Digestive Diseases and Sciences

, Volume 58, Issue 12, pp 3554–3557 | Cite as

African–Americans, Hispanic Americans, and Non-Hispanic Whites Without GERD or Reflux Symptoms Have Equivalent 24-h pH Esophageal Acid Exposure

  • Kenneth J. Vega
  • Tracy Langford
  • Carlos Palacio
  • Janet Watts
  • M. Mazen Jamal
Original Article



Ambulatory esophageal pH monitoring is, currently, the recommended diagnostic exam for gastroesophageal reflux disease. Data are currently available for African–American (AA) and non-Hispanic white (nHw) volunteers among United States ethnic groups. The purpose of this study was to obtain normal values of 24-h esophageal pH by monitoring healthy adult Hispanic American (HA) volunteers and to compare these with values obtained from healthy AA and nHw volunteers to determine if ethnic variation exists in 24-h esophageal pH.


24-h Dual esophageal pH monitoring was performed for healthy AA, HA, and nHw. Values for total number of reflux episodes, episodes longer than 5 min, total reflux time, and longest reflux episode in the proximal and/or distal esophagus were obtained for all groups. Differences between groups were considered significant if p < 0.05.


One-hundred and thirty-six subjects volunteered and completed 24-h pH testing. Fifty-three were AA, 25 HA, and 58 nHw, with males accounting for 52, 47, and 47 %, respectively, of each group. AA were older than nHw only and nHw had a lower body mass index than both AA and HA. Shorter study duration was observed for HA than for AA and nHw. No difference was observed between ethnic groups for any measured pH data in the proximal or distal esophagus.


No difference exists in values obtained during esophageal pH monitoring among healthy AA, HA, and nHw. This indicates that currently accepted normal values of ambulatory esophageal pH monitoring can be used for all major United States ethnic groups without compromising diagnostic accuracy.


Esophagus Acid African–American Hispanic American 24-h pH test Reflux episodes Ethnicity 



The authors would like to thank Myrna Mattos, RN, Sandra Canham-Bandy MS, AHIP, Lakina Campbell, Nancy Chaffin, and Shannon Lloyd for their assistance in this investigation.

Conflict of interest



  1. 1.
    Rosen SN, Pope CE II. Extended esophageal pH monitoring. An analysis of the literature and assessment of its role in the diagnosis and management of gastroesophageal reflux disease. J Clin Gastroenterol. 1989;11:260–270.PubMedCrossRefGoogle Scholar
  2. 2.
    Johnsson F, Joelsson B, Isberg PE. Ambulatory 24-hour intraesophageal pH monitoring in the diagnosis of gastroesophageal reflux disease. Gut. 1987;25:1145–1156.CrossRefGoogle Scholar
  3. 3.
    Richter JE, Bradley LA, DeMeester TR, Wu WC. Normal 24-hr ambulatory esophageal pH values. Influence of study center, pH electrode, age and gender. Dig Dis Sci. 1992;37:849–856.PubMedCrossRefGoogle Scholar
  4. 4.
    Garn SM, Smith NJ, Clark DC. Lifelong differences in hemoglobin levels between blacks and whites. J Nat Med Assoc. 1975;67:91–96.Google Scholar
  5. 5.
    Kraemer MJ, Hunter R, Rosse C, Smith NJ. Race-related differences in peripheral blood and bone marrow cell populations of American black and American white infants. J Nat Med Assoc. 1977;69:327–331.Google Scholar
  6. 6.
    Schoenberg JB, Beck GJ, Bouhuys A. Growth and decay of pulmonary function in healthy blacks and whites. Respir Physiol. 1978;33:367–393.PubMedCrossRefGoogle Scholar
  7. 7.
    Reed WW, Diehl LF. Leukopenia, neutropenia and reduced hemoglobin levels in healthy American blacks. Arch Intern Med. 1991;151:501–505.PubMedCrossRefGoogle Scholar
  8. 8.
    Christian CL, Werley B, Smith A, Chin N, Garde D. Comparison of employees’ white blood cell counts in a petrochemical plant by worksite and race. J Nat Med Assoc. 1994;86:620–623.Google Scholar
  9. 9.
    Morgan TO, Jacobsen SJ, McCarthy WF, Jacobsen DJ, et al. Age-specific reference ranges for serum prostate specific antigen in black men. N Engl J Med. 1996;335:304–310.PubMedCrossRefGoogle Scholar
  10. 10.
    Vega KJ, Langford-Legg T, Jamal MM. Ethnic variation in lower esophageal sphincter pressure and length. Aliment Pharmacol Ther. 2008;28:655–659.PubMedCrossRefGoogle Scholar
  11. 11.
    Vega KJ, Langford-Legg T, Watts J, Lambiase C, Lambiase LR, Jamal MM. Reflux Episodes are similar in healthy African–Americans and non-Hispanic whites. Dis Esophagus. 2010;23:609–612.PubMedCrossRefGoogle Scholar
  12. 12.
    Fisher BL, Pennathur A, Mutnick JL, et al. Obesity correlates with gastroesophageal reflux. Dig Dis Sci. 1999;44:2290–2294.PubMedCrossRefGoogle Scholar
  13. 13.
    El-Serag HB, Graham DY, Satia JA, et al. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol. 2005;100:1243–1250.PubMedCrossRefGoogle Scholar
  14. 14.
    Jacobson BC, Somers SC, Fuchs CS, et al. Body-mass index and symptoms of gastroesophageal reflux disease in women. N Engl J Med. 2006;354:2340–2348.PubMedCrossRefGoogle Scholar
  15. 15.
    Iovino P, Angrisani P, Galloro G, et al. Proximal stomach function in obesity with normal or abnormal oesophageal acid exposure. Neurogastroenterol Motil. 2006;18:425–432.PubMedCrossRefGoogle Scholar
  16. 16.
    Sharma P, Wani S, Romero Y, et al. Racial and geographic issues in gastroesophageal reflux disease. Am J Gastroenterol. 2008;103:2669–2680.PubMedCrossRefGoogle Scholar
  17. 17.
    Vega KJ, Chisholm S, Jamal MM. Comparison of reflux esophagitis and its complications between African–Americans and non-Hispanic whites. World J Gastroenterol. 2009;15:2878–2881.PubMedCrossRefGoogle Scholar
  18. 18.
    Khoury JE, Chisholm S, Jamal MM, Palacio C, Pudhota S, Vega KJ. African–Americans with Barrett’s esophagus are less likely to have dysplasia at biopsy. Dig Dis Sci. 2012;57:419–423.PubMedCrossRefGoogle Scholar
  19. 19.
    Cook MB, Chow WH, Devesa SS. Oesophageal cancer incidence in the United States by race, sex and histologic type 1977–2005. Br J Cancer. 2009;101:855–859.PubMedCrossRefGoogle Scholar
  20. 20.
    Vega KJ, Jamal MM, Wiggins CL. Changing pattern of esophageal cancer incidence in New Mexico: a 30-year evaluation. Dig Dis Sci. 2010;55:1622–1626.PubMedCrossRefGoogle Scholar
  21. 21.
    El-Serag HB, Ergun GA, Pandolfino J, et al. Obesity increases oesophgaeal acid exposure. Aliment Pharmacol Ther. 2005;22:1005–1010.PubMedCrossRefGoogle Scholar
  22. 22.
    Corley DA, Kubo A, Zhao W. Abdominal obesity, ethnicity and gastro-oesophageal reflux symptoms. Gut. 2007;56:749–755.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Kenneth J. Vega
    • 1
    • 4
  • Tracy Langford
    • 1
  • Carlos Palacio
    • 2
  • Janet Watts
    • 1
  • M. Mazen Jamal
    • 3
  1. 1.Division of GastroenterologyUniversity of Florida College of Medicine-JacksonvilleJacksonvilleUSA
  2. 2.Department of MedicineUniversity of Florida College of Medicine-JacksonvilleJacksonvilleUSA
  3. 3.Gastroenterology SectionVeterans Affairs Medical CenterLong BeachUSA
  4. 4.Division of Digestive Diseases and NutritionUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA

Personalised recommendations