When Should I See A Doctor
Occasional heartburn is common and can often be self-treated with OTC medications and lifestyle changes. If your nighttime heartburn symptoms worsen, or two or more times a week, it may be a sign of gastroesophageal reflux disease . While GERD is not life threatening, you should talk to a doctor if your symptoms persist for more than a couple weeks. Some individuals are able to manage the discomfort of GERD on their own, but in some cases, stronger medications or surgery may be needed to ease symptoms.
*BASED ON 9-HOUR ACID CONTROL STUDIES DURING THE DAY AND 12-HOUR ACID CONTROL STUDIES DURING THE NIGHT. ACID CONTROL DOES NOT IMPLY SYMPTOM RELIEF.
A Maintain A Healthy Body Weight
Do you know your body mass index ? If not, start now by entering your weight and height into a BMI calculator to use the NIH calculator and find your current BMI.
A healthy BMI is between 19 and 25, but anyone with a compromised LES should not be at the high end of normal. We recommend a BMI of 24 or less. Why is this important? We wrote a cornerstone article titled How is your excess weight destroying your LES , which we highly recommend you read if you have a BMI greater than 24.
This excess weight does two things that will increase your GERD symptoms. First, it distends the stomach, pulling down on the LES and stretching it out. Over a long-term, this will reduce the effectiveness of the LES to act as an effective barrier between the stomach and the oesophagus.
Second, it puts added pressure on the diaphragm, potentially pushing stomach content into the esophagus. Many research studies have proven that a reduction in BMI will reduce GERD symptoms. In an NIH published paper researchers concluded the following:
In summary, our findings suggest that, beyond being overweight or obese, the risk of GERD symptoms rises progressively with increasing BMI, even among normal weight individuals. This appears true for all degrees of symptom severity and duration, as well as for nocturnal symptoms. Notably, weight loss was associated with a decreased risk of symptoms.
How To Treat Frequent Heartburn
If youre experiencing frequent heartburn, taking an OTC medication could help. One way to treat frequent heartburn is with OTC proton pump inhibitors . OTC PPIs like Nexium® 24HR turn off the acid pumps in your stomach and reduce the amount of acid that can flow back to the esophagus. Taking just 1 pill in the morning for 14 days* can provide you with 24-hour protection from frequent heartburn. To compare all heartburn treatments, please visit our “Compare Treatments” page. Remember, if an OTC medication doesnt seem to work for you after the directed usage period, see your doctor.
*Use as directed for 14 days to treat frequent heartburn. Nexium® 24HR may take 1-4 days for full effect.
Works round the clock with great relief!
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Check If You Have Acid Reflux
The main symptoms of acid reflux are:
- heartburn a burning sensation in the middle of your chest
- an unpleasant sour taste in your mouth, caused by stomach acid
You may also have:
- a cough or hiccups that keep coming back
- a hoarse voice
Your symptoms will probably be worse after eating, when lying down and when bending over.
Make Lunch Your Biggest Meal Of The Day
Eating a big meal can put pressure on your stomach and allow acid to travel back up into your esophagusand that will only be compounded if you lie down soon afterward. To prevent a major case of acid reflux at night, Huber recommends eating a heavier lunch and a lighter dinner. I’ve started to spend a few hours on Sunday meal prep so that I can get more substantial lunches ready for the week.
Sleeping With Acid Reflux
Acid reflux, also referred to as heartburn, is no stranger to most of us and is something many people live with daily. Four out of five people who suffer with regular heartburn are also affected during the night time.
As we wind down and prepare our bodies for sleep, there are many factors contributing to the quality of sleep we’ll receive. However, sleeping with acid reflux can cause pain, discomfort and ultimately fatigue.
We all know the importance of getting some decent shut eye, so Rennie are laying down some facts and tips to ensure you get quality sleep, even with acid reflux.
Learn What Causes Heartburn For Youthen Avoid It
Fat, caffeine, chocolate, citruspregnant women with heartburn have been advised to avoid all of the above at one time or another. But what causes reflux in one woman might not be a trigger for another.
Rather than tell his pregnant patients to avoid a specific food, Dr. Richter says he advises them to stay away from foods that specifically aggravate them. Everybody’s different, Dr. Richter says. Some pregnant women can chow down on spicy Mexican food or a plate of spaghetti and meatballs with no ill effects.
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Best Sleeping Positions For Heartburn
LEFT OR RIGHT?
Its advisable to sleep on your left side. Sleeping on the right has been found to relax the connecting muscles between the stomach and the oesophagus. When these muscles are contracting they help to control the process of acid reflux.
FRONT OR BACK?
Try to avoid sleeping on your front. This can put pressure on your stomach which pushes acid upwards to cause heartburn. This is more likely to happen if you are overweight or obese, but you should try other positions to see whats best for you, regardless of your weight.
UP OR DOWN?
When lying in bed, raising your head and shoulders a few inches can stop acid rising towards your chest and causing heartburn. A wedge shaped pillow or a few blocks that elevate the whole upper body can work wonders when youre trying to sleep with acid reflux.
Why Do You Get Reflux More At Night
You may experience more reflux at night than during the day. The reason for this is gravity. When you sit or stand, gravity helps move the food through your esophagus and into the stomach. When youâre laying down, you lose the effect of gravity on the food traveling through your digestive system. Laying down also prevents gravity from keeping bile and acids from traveling up into the esophagus, causing heartburn. Because of this, many people find their heartburn is worse at night.
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Gerd And Obstructive Sleep Apnea
Research has also identified a link between GERD and obstructive sleep apnea , a sleep disorder that involves blockage of the airway that incites pauses in breathing during sleep. Debate exists among experts about whether GERD causes OSA, OSA causes GERD, or if they simply share similar risk factors.
It is possible that GERD affects the airway and ability to breathe normally, causing more apneas during the night. At the same time, people with OSA wake up frequently at night and may then detect GERD symptoms. Lack of sleep from OSA may make the esophagus more susceptible to reflux.
In addition, factors like alcohol consumption, smoking, and obesity can increase risk for both GERD and OSA, so the correlation between the conditions may be a result of these factors.
While the exact relationship between GERD and OSA is subject to further research, it is clear that the conditions can occur together and create significant complications for a persons sleep, comfort, and overall health.
How To Cure Heartburn Four Quick Fixes And Long
How to cure heartburn you ask? Well, theres no easy answer to that question.
If youve been struggling with acid reflux for any length of time, then you know there isnt a quick fix to this disease as a whole. GERD has many symptoms, one of which is heartburn. At the crux of this disease is the lower oesophageal sphincter . Located at the junction of the oesophagus and the stomach, the LES can weaken and no longer function as an effective barrier, allowing the acidic contents of the stomach to back-flow up into the oesophagus. When this happens, heartburn often follows. This weakening of the LES is progressive, so the more often you reflux, the more frequent the episodes become.
Learn more: GERD explained: The role of the LES
Medications can help relieve acid reflux symptoms by making the contents of the stomach less acidic however, they dont stop reflux from happening. Thats why managing GERD requires commitment and diligence: Watching what and how you eat and making lifestyle choices aimed at minimizing reflux can reduce your symptoms AND help stop the progression of the condition.
But sometimes, despite your best efforts to manage your GERD, heartburn strikes and you need relief . So though we cant provide a definite answer to how to cure heartburn? We can offer four quick fixes to help you cool the burn.
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Why Exactly Does Pregnancy Cause Heartburn
Heartburn during pregnancy will plague most moms-to-be at some point because progesterone, the hormone that relaxes muscles in pregnancy, also relaxes the stomach valve that keeps acid out of the esophagus. In addition, the growing uterus crowds the stomach, forcing acid into the esophagus.
But there are safe, effective ways to stop it. “Pregnant women really don’t need to suffer with heartburn anymore,” says Adrienne Einarson, RN, assistant director of clinical services at Motherisk, a Toronto-based program that investigates the effects of prenatal exposures on maternal and fetal health. Here, experts recommend 12 different ways to soothe heartburn during pregnancy.
Natural Remedy: Use Baking Soda
You may find relief from infrequent heartburn with sodium bicarbonate, otherwise known as baking soda. Simply mix ½ teaspoon with four ounces of water to help neutralize the acid. Note this contains sodium and should not be used if you are on a sodium-restricted diet. Check with your doctor if you are taking any prescriptions drugs, are pregnant or have a chronic health condition before using baking soda to relieve heartburn.
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How Acid Reflux Affects Your Sleep
So what’s the connection between acid reflux and sleep? As I can attest, heartburn is usually worse at night, and that can make falling asleep more difficult. “Most people are prone to acid reflux when they lie down,” says Scott Huber, MD, gastroenterologist at the Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore. When you’re lying down, you don’t have gravity to pull acid back down into your stomach the way you do when you’re sitting or standing up, Huber explains.
According to an American Journal of Gastroenterology survey of 1,000 people with heartburn at least once a week, 79% of respondents said they experience heartburn at night. Three-quarters of nighttime heartburn sufferers said heartburn affected their sleep, while 63% said they believed heartburn negatively impacted their ability to sleep well, and 40% said they believed it made it harder to function the next day. Per the National Sleep Foundation, if you have acid reflux, you could very well wake up in the middle of the night with heartburnand you might even experience middle-of-the-night choking or coughing, depending on how far up your esophagus the acid travels.
How Do You Get Rid Of Heartburn
Studies show that reducing overall body weight has a positive impact on reducing heartburn symptoms. Eating a diet full of fiber, protein, healthy fats, and vegetables can help lower your overall body mass. Exercising regularly, even just taking a walk around your neighborhood, can also help you lower body weight, and help you sleep . Cutting back on smoking, caffeine intake, and alcohol consumption significantly reduces heartburn attacks and also promotes better sleep.
Antacids, an over-the-counter medication, can manage mild heartburn symptoms by neutralizing the acid in your stomach. They are effective in reducing symptoms but require frequent administering and should not be taken longer than a few days.
Check with your doctor before starting any medication. If over-the-counter medication does not help, your doctor may be able to prescribe additional medication.
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Sleep With Your Head And Shoulder On An Incline
Lying down flat presses the stomach’s contents against the LES. With the head higher than the stomach, gravity helps reduce this pressure and keeps stomach contents where they belongin the stomach. You can elevate your head in a couple of ways. You can place bricks, blocks or anything that’s sturdy securely under the legs at the head of your bed. You can also use a wedge-shaped pillow to elevate your head.
Know Your Medication Side Effects
Certain medications may contribute to GERD. Some common ones include:
- anticholinergics, which treat, among other conditions, overactive bladder and chronic obstructive pulmonary disorder
- tricyclic antidepressants
- nonsteroidal anti-inflammatory drugs , such as ibuprofen
If these or other medications are causing acid reflux or other symptoms, tell your doctor. Alternative treatments may be available.
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What Helps Heartburn Fast At Night
These tips can quickly help relieve nighttime heartburn.
22. Prop yourself up in bed
Keeping yourself upright in bed can help take some pressure off your stomach and valve and relieve symptoms.
23. Try baking soda and water
Baking soda can help neutralize acid. Try drinking a half teaspoon of baking soda dissolved in 4 ounces of warm water.
24. Take antacids
You can buy antacids from your pharmacy. These work by changing your stomach acid that causes heartburn.
25. Try over-the-counter histamine-2 blockers
Histamine-2 blockers help heartburn by changing how much acid your stomach makes. These can relieve symptoms for a few hours.
26. Try OTC proton pump inhibitors
You can try these medications from your pharmacy if nothing else is working. These should only be taken for 14 days at a time and only 3 times a year.
27. Take prescription medications
If nothing helps your heartburn, talk to your doctor. They can give you stronger prescription medications.
Sometimes surgery on your esophagus sphincter can help heartburn that doesnt get better with treatment. Talk to your doctor about ongoing heartburn.
What Causes This Burning Sensation
When you eat, food passes down your throat and through your esophagus to your stomach. A muscle controls the opening between the esophagus and the stomach. It remains tightly closed except when you swallow food.
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 .
About one in 10 adults has heartburn at least once a week, and 1 in 3 have it every month, says Dr. Gabbard. About 10 to 20% of adults have chronic heartburn.
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Instead Sleep On Your Left
You may have heard that sleeping flat on your left side provides heartburn relief, which is true. In this position, your LES typically stays above sea level or above the level of gastric contents, making refluxing more difficult. Should stomach acid escape, gravity is able to return it to your stomach quicker than when youre on your right side 6-7.
Whats more, reflux on your left side tends to be more gaseous in nature4, which decreases potential damage from acid exposure. Because symptoms tend to be milder and less frequent when lying on your left side compared to on your right side or on your back, lying on your left is considered the optimal flat position for sleeping with acid reflux and other gastrointestinal disorders, like GERD.
Try Sleeping On Your Left Side
Gastroesophageal reflux disease occurs when the upper portion of the digestive tract is not functioning properly, causing stomach contents to flow back into the esophagus. The esophagus is a muscular tube linking the mouth to the stomach. In normal digestion, a specialized ring of muscle at the bottom of the esophagus called the lower esophageal sphincter opens to allow food to pass into the stomach and then quickly closes to prevent backflow into the esophagus. The LES can malfunction, allowing contents from the stomach, including food and digestive juices, such as hydrochloric acid, to push up into the esophagus. In GERD, this backflow is ongoing.
When you are standing, or sitting upright, gravity helps prevent stomach contents from rising up into the esophagus. However, reflux can become much worse while you are sleeping or lying in bed without the aid of gravity, it is much easier for stomach contents to spill through the malfunctioning LES and flow into the esophagus. This leads to an increase in symptoms, such as a burning in the chest, the feeling of food or liquid rising into the mouth, a sour or bitter taste, a sore throat, and coughing, which can make getting a good nights sleep a difficult task.
First published in the Inside Tract® newsletter issue 201 2017
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Take An Acid Neutralizer
When heartburn hits and you need relief, try an antacid like Tums, Rolaids, or Maalox. These medications act quickly to neutralize the acid in the stomach, which can reduce your symptoms. Dont have any on hand? Dissolve a teaspoon of baking soda in eight ounces of water and drink to neutralize the acid in your stomach. Just use caution with this home remedy since its high in sodium and shouldnt be used by people on a sodium-restricted diet.
We also like H-2 blockers, also known as Histamine H2-receptor antagonists. These include such brand names a Pepcid, Pepcid AC, Tagamet, and Zantac. These medications dont work as quickly as acid neutralizers, but they are still very fast. H2 blockers should be taken about 30 minutes before you eat or when you typically experience symptoms.
The benefit of H2 blockers is that they work longer than antacids, but they dont have the same medical risks associated with proton pump inhibitors. As is true with all medications we highly recommend that you discuss use with your doctor before you begin any drug treatment, prescription or over-the-counter.
And remember that while these quick fixes may help relieve your GERD symptoms, they dont address the underlying cause of those symptoms. Your goal should be to stop reflux from happening in the first place, which is why we recommend several long-term solutions to cure heartburn.