Dear Alice,

I'm having this problem called gastric reflux. That is, when I lie down to go to sleep at night, the fluid in my stomach tends to flow back into my lower throat region. Because the fluid is very acidic, my throat is always feeling sore, and I can't speak loudly or for long because of this. This is really annoying. The doctor told me not to eat within two to three hours before going to bed, so I gave up the habit of eating snacks before bed. I eat my dinner at eight and go to bed at twelve, which seems to be a long enough time. But it didn't help. I tried everything. For some days I jogged before sleeping, in the hope that it will 'shake the food deeper down'. And I tried using a high pillow too. It helped a bit but the posture is very uncomfortable and I often slip down when asleep. The problem has existed for months. What should I do?

— Signed, The cow

Dear The cow,

It sounds like you are all too familiar with the signs and symptoms of gastric reflux (also known as Gastro Esophageal Reflux Disease or GERD). GERD is a condition in which stomach acid flows back (reflux) up into your throat (via the esophagus) and can cause horrible heartburn. The constant acid reflux can irritate the lining of your esophagus causing inflammation. This irritation can lead to narrowing of the esophagus (causing a person to have difficulty swallowing), ulcers, and even a slightly increased risk of esophageal cancer.

You're already

doing lots of good things to help decrease the acid reflux (like avoiding large meals before bed, allowing a few hours to digest after eating before lying down, and propping up your upper body to have gravity help keep the acid down while you sleep). Here are some more ideas for you to consider:

  • Instead of using a high pillow, try propping up your whole bed with a couple of cinder blocks under the posts at the head of your bed.
  • Avoiding tight fitting pants and bending over for extended periods after eating can reduce the pressure on your stomach.
  • If you're overweight, losing five to ten percent of your body weight could tremendously decrease the symptoms of GERD.
  • If you're a smoker, quitting smoking can help.
  • Certain foods (like fatty foods, spicy foods, chocolate, caffeine, onions, tomato sauce, carbonated beverages, alcohol, and peppermint/wintergreen flavorings) can make the reflux worse, so identifying which foods bother you and avoiding them may help.
  • You may try eating smaller meals more frequently (like six smaller meals as opposed to three larger meals in a day).
  • Over-the-counter medicines may help:
    • Antacids (like Maalox, Mylanta, Rolaids, or Tums) can neutralize stomach acid to provide some quick relief.
    • H2-receptor blockers (like Tagamet, Pepcid, Axid, or Zantac) can reduce the production of stomach acid. These medicines don't work as fast as the antacids, but they tend to provide longer relief.
    • Proton pump inhibitors (like Prilosec or Prevacid) can block acid production and allow time for the damaged esophageal tissue to heal, but Prilosec is meant for short-term use only (unless a doctor prescribes it for long-term use).

There are stronger prescription medications and less-invasive surgical procedures your health care provider could give you that could really help reduce the discomfort associated with GERD, so you may want to consider seeing your health care provider if you have:

  • Heartburn several times a week.
  • Heartburn that returns soon after the antacid medicine wears off.
  • Heartburn that wakes you up at night.
  • Difficulty swallowing.
  • Regurgitated blood.
  • Stool that is black (black in your poop means you're bleeding somewhere in your digestive tract).
  • Symptoms that persist even though you're taking prescription medications.

Hopefully some of these suggestions help you find relief!


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