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In the assessment of gastroesophageal reflux, pH levels traditionally are measured 5 cm above the manometrically defined lower esophageal sphincter to avoid slippage of the pH electrode into the stomach when the esophagus shortens during swallowing. The reference standard (percent time pH <4 during 24-hour monitoring) for normal distal acid exposure established by this technique is 5%. However, recent reports suggest that acid exposure may be higher closer to the esophagogastric junction. In this study, researchers used a novel endoscopic technique to compare acid exposure in the most distal esophagus with that in the conventional site in 11 patients who had chronic dyspepsia, normal endoscopy findings, and no evidence of hiatal hernia.
In e…