What is the Bernstein Test?

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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 22 September 2018
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The Bernstein test is a medical test conducted to assess esophageal health and function. It may be used in the process of diagnosing heartburn, and can be performed alone or as part of a group of medical tests, depending on the situation. This test is an outpatient procedure and people can usually leave as soon as the test is finished. It is also a relatively low risk medical test, and a doctor can discuss specific risks and concerns with the patient before the test is performed.

Also known as an acid perfusion test, the Bernstein test requires the patient to abstain from water and food for eight hours before testing. The test is often scheduled in the morning to make it convenient for patients to fast; they can simply sleep through the fast and wait to have breakfast until after the test. The patient will report to a hospital or clinic for the test, and a nasogastric (NG) tube will be inserted for the Bernstein test.


First, a mild hydrochloric acid solution is dripped into the tube, and the patient is asked about pain, discomfort, and other sensations. Next, a saline solution is moved through the tube, and the patient is asked again about any sensations experienced. The responses are noted and then the tube is withdrawn. Many patients find that the tube makes them gag or feel uncomfortable, and medical providers are aware of this. They will be careful while inserting and removing the tube to avoid injuring the patient and are willing to take their time if a patient has trouble with the process.

If the results of the Bernstein test are negative, it means that heartburn is not being caused by acid reflux. If the patient experiences pain or discomfort after the acid solution, it suggests that the esophagus is inflamed and that acid reflux is occurring. If pain is also experienced after the salt solution is rinsed through the tube, the doctor needs to perform additional diagnostic tests to learn more about what is going on inside the patient.

Using the Bernstein test results, a doctor may make treatment recommendations or recommendations for additional diagnostic testing. Sometimes heartburn can be tricky to diagnose and it may require a series of tests to narrow down the cause of the sensation, including imaging studies of the esophagus to get a view inside. It is important to follow through on a diagnosis even if testing becomes tedious because sometimes pain in the esophagus can be a sign of cancer or other problems which require aggressive and prompt medical treatment.



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