VERIFIED CONTENTAuthor: Aleksandra Żyłowska-Mharrab, dietitian, food technologist, educator

Most people have had heartburn at least once in their lifetime. The statistics can really surprise you. 1 in 10 adults has heartburn at least once a week. 1 in 3 - each month, and 10-20% suffer from chronic heartburn. Burning sensation in the esophagus, a sour taste in the mouth, sometimes pain in the breastbone radiating to the throat, nausea and belching. Heartburn can be a symptom of a variety of gastrointestinal diseases, but it is usually caused by lifestyle. It is often a symptom of gastroesophageal reflux.

Yes, heartburn and acid reflux are not the same. Reflux is a digestive disorder with weakness in the esophageal sphincter and the reflux of acid from the stomach into the esophagus, and heartburn is a subjective burning sensation. Reflux may or may not be heartburn. And heartburn may be a sign of a problem other than acid reflux.

Many people experience heartburn in the evening before bedtime and at night. It can only occur then or increase at night. Night heartburn is experienced by 4 out of 5 people who struggle with heartburn or acid reflux on a daily basis.

Where does heartburn at night come from?

There may be several causes of heartburn at night. Heartburn at night can be caused by something as prosaic as eating too late before bedtime, but its sources can also be found in lifestyle, diseases, medications and … too tight pants. Yes, tight-fitting clothes, slimming underwear, or stiff jeans sticking to the stomach increase abdominal pressure and are one of the causes of heartburn.

Nighttime heartburn does not come from any other cause than daytime heartburn, but it is more troublesome at night because you are lying down. The stomach and esophagus are at the same level, and the contents of the stomach flow more easily into the esophagus than in a sitting position. While lying in bed, you cannot count on the help of gravity, which pulls the stomach contents down despite the pressure in the abdominal cavity.

Heartburn and weakened esophageal sphincter

The immediate cause of heartburn in many cases is a non-closing esophageal sphincter. But it is not a cause in itself. The following factors are responsible for the weakening of the esophageal sphincter:

  • smoking,
  • alcohol abuse,
  • chronic stress (in recent years it is an increasingly common cause of nighttime heartburn, often underestimated and difficult to diagnose),
  • drugs with the side effect of relaxing the esophageal sphincter, incl. bronchodilators, antidiabetic drugs, antidepressants, scopolamine, antispasmodics, drugs for Parkinson's disease, hormonal contraception, and some painkillers, such as the popular ibuprofen.

Heartburn in a hiatal hernia

A hiatal hernia can lead to heartburn as it causes the stomach and lower esophageal sphincter to travel above the diaphragm, making it easier for stomach fluids to travel up into the esophagus.

Heartburn caused by inadequate diet

The link between heartburn and diet seems obvious. After all, it's all about the digestive tract. Certain foods cause heartburn in so many people that they can be considered nutritional triggers of heartburn. Foods that promote heartburn at night include:

  • tomatoes, tomato sauce, ketchup,
  • citrus,
  • spicy spices and spicy dishes,
  • onion and garlic,
  • milk and dairy products,
  • foods rich in fat, e.g. crisps, fried fries, fried red meat,
  • fast food,
  • mint (the use of mint teas for heartburn can be deceptive. Mint is associated with a refreshing, menthol aftertaste and may seem to relieve heartburn, quite the opposite),
  • chocolate,
  • sparkling water and carbonated drinks,
  • coffee and tea.

It is worth knowing that heartburn can also be caused by products that cause food allergies and intolerances.

  • Food allergy or food intolerance? Learn the differences

Heartburn caused by eating too late

Eating large meals too late without having enough time to digest it often results in nighttime heartburn. It takes at least 2-3 hours for a meal to completely empty the stomach. This is the minimum time that should be allowed from eating until going to bed. Otherwise, large amounts of food and digestive juices are still found in the stomach. In the supine position, it is easier to retract them into the esophagus and induce a feeling of heartburn. Lying down right after a meal, regardless of its time, is also not the best idea. The sitting or standing position by gravity helps the stomach contents slide downwards. In the supine or even semi-recumbent position, the stomach contents have a greater chance of regressing, especially atweakened esophageal sphincter.

Heartburn and obesity

Excess body weight puts more pressure on the abdominal cavity. This can increase the risk of heartburn at night. Overweight and obese people are more likely to develop heartburn, especially if they are dealing with abdominal obesity.

Pregnant heartburn

The occurrence of night heartburn in pregnancy affects up to 45% of pregnant women. This is due to several factors - the decreasing space for organs inside the abdominal cavity, sometimes too much weight gain, often stress. During this period, heartburn is also associated with a change in the hormones produced by the body. During pregnancy, the secretion of progesterone increases, which relaxes the muscles of the digestive tract, including the esophageal sphincter. For this reason, stomach contents enter the esophagus more easily when lying down.

How to deal with heartburn at night?

To get rid of heartburn at night, it's best to eliminate its cause - do not eat before going to bed, avoid heartburn-causing foods, quit smoking (in smokers who have quit their heartburn can be reduced by up to 44!), Reduce alcohol … However, not in every life situation it is possible to influence the cause of problems with the esophagus that burns at night. There are some medications that cannot be stopped. Making your life less stressful is often a long process. You must report your pregnancy so that your heartburn is over.

So how to deal with heartburn at night, when its immediate cause cannot be eliminated or it is difficult to determine?

  • Sleep on your left side. Sleeping on your left side can improve the flow of acid and other contents from the esophagus to your stomach.
  • Sleep with your head and chest slightly above the stomach. In the supine position, the stomach and esophagus are at the same level, which facilitates the flow of acidic gastric contents into the esophagus.
  • Keep a food diary. Make a careful note of everything you eat and when heartburn occurs. If food is the cause of heartburn, with a little diligence and patience, you will be able to spot the non-obvious foods causing it.
  • Wear loose-fitting clothes. If you do not know what is causing your night heartburn or you cannot eliminate its cause, avoid tight clothes in the afternoon and evening, which additionally increase the pressure in the abdominal cavity and aggravate heartburn.
  • Eat in peace. Eating meals quickly and under stress increases the secretion of acidic gastric juices.
  • Stay upright after eating. Let gravity work. Also, avoid bending or stretching while lifting heavy objects.
ExpertAleksandra Żyłowska-Mharrab, dietician Food technologist, dietitian, educator. A graduate of Biotechnology at the Gdańsk University of Technology and Nutritional Services at the Maritime University. A supporter of simple, he althy cuisine and conscious choices in everyday nutrition. My main interests include building permanent changes in eating habits and individually composing a diet according to the body's needs. Because the same thing is not he althy for everyone! I believe that nutritional education is very important, both for children and adults. I focus my activities on spreading knowledge about nutrition, analyze new research results, and make my own conclusions. I adhere to the principle that a diet is a lifestyle, not strict adherence to meals on a sheet of paper. There is always room for delicious pleasures in he althy and conscious eating.

Category:

Gastrology