A large number of people suffer from the heartburn symptoms associated with gastroesophageal reflux disease (GERD). Relatively little has been published on its potential for biasing a breath alcohol measurement. The present case describes an individual (white male, aged 23) who experimentally consumed 1.0 g/kg of an alcohol beverage and subsequently provided breath and blood samples for analysis. Breath expirograms were also collected following several different preexhalation breathing maneuvers. Shortly after the end of drinking the mean of replicate breath alcohol results exceeded that of the corresponding venous blood alcohol. A later paired comparison (during the postabsorptive phase) showed the blood alcohol to exceed the breath. None of the expirograms provided evidence that "mouth alcohol" due to gastroesophageal reflux had biased any test results. People with GERD can provide biased-free end-expiratory breath alcohol results where sound forensic practice is followed, which includes: 15-min. preexhalation observation, duplicate testing, instrumental detection systems, and trained alert operators who ask appropriate questions and watch for associated signs.
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