Blog 8/23/2017

Weekly Clinical Service Dose: Why Does Your Heartburn Always Seem Worse at Night?


Tips for reducing night-time heartburn

If you suffer from heartburn, you know that burning sensation in your chest is always unpleasant.

But you may wonder why it often seems worse when you’re trying to get some sleep.

Why is it more likely to flare up at night?

Blame it on the natural force of gravity. It doesn’t work in your favor when you’re lying down.

When you sit or stand, gravity helps move your food through the esophagus and into the stomach where digestion occurs.

But when you are lying down, you lose gravity’s help in allowing your esophagus to clear food, bile and acids. And that can allow for heartburn to happen.

What causes this burning sensation? 

When you eat, food passes down your throat and through your esophagus to your stomach. A muscle (the lower esophageal sphincter) controls the opening between the esophagus and the stomach.

It remains tightly closed except when you swallow food.

But when this muscle fails to close after food passes through, the acidic contents of your stomach can travel back up into the esophagus. Doctors refer to this backward movement as reflux.

When stomach acid hits the lower part of the esophagus, it can produce a burning sensation.

This is what we call heartburn or, more formally, gastroesophageal reflux disease (GERD).

About one in 10 adults has heartburn at least once a week, and one in three have it every month.

Tips to reduce nighttime heartburn

There are other steps you can take to reduce heartburn 

  • Lose weight. Body mass index (BMI) takes weight and height into account. People who are overweight (BMI of 25 or above) are at a greater risk for heartburn.
  • Stop smoking. Research suggests that if you can quit smoking, it will help.
  • Eat smaller, less fatty meals, especially later in the day. For someone with chronic heartburn, a meal of less than 500 calories and 20 grams of fat is ideal.
  • Wait at least three hours after eating to go to bed. It takes the stomach four to five hours to fully empty a meal, so give it at least three hours.
  • Try acid-reducing medications. The most commonly prescribed medications for GERD are proton pump inhibitors. While thought to be generally safe, patients with long-term use of these medications should discuss potential risks with their physicians.



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