerely/ Robert A. Wascher, MD, FACS

http://doctorwascher.com

Thank you very much for the information. It was very helpful.

1. Can 24-hour PH monitoring test reveal bile reflux? If not, what tests are available?

2. As soon as I eat a meal with salt, within 1-2 minutes, my chest pain gets worse. If I follow a low-sodium diet it eases out. Does it imply a hypersensitive esophagus to salt? Are there any tests available to verify salt hypersensitivity other than Bernstein test?


3. I abruptly wake up from sleep everyday after 5,6 hours. At that time I don't feel any acidic/alkaline taste in my mouth. But I experience chest pain. Can this be because of acidic/alkaline reflux? Sleep apnea is ruled out.

I appreciate your help.