DIAGNOSTIC PATTERNS

Eight curves. Eight answers.

The reacidification curve is the result. Below is the full range of patterns the bicarbonate challenge produces, and what each one indicates.

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PATTERN 01

Normal reacidification

THE CURVE

Strong baseline, clean rise, a sustained plateau, then a decisive return to baseline by roughly 18 minutes.

INDICATES

Intact parietal cell mass and adequate secretory capacity.

RESOLVES

Rules out acid insufficiency and directs the workup downstream.

PATTERN 02

Hyperchlorhydria

THE CURVE

Low resting pH; four challenges each overwhelmed in under 10 minutes, with no plateau and no fatigue across rounds.

INDICATES

Sustained acid hypersecretion.

RESOLVES

Objective output data to inform antisecretory decisions rather than an empiric trial.

PATTERN 03

Extreme hyperchlorhydria

THE CURVE

Strongly acidic baseline; early challenges barely register, then the line stays flat as buffer is neutralized on contact, with the sensor confirmed ex vivo.

INDICATES

Acid output at the upper extreme.

RESOLVES

Flags intensity warranting investigation of the driver.

PATTERN 04

Hypochlorhydria

THE CURVE

Normal baseline and rise, then a prolonged plateau beyond 40 minutes before a late, fast drop.

INDICATES

Reduced secretory capacity, the most common Heidelberg finding.

RESOLVES

Objective evidence of low output behind bloating, deficiency, or reflux unresponsive to acid suppression.

PATTERN 05

Fatiguing hypochlorhydria

THE CURVE

Normal start, then a jagged, surging, unsustained recovery dragging out to roughly 58 minutes.

INDICATES

Output that initiates but cannot be sustained, capacity at its margin.

RESOLVES

A declining trend that a single challenge test or a serum marker misses.

PATTERN 06

Achlorhydria

THE CURVE

No acidic baseline at pH near 6.5; betaine HCl is required to acidify, and the stomach drifts back to alkaline once it wears off.

INDICATES

Absent endogenous acid production, the end stage of autoimmune atrophic gastritis and the hallmark of pernicious anemia.

RESOLVES

Direct implications for protein digestion, nutrient absorption, and the gastric barrier.

PATTERN 07

Declining sequential response

THE CURVE

First recovery 13 minutes, second 18, third does not recover; progressive prolongation across challenges.

INDICATES

Adequate under single demand, inadequate reserve under repeated demand.

RESOLVES

Early decline that single point testing reports as normal; relevant in autoimmune thyroid disease, type 1 diabetes, and a family history of pernicious anemia.

PATTERN 08

Bile reflux

THE CURVE

Clean recovery, then erratic alkaline spikes with no challenge given, then stable acidity once betaine is added.

INDICATES

Alkaline bile reflux through an incompetent pylorus, not secretory failure.

RESOLVES

Separates mechanical pseudo-hypochlorhydria from true acid deficiency, a distinction that changes management.

The conditions behind these patterns →

Indicated for use by qualified healthcare professionals. CAUTION: Federal Law (USA) restricts these devices to sale by or on the order of a physician.

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The Heidelberg pH Capsule is a Class I, 510(k)-exempt, preamendments device, classified under 21 CFR §876.1400. Registration of an establishment or listing of a device does not denote FDA approval, clearance, or endorsement.