Nighttime heartburn can significantly affect sleep, work performance, and quality of life. Nighttime heartburn can cause more damage to the esophagus than daytime heartburn and increase the risk of developing other serious conditions, including cancer of the esophagus.
During the day, when your body is upright, gravity can help direct stomach acids from the esophagus back into the stomach. However, at night, heartburn symptoms often worsen because gravity can no longer direct stomach acids from the esophagus back into the stomach while you're lying down. In addition, swallowing and saliva help control acid reflux. Since swallowing occurs less often while sleeping, reflux at night may lead to irritation and inflammation in the esophagus.
According to recent research, more than eighty percent of GERD (gastroesophageal reflux disease) patients experience heartburn at night. One study published in the journal Chest found that nighttime heartburn was significantly associated with drinking carbonated soft drinks, insomnia, obesity, using benzodiazepine sleeping pills, hypertension, and asthma. "Overall, heartburn during sleep may be associated with sleep complaints and excessive daytime sleepiness," the study authors conclude.
Lifestyle changes that can minimize GERD symptoms include: avoid medications that can worsen heartburn (such as aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs), avoid lying down within 3 hours of eating, avoid eating food for 2-3 hours before bedtime, maintain a healthy weight and stop smoking. In addition, supplementation with essential nutrients including licorice extract, digestive aids, and green tea extract can help prevent heartburn.
Over-the-counter (OTC) medications such as antacids, H2 blockers (Tagamet), and proton pump inhibitors (Prilosec OTC) can help relieve GERD symptoms. These drugs are also available in higher doses by prescription. If medications don't relieve symptoms, or if symptoms get worse or persist, non-surgical or surgical procedures may be necessary. The Stretta Procedure is a minimally invasive, non-surgical procedure performed with an endoscope (a thin tube directed into the esophagus). However, individual outcomes may vary and there is a potential for serious complications. If all treatments have failed or if esophageal cancer develops from chronic GERD, surgeries such laparoscopic antireflux surgery (minimally invasive surgery), laparotomy (abdominal surgery) or thoracotomy (chest surgery) may be indicated. Unfortunately, experts are not certain if these procedures will lead to a permanent cure
REFERENCES:
1. Fass R et al. Predictors of heartburn during sleep in a large prospective cohort study. CHEST 2005 May;127(5):1658-66.
2. Chand et al. Sleep dysfunction in patients with gastro-oesophageal reflux disease: prevalence and response to GERD therapy, a pilot study.
Aliment Pharmacol Ther 2004 Nov 1;20(9):969-74.
3. Life Extension eds., Disease Prevention and Treatment, 4th ed. (Hollywood, Florida: Life Extension Media, 2003), Gastroesophageal Reflux Disease, online: http://search.lef.org/LEFCMS/aspx/PrintVersionMagic.aspx?CmsID=113668
4. Treating Heartburn with Surgery. WebMD:
http://www.webmd.com/content/article/45/1815_50341?Printing=true
5. The Stretta procedure to Treat GERD, WebMD:
http://www.webmd.com/content/article/75/89791htm?Printing=true
6. Nighttime Symptom Control, WebMD:
http://www.webmd.com/content/pages/17/100333.htm?Printing=true
Posted by Elaine Gavalas on June 14, 2006 02:26 PM
