Heartburn is not always taken seriously. Most of us experience it at some point or the other but 1 in 10 Americans suffer with heartburn on a daily basis. Despite its name, heartburn has nothing to do with the heart. Neither is heartburn a disease. It is actually a symptom of a disease known as GERD (gastroesophageal reflux disease).
Heartburn is one of the symptoms you experience when stomach acid flows backward up into the food pipe (esophagus). In the ideal situation, this should not happen. But there are many circumstances where the mechanism that normally prevents stomach acid from flowing backwards fails to act as it should.
Reflux Worse At Night
Acid reflux can occur at anytime but is usually worse after eating and when lying down. Naturally it is worse at night because a person is lying flat while sleeping. However, another factor that exacerbates the situation is that stomach acid production increases at night. Overall this makes nighttime one of the worst periods in the day for chronic GERD sufferers. The lower esophageal sphincter (LES) is dysfunctional in chronic GERD, thereby allowing stomach acid to enter the esophagus. These muscles are further relaxed during sleep.
Not only can GERD cause severe discomfort, it can also affect sleep. Silent acid reflux ix common and may people do not realize that the reason they are unable to have a restful sleep at night is because of their reflux. Apart from the difficulty sleeping, the only other symptoms they may experience is a slight morning sore throat and sour taste in the mouth upon waking. The characteristic heartburn with nausea may not be present in these cases.
It is advisable that chronic GERD suffers take medication at bedtime. Antacids neutralize the stomach acid to some extent and helps coat the esophagus thereby protecting it. However, its effects may not last throughout the night. It is not advisable to drink water after taking antacids at bedtime. Proton pump inhibitors (PPIs) and other acid-suppressing drugs are the preferred option for nighttime heartburn. It decreases acid production and works for longer periods of time than antacids.
Elevate the Head of the Bed
Gravity plays a part in nighttime heartburn. When lying flat, the stomach acid can more easily slip backwards up into the esophagus. Conversely standing upright reduces reflux since the acid would have to work against gravity to enter the esophagus. It is not practical to sleep in a sitting position. Ideally the head of the bed should be elevated by 4 to 6 inches (about 10 to 15 centimeters). This can be achieved with a few blocks or bricks placed under the head of the bed. However, this can be inconvenient for others sleeping on the same bed and specially-designed wedge pillows can help you sleep on a slight incline without disturbing others.
No Meals Before Bedtime
Avoid eating within 2 to 3 hours before bedtime. Reflux, and therefore heartburn, tends to worsen after meals. Since digestion in the stomach can go on for a few hours after eating, you will need to keep a sufficient gap between meals and bedtime. For most people, dinner is usually the largest meal of the day which further exacerbates the problem. Rather keep to smaller meals for dinner if you will need to sleep shortly after eating. Remember that your body is switching to a low metabolic state while you sleep so large meals are not necessary. Snacks before bedtime or even waking up to snack should definitely be avoided.
Stay Away from Trigger Foods
There are some foods to avoid in acid reflux. Chocolates, citrus fruits and tomatoes, coffee, fatty foods, peppermint and spicy meals are common trigger foods for most people. Ideally you should avoid these foods and beverages in the evening and especially before bedtime. What seems like a harmless chocolate snack before bedtime can be a major trigger in nighttime heartburn. So even a very small quantity of these foods can be enough to trigger acid reflux. Rather drink water before bedtime if you feel like you need a little something in your tummy. Milk may be a better option as it helps to some extent in neutralizing the stomach acid.
Skip the Nightcap and Smoking
Alcohol is a major trigger for acid reflux, as is the case with cigarette smoking. If you are in the habit of enjoying a nightcap, then it is time to stop if you suffer with nighttime heartburn. Alcohol relaxes the muscles of the lower esophageal sphincter (LES) and make the passage of stomach acid into the esophagus all that much easier. Tobacco smoking, whether it is a cigar, cigarette or pipe, is also a major aggravating factor for nighttime heartburn. Tobacco increases stomach acid production and interferes with the lower esophageal sphincter. Fortunately its effects wear off relatively quickly but its best to avoid smoking before bedtime.
Sleep on Your Left Side
Several studies have show that sleeping on the left side can help ease acid reflux. On the other hand sleeping on your right side can worsen reflux. The reason for this difference when sleeping on one side over the other is not fully understood. It is believed that sleeping on the right side may relax the lower esophageal sphincter (LES), the main gateway that controls the movement of contents between the stomach and esophagus. Another theory is that the area where the stomach and esophagus meets sits higher than the gastric acid when lying on the left side. Whatever the case, if sleeping on one side helps you then try to stick to it if possible.
Use Loose Fitting PJs
Any pressure on or in the abdomen can worsen acid reflux. While problems within the abdominal cavity have to be approached by different measures, one of the main issues with pressure from the outside is tight fitting clothing. The pressure on the abdomen and ultimately the stomach can hamper the quick emptying of the stomach and push its contents up into the esophagus. Using loose fitting pajamas (PJs) can therefore help. Ensure that elasticated clothing is comfortable to wear and stretches sufficiently. Pajamas that do not stretch should be of the appropriate size so as not to hold tightly and press against the abdomen.
Walk Around After A Meal
A short walk before bedtime can also help with easing nighttime heartburn. It is more important to have a walk after dinner so as to help with stomach emptying and improve digestion. But all too often you may feel a bit bloated after eating a large dinner. Instead wait a while after eating. Once you feel less bloated, then have a short walk – even walking on the spot can be helpful. Exercise just before bedtime can also help with sleeping better. But avoid activities that involve lying down or bending over as this can worsen acid reflux.