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
Acid dissociation constant the added complication that the neutral molecule is subject to an internal acid–base equilibrium in which the basic amino group attracts and binds the proton from the acidic carboxyl group, forming a zwitterion. At pH less than about 5 both the carboxylate group and the amino group are protonated. As pH increases the acid dissociates according to At high pH a second dissociation may take place. Thus the zwitterion, , is amphoteric because it may either be protonated or deprotonated. The equilibrium constant "K" for a base is usually defined as the "association" constant for protonation of the base, B,