Esophageal pH monitoring developed a dependable external reference electrode. Using this technique to monitor esophageal acid exposure patients for periods up to 24 hours, DeMeester and Johnson were able to identify the most important parameters of esophageal acid exposure, and they developed a composite pH score to quantify gastroesophageal reflux. The initial 24-hour pH studies required hospitalization until the introduction of microcircuits in the 1980s that allowed portable esophageal pH monitoring in an outpatient setting. Gastroesophageal reflux disease (GERD) is a common disease in western countries. In the United States, 7% of the population experiences heartburn daily and 44% at least once a
PH that liquid junction potentials are independent of pH. Also, extreme pH implies that the solution is concentrated, so electrode potentials are affected by ionic strength variation. At high pH the glass electrode may be affected by "alkaline error", because the electrode becomes sensitive to the concentration of cations such as Na and K in the solution. Specially constructed electrodes are available which partly overcome these problems. Runoff from mines or mine tailings can produce some very low pH values. Hydrogen ion concentrations (activities) can be measured in non-aqueous solvents. pH values based on these measurements belong to a different scale