How to Treat Nighttime Acid Reflux

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Acid reflux often stirs at nighttime, but adjusting the angle of your bed and lengthening the interval between dinnertime and bedtime can help. Learn helpful nighttime strategies in this free video on living with acid reflux.

Part of the Video Series: Living with Acid Reflux
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Video Transcript

Hi, I'm Dr. David Hill, and today we're going to talk about treating night time acid reflux. Now, acid reflux is a condition where acid from the stomach, and often gastric contents, like what you just ate, come back up into the esophagus. Supposed to be a one way valve, they're not supposed to come back up. But, in many people they do, due to a variety of factors. Obesity may play a role, smoking cigarettes plays a major role, the use of alcohol or caffeine can contribute, eating greasy foods or fatty foods, or just eating a meal that's too large can contribute. Now, a lot of people get their reflux at night. Why is that? Well, when we lie down, we don't have gravity working for us. All of a sudden, we're flat, and the gravity that might be holding gastric contents where they belong, isn't helping us keep those things there, and they come up into the esophagus. Now, there are a few things we can do. The most obvious are to cut out the things that make reflux worse. Again, the fatty meals, large meals, alcohol, caffeine, cigarettes. You want to lose weight if you happen to be overweight. But, another thing that you can do is eat a little bit earlier. You'd like to see, ideally, three hours between the time that you finish your meal, and the time that you lie down to go to bed. Now, how you lie down also makes a difference. Ideally, you'd elevate the head of your bed if you can do so safely using cinder blocks, or bricks, or some sort of other wooden block. You could put something under the mattress to elevate the mattress as well. When you lie down, you want to lie on your left side. We have a fancy term for this, is the left lateral left lateral decubitus position, but what it means is your left shoulder's against the mattress. It's just that simple. That creates an angle that makes it a little less likely for stomach acid to come up into your esophagus. Now, medications can also be very useful. The most simple, and short term medications, are the antacids like Tums, Maalox, and Mylanta, they just neutralize the stomach acid in your stomach. A more medium term solution are called H2 antagonists. Why that? These are antihistamines, but they work against the histamine receptor type two, instead of the histamine receptor type ones that fight allergies. Those medicines are Ranitidine, Zantac. There's Pepcid AC, these all end in -idine: Nizantidine, Ranitidine, etcetera. You can find most of them. Cimetidine is another one. Find most of those over the counter at your pharmacy. Now, for longterm control, and for the most potent control, you can use a class of medications called proton pump inhibitors. The most widely available of these is the over the counter Omeprazole, or Prilosec. This is a highly effective medication. But, if you find that you're needing to treat reflux in any way for more than about two weeks, do seek care from a doctor. Chronic reflux can be very dangerous. It can cause scarring of the esophagus. It can even lead to esophageal cancer. So, this is not something that you want to sit on for weeks or months on end without having adequately controlled. It can be very challenging to get it under good control, and sometimes you need the help of a gastroenterologist, a stomach and intestines specialist, to make sure that everything is working, and that you're not at risk of significant complications. Talking about treating night time gastroesophageal reflux, I'm Dr. David Hill.


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