Acid Reflex and the Bernstein Test

The Bernstein test, also called acid perfusion test, is a diagnostic procedure used to try to reproduce the symptoms of heartburn. Usually performed in a gastroenterology laboratory, the procedure can help to determine whether your heartburn symptoms are caused by acid coming up from the stomach and irritating the esophagus. It is usually done along with other tests that measure esophageal function. Here's what you need to know about the Bernstein test and its aftermath.

Patient with Chest Pain
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Preparation for the Bernstein test is limited to short-term fasting. You will be asked to not eat or drink anything for 8 hours before the test.

How the Test Is Performed

A nasogastric (NG) tube is inserted through your nose and down into your esophagus. When the tube is in place, a diluted solution of hydrochloric acid (similar to stomach acid) is passed through the NG tube and into your esophagus. You will be asked if there is any pain or discomfort.

Next, a saline (salt water) solution is passed through the NG tube and into your esophagus, and you will again be asked if there is any pain or discomfort. After your responses are noted, the NG tube is removed.

What to Expect During the Test

Don't be surprised if you feel discomfort during most of the procedure. First, you may experience a gagging sensation when the tube is being placed. There is a risk of gagging or vomiting, which is why fasting beforehand is important. Then, since the purpose of the Bernstein's test is to recreate acid reflux, there is the possibility that you will have some heartburn. Afterward, your throat might also be sore.

Interpreting Your Results

The results of this procedure can mean one of three things:

  • If you experience no pain with either solution, this usually means your esophagus is healthy and no irritation is present.
  • If you experience pain with the acid solution but not the saline solution, this can mean that your heartburn is probably due to acid reflux.
  • If you experience pain with both the acid and saline solutions, your healthcare provider will need to perform further tests to determine the cause of your heartburn symptoms.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • "Understanding Your GI Tract ." The American College of Gastroenterology. 13 Apr 2009.
  • Carol Ann Rinzler, Ken DeVault, MD. Heartburn & Reflux for Dummies. Wiley Publishing, Inc., 2004. Print.
  • Peikin, M.D., Steven R.. Gastrointestinal Health. HarperCollins Publishers, Inc., 1999. Print.

By Sharon Gillson
 Sharon Gillson is a writer living with and covering GERD and other digestive issues.