Reliability of breath-alcohol analysis in individuals with gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is widespread in the population amon g all age groups and in both sexes. The reliability of breath alcohol analy sis in subjects suffering from GERD is unknown. We investigated the relatio nship between breath-alcohol concentration (BrAC) and blood-alcohol concent ration (BAC) in 5 male and 5 female subjects all suffering from severe gast roesophageal reflux disease and scheduled for antireflux surgery. Each subj ect served in two experiments in random order about 1-2 weeks apart. Both t imes they drank the same dose of ethanol (similar to 0.3 g/kg) as either be er, white wine, or vodka mixed with orange juice before venous blood and en d-expired breath samples were obtained at 5-10 min intervals for 4 h. An at tempt was made to provoke gastroesophageal reflux in one of the drinking ex periments by applying an abdominal compression belt. Blood-ethanol concentr ation was determined by headspace gas chromatography and breath-ethanol was measured with an electrochemical instrument (Alcolmeter SD-400) or a quant itative infrared analyzer (Data-Master). During the absorption of alcohol, which occurred during the first 90 min after the start of drinking, BrAC (m g/210 L) tended to be the same or higher than venous BAC (mg/dL). Ln the po st-peak phase, the BAC always exceeded BrAC. Four of the 10 subjects defini tely experienced gastric reflux during the study although this did not resu lt in widely deviant BrAC readings compared with BAC when sampling occurred at 5-min intervals. We conclude that the risk of alcohol erupting from the stomach into the mouth owing to gastric reflux and falsely increasing the result of an evidential breath-alcohol test is highly improbable.