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What to Do About Very Bad Acid Reflux at Night?

Acid reflux is a condition characterized by the regurgitation of food particles and digestive juices from the stomach back into the esophagus, which connects the stomach to the throat. It is a main component of the condition called gastroesophageal reflux disease (GERD). In some individuals, acid reflux and GERD are particularly severe at night. A number of options are available to ease the discomfort of nighttime reflux.

  1. Additional Symptoms of GERD

    • According to the Mayo Clinic, your acid reflux symptoms may be accompanied by other signs of GERD, including a burning sensation in your chest (heartburn), sore throat or hoarseness, swallowing difficulties, chest pain, a dry cough and a feeling similar to having a lump in your throat. If your nighttime reflux symptoms are severe, see your doctor for a full diagnosis.

    Over-the-Counter Medications

    • Your doctor will likely begin treating your reflux by recommending a combination of over-the-counter medications and certain lifestyle modifications. To help neutralize your stomach acid, she may suggest an antacid product such as Tums, Rolaids or Mylanta. To help reduce your acid production, she may suggest a group of medicines called H-2-receptor blockers. Common examples here include famotidine (Pepcid AC), ranitidine (Zantac 75) and cimetidine (Tagamet HB). To help block acid production more completely, she may suggest a group of medications called proton pump inhibitors. Commonly available examples include omeprazole (Prilosec OTC) and lansoprazole (Prevacid 24 HR).

    Lifestyle Modifications

    • A number of simple lifestyle changes will reinforce the effects of medication. First, do not eat within three hours of your bedtime. This will give your body time to properly digest any food before you sleep. Avoid wearing tight clothing at night. Use gravity to your benefit by placing wooden blocks six to eight inches tall securely under the bedposts at the head of your bed. This elevation will make it much more difficult for acidic stomach contents to reach your esophagus. While you might try to mimic this approach by propping yourself up in bed with a bunch of pillows, this solution is not typically effective.

      There are a number of additional lifestyle modifications that will help ease your overall reflux symptoms. If you are overweight, shedding extra pounds will tend to decrease reflux. If you smoke, quitting will also help. If you know that certain foods or drinks worsen your reflux, avoid them whenever possible. You can also ease your symptoms by eating smaller amounts of food at any single meal.

    Prescription Medications and Surgery

    • If over-the-counter medications and lifestyle changes are not sufficient to relieve your nighttime acid reflux, your doctor may also choose to use prescription medications. In addition to prescription-strength H-2-receptor blockers and proton pump inhibitors, he may prescribe a class of medications called prokinetic agents, which work by tightening the muscular sphincter that normally keeps food from re-entering your esophagus. In more extreme cases, your doctor may recommend surgery to tighten this sphincter or create a barrier to stop reflux from occurring. Consult your doctor or surgeon to learn the details of these procedures.

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