What causes heartburn at night? How can you relieve heartburn at night? Get answers to these questions and more in our comprehensive guide.

Understanding Heartburn at Night

Heartburn at night is a common problem that can disrupt sleep and cause discomfort. It occurs when stomach acid flows back into the esophagus, leading to a burning sensation in the chest or throat. Several factors can contribute to heartburn at night, including the foods you eat, your sleep position, and certain medical conditions.

Causes of Nighttime Heartburn

Heartburn at night can be caused by a variety of factors, including:

• Eating too close to bedtime: Consuming large meals or certain foods right before bed can increase the risk of heartburn, as the stomach is still actively digesting when you lie down.
• Gastroesophageal reflux disease (GERD): GERD is a chronic condition that causes the contents of the stomach to frequently flow back into the esophagus, leading to persistent heartburn.
• Pregnancy: Hormonal changes and increased pressure on the stomach during pregnancy can contribute to heartburn, especially at night.
• Certain medications: Some prescription drugs, such as pain relievers, antidepressants, and blood pressure medications, can relax the esophageal sphincter and increase the risk of reflux.
• Obesity: Extra weight can put pressure on the abdomen and make it easier for stomach contents to flow back into the esophagus.
• Dietary triggers: Spicy, fatty, or acidic foods, as well as alcohol and caffeine, can all aggravate heartburn symptoms.

Treating Nighttime Heartburn

There are several strategies you can try to relieve heartburn at night:

Over-the-Counter Medications

Over-the-counter antacids, like Tums or Rolaids, can help neutralize stomach acid and provide quick relief. Acid-reducing medications, such as H2 blockers (e.g., Pepcid) or proton pump inhibitors (e.g., Prilosec), can also be effective in reducing acid production.

Home Remedies

Some simple home remedies can help alleviate nighttime heartburn, including:

• Sleeping on your left side: This position can help prevent stomach acid from flowing back into the esophagus.
• Elevating the head of your bed: Using a wedge pillow or raising the head of your bed can help keep stomach acid down.
• Avoiding large, heavy meals close to bedtime: Eat smaller, lighter meals earlier in the evening to give your body more time to digest before lying down.
• Limiting trigger foods: Avoid spicy, fatty, or acidic foods, as well as alcohol and caffeine, which can all worsen heartburn.

When to See a Doctor

If home remedies and over-the-counter medications don’t provide relief, or if you experience persistent or severe heartburn, it’s important to see a healthcare provider. They can help diagnose the underlying cause and recommend more effective treatment options, including prescription medications or lifestyle changes.

Preventing Nighttime Heartburn

To prevent heartburn at night, try these tips:

1. Eat smaller, more frequent meals throughout the day instead of large, heavy meals.
2. Avoid lying down for at least 2-3 hours after eating.
3. Limit your intake of trigger foods, such as spicy, fatty, or acidic items.
4. Maintain a healthy weight and exercise regularly to reduce pressure on your stomach.
5. Quit smoking and limit alcohol consumption, as these can weaken the esophageal sphincter.
6. Wear loose-fitting clothing to avoid putting extra pressure on your abdomen.
7. Elevate the head of your bed or use a wedge pillow to keep your upper body elevated during sleep.

Seeking Medical Attention

If heartburn at night persists despite lifestyle changes and over-the-counter remedies, it’s important to see a healthcare provider. They can evaluate your symptoms, diagnose any underlying conditions, and recommend more effective treatments, such as prescription medications or surgical interventions in severe cases. Don’t hesitate to seek medical attention if your heartburn is severe, frequent, or interfering with your daily life.

Heartburn at night: Causes and remedies

People who experience heartburn at night may find that it is painful and disrupts their sleep.

There are a few common causes of heartburn at night, which include consuming particular foods, eating too close to bedtime, and taking certain prescription medications.

Heartburn at night or worsening heartburn symptoms may be a sign of gastroesophageal reflux disease (GERD).

Many simple home remedies can help ease the symptoms while a person works with a doctor to find a more permanent solution.

In this article, learn about the possible causes of heartburn at night, as well as how to treat them.

Heartburn occurs as a result of food and acid leaking from the stomach up into the food pipe, or esophagus. Experiencing heartburn at night may mean that a person ate too soon before going to bed.

As a person swallows their food, it passes through the esophagus and into the stomach through a band of muscle called the esophageal sphincter. The esophageal sphincter acts as a valve to the stomach, keeping food from moving back into the esophagus.

Sometimes, the esophageal sphincter may fail to close completely, allowing acid and food to leak from the stomach up into the esophagus. When this occurs, it causes the burning sensation that people call heartburn.

Heartburn at night can occur as the person lies down to sleep or while they are sleeping.

When someone eats while either sitting or standing, the force of gravity helps keep acid and food inside the stomach during digestion, making symptoms less likely.

However, when the person lies down, their position can make it easier for the stomach contents to leak back up through the esophageal sphincter.

Several other risk factors contribute to heartburn at night, including:

• dietary triggers, such as spicy food
• having obesity
• high stress levels
• smoking or drinking alcohol
• wearing tight fitting clothing
• eating very large meals
• eating too close to bedtime

It is common for women to experience heartburn during pregnancy, even if they did not frequently experience it before becoming pregnant.

Research from 2015 notes that 17–45% of women experience heartburn during pregnancy. It can occur for many reasons, including the added pressure inside the body, weight gain, and changes in hormones and stress levels.

Most of the time, dietary and lifestyle changes can help control heartburn symptoms.

However, if home remedies prove ineffective for pregnant women, or they cannot take certain medications, they should speak to a doctor about other options.

Many home remedies and nonprescription medications may help people deal with heartburn at night.

Over-the-counter medications

Over-the-counter (OTC) medications, such as antacids or acid reducers, may help treat occasional digestive upsets and heartburn.

Antacids

Antacids work by neutralizing the acid in the stomach, providing relief from symptoms. There are a few different OTC antacids to choose from, including:

• calcium carbonate (Tums)
• magnesium hydroxide (Milk of Magnesia)
• sodium bicarbonate (baking soda, Alka-Seltzer)
• bismuth subsalicylate (Pepto-Bismol)

Acid reducers

Acid reducers work to decrease the production of acid in the stomach. There are two main types of acid reducers: proton pump inhibitors (PPIs) and histamine antagonists (h3 antagonists).

A few different OTC acid reducers are available, including:

• famotidine (Pepcid AC)
• omeprazole (Prilosec OTC)
• esomeprazole (Nexium 24HR)

Similar medications may be available with a doctor’s prescription.

These OTC medications can help relieve heartburn, but they are not long-term solutions. Anyone using OTC medications for heartburn relief should talk to a doctor if the symptoms last for more than 2 weeks.

Home remedies

If heartburn at night is becoming a regular issue, it is best to see a doctor for a diagnosis and to discuss long-term treatment options.

Some home remedies can relieve symptoms in the meantime. These include:

Sleeping on the left side of the body

People may notice that their symptoms get better if they sleep on their left side. Some believe that this helps relieve pressure on the stomach, making it less likely that stomach acid will leak into the esophagus.

Elevating the head and chest

For people who sleep on their back, heartburn may occur if stomach acid leaks from the stomach back into the esophagus as they lie down.

In these cases, the person can try to reduce their symptoms by using gravity and elevating the head and chest higher than the lower abdomen.

Specially designed wedge pillows are one way to keep the upper body more upright during the night. Alternatively, a person can try raising the upper half of the bed slightly. Safely placing cinder blocks, bricks, or wood beams under the head of the bed can help.

The National Institute of Diabetes and Digestive and Kidney Diseases note that simply placing extra pillows under the head will not help. The goal is to raise the entire upper abdomen to allow the force of gravity to keep stomach acid down.

Losing weight

Excess weight puts more pressure on the abdomen and can increase the risk of heartburn.

Losing weight, if necessary, may help relieve symptoms. Pregnant women should not usually try to lose weight, however, so they should speak to a doctor about other options.

Avoiding tight clothing

Sometimes, wearing tight, restrictive clothing puts pressure on the abdomen, making heartburn more likely.

People may find it beneficial to wear loose fitting pajamas to bed rather than restrictive clothing, such as bras, compression shirts, or items with tight waistbands.

Avoiding late night snacking

Eating too late in the night may also cause symptoms to flare up. It takes time for foods to pass through the stomach and further into the digestive system after eating.

People who eat closer to bedtime and experience heartburn may wish to try ending their last meal at least 2–3 hours before they go to bed.

Eating smaller meals

Eating a large or high fat meal in the evening may mean that the body is still trying to digest the food by bedtime.

Switching to smaller or lighter meals later in the day may help reduce the risk of heartburn in some people.

The authors of a 2014 study recommend that people eat no fewer than three meals each day but aim for four or five. They reason that people who eat more frequently will have smaller meals.

Avoiding trigger foods

Some foods may be more likely than others to trigger heartburn. Common food triggers for heartburn include:

• tomatoes and tomato products, such as pasta sauce and ketchup
• citrus fruits, including oranges and lemons
• spicy foods
• greasy foods
• peppermint
• chocolate
• alcohol
• carbonated beverages, such as soda or sparkling water
• coffee, tea, or other caffeinated beverages

Keeping a food journal and noting which foods cause heartburn can help people eliminate problematic foods from their diet or avoid eating them in the evening.

Quitting smoking

Smoking may contribute to heartburn. Smoking irritates the esophagus, and it may also relax the esophageal sphincter and increase stomach acid.

Smoking can also cause forceful coughing, which may aggravate heartburn in some cases.

Checking medication side effects

Heartburn is a common side effect of many different medications. If a person starts getting heartburn at night soon after they begin taking a new medication, the drug could be the cause.

Anyone who suspects that their symptoms are a side effect of a medication should talk to their doctor. It is essential not to stop taking any medication without consulting a doctor first.

Experiencing heartburn at night is common, especially if a person eats too late in the evening.

People can treat occasional bouts of heartburn by using OTC antacids or making simple lifestyle changes.

Anyone who regularly experiences heartburn at night or notices the symptoms getting worse over time should see a doctor. The doctor can help identify any underlying conditions, such as GERD.

The Reason Your Heartburn is Worse at Night

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Whether after eating food with tomato sauce or wearing tight pants, you dread that unpleasant burning sensation in your chest. If you’re suffering from heartburn, you’re not alone. According to the American College of Gastroenterology, more than 60 million Americans have heartburn at least once a month, and 15 million experience it every day. Elderly people and pregnant women are more likely to experience symptoms of heartburn.

Heartburn, or acid reflux (gastroesophageal reflux), occurs when liquids in the stomach flow back into the esophagus. This happens when the lower esophageal sphincter (LES), the muscle between the esophagus and the stomach, relaxes. During eating, the LES relaxes to let food into the stomach and contracts to prevent backflow into the esophagus. Even in people who don’t experience acid reflux, stomach acid may travel into the esophagus for brief periods without symptoms.

Why Do You Get Reflux More at Night?

You may experience more reflux at night than during the day. The reason for this is gravity. When you sit or stand, gravity helps move the food through your esophagus and into the stomach. When you’re laying down, you lose the effect of gravity on the food traveling through your digestive system. Laying down also prevents gravity from keeping bile and acids from traveling up into the esophagus, causing heartburn. Because of this, many people find their heartburn is worse at night.

How to Reduce Nighttime Heartburn

• Lose Weight. People who are overweight (a BMI of 25 or above) are more likely to suffer from heartburn. If you have a BMI of 25 or above and you want to lose weight, our nutrition counseling services may be able to help.
• Stop Smoking. A study found that patients GERD improved by more than 40 percent after they stopped smoking. In the same study, the people who didn’t quit smoking saw a less than 20 percent improvement. Quitting smoking is one of the most important things you can do to improve GERD symptoms. It also improves your overall health.
• Change Your Eating Habits. For those suffering from chronic heartburn, smaller, less fatty meals may offer relief. Aim for less than 500 calories and 20 grams of fat. After eating, wait at least three hours before going to bed. It takes four to five hours for the stomach to fully digest a meal, and waiting three hours after eating will make you much more comfortable.
• Use Medications. Proton pump inhibitors are commonly prescribed to control acid reflux.
• Consider Food Sensitivities When Making Choices. During meal planning and preparation, keep your food sensitivities in mind. Avoid foods that can trigger digestive problems. These foods may include tomatoes, lemons, dairy products, or alcohol.
• Use a Body Pillow. A body pillow or other sleep positioning implement will keep you on your left side. Lying on your left side allows acids to pass through the lower esophageal sphincter into the stomach. Make sure your head is elevated, too, as this allows gravity to work.

If you have tried some or all of these suggestions, and you’re still experiencing symptoms of acid reflux, request an appointment today.

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90,000 reasons. What to do with heartburn and how to get rid of it

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Evtushenko-Sigaeva Maria Vyacheslavovna

Leading physician

Gastroenterologist

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Heartburn is a feeling of discomfort and burning in the upper abdomen (pit of the stomach) and in the chest (more precisely behind the sternum – along the esophagus). Heartburn is caused by acidic stomach contents entering the esophagus. For the stomach, an acidic environment is normal, it is a necessary component of the digestive process. But the esophagus is intended only for transporting food, and the ingress of acid from the stomach into it causes irritation of the mucous membrane.

Heartburn symptoms

Heartburn is often accompanied by belching and bloating (flatulence). There may be a feeling of nausea.
Heartburn appears, as a rule, after eating and can last for a considerable time – up to 2 hours or longer. Lying down and bending over can trigger or exacerbate heartburn.
In some cases, patients complain that heartburn makes swallowing difficult and interferes with sleep. In an asthmatic, heartburn can cause wheezing, coughing, and difficulty breathing.
Sometimes heartburn can be mistaken for a burning sensation in the chest caused by problems of the cardiovascular system (this is how angina pectoris can manifest itself). However, a burning sensation in the chest with angina pectoris usually occurs after exercise or stress and is not associated with food intake. In the case of angina pectoris, the burning sensation will pass if you take nitroglycerin, but nitroglycerin does not work on heartburn. If you managed to defeat heartburn with nitroglycerin, contact a cardiologist – you need to do an ECG and check the condition of the heart.

Causes of heartburn

Heartburn can occur even in a healthy person. As a direct cause of heartburn may be:

• overeating. With an excessive amount of food eaten, the stomach stretches, and the air that was in the lumen of the stomach enters the esophagus. Together with air, drops of gastric contents can also enter the esophagus;
• Too many citrus fruits eaten. Citrus juice further increases the acidity in the stomach, which leads to irritation of the mucous membrane;
• spices and spices. The gastric mucosa is adapted to dishes of a certain spiciness. Eating unexpectedly spicy foods (something exotic) is very likely to give you heartburn;
• coffee if you drink too much or make it too strong;
• carbonated drinks or foods that cause gas. The gases accumulated in the stomach will exit through the esophagus (belching), and at the same time drops of the contents of the stomach will cause irritation of the mucous membrane;
• Aerophagy, i.e. swallowed air. You can swallow air, for example, if you talk while eating;
• certain drugs;
• stress;
• lifting weights and bending over immediately after eating, which increases intra-abdominal pressure.

A number of factors favor the occurrence of heartburn . This:

• smoking. Tobacco smoke provokes the release of excess gastric juice, irritating the gastric mucosa;
• overweight (obesity). Obesity increases intra-abdominal pressure;
• pregnancy. In this case, intra-abdominal pressure rises due to the enlarged uterus;
• clothing too tight, constricting the abdominal cavity.

Recurrent heartburn is a symptom of many diseases of the gastrointestinal tract such as:

• reflux gastroesophageal disease;
• hiatal hernia;
• chronic gastritis with increased secretion;
• peptic ulcer of the stomach and duodenum;
• chronic pancreatitis;
• chronic cholecystitis;
• biliary dyskinesia;
• esophageal sphincter insufficiency;
• cancer of the stomach or pancreas.

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Heartburn: what to do?

With an attack of heartburn, doctors prescribe adsorbents, enveloping agents, drugs that reduce acidity. Baking soda is often used as a home remedy, but it is undesirable to use it as a regular remedy. Baking soda, although it neutralizes the acid, causes an increase in carbon dioxide when it enters the stomach, which creates increased pressure inside the stomach and can cause a second bout of heartburn.

If heartburn occurs from time to time, the presence of some chronic disease should be assumed. In this case, it is necessary to consult a gastroenterologist and undergo an examination.

Heartburn prevention

Whatever the cause of heartburn, there are measures that will definitely benefit you:

• eat right. Minimize fatty, spicy and salty foods. Try to eat less chocolate, coffee, alcohol, carbonated drinks. Avoid large meals. Food should be chewed thoroughly;
• do not go to bed immediately after eating, do not lift heavy objects or bend over;
• wear clothing that does not compress the abdominal cavity;
• watch your weight;
• stop smoking.

Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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Heartburn at night ⛑ symptoms, prevention of nighttime heartburn

GERD (gastroesophageal reflux disease) and other diseases of the gastrointestinal tract (GIT) often lead to an unpleasant symptom – a nocturnal attack of heartburn. This is a specific condition that can also be accompanied by a feeling of hunger or mild stomach pain.

Why does heartburn worsen at night, how can it be quickly extinguished and what preventive measures are there?

General

Heartburn is not a disease, but a common symptom of digestive disorders or diseases of the upper gastrointestinal tract. Its appearance is associated with increased acidity of the stomach and the reverse release of its contents into the esophagus.

Heartburn can be the result of overeating, then it occurs once, passes quickly and does not bother. Frequent burning sensation after eating is a reason to see a doctor. Heartburn at night in healthy people does not occur, so nighttime attacks also serve as a reason to seek the advice of a specialist.

Irregular heartburn in the evening may simply indicate an unhealthy late dinner. If it occurs quite infrequently, it may be sufficient to balance the diet and not overload the stomach.

Heartburn can also occur if the lower esophageal sphincter (folds in the lining of the lower esophagus that normally function as a “valve”) fails to prevent stomach contents from flowing back up into the esophagus along with acid. There is no protective mucus in the esophagus, so acid is dangerous for it. This condition is called gastroesophageal reflux disease (GERD). According to the World Organization of Gastroenterology, heartburn is a clear symptom of GERD in 70% of cases [2].

The causes of nighttime heartburn are the same as those of the daytime. The condition is aggravated by the fact that in some diseases of the gastrointestinal tract there is an active production of gastric juice at night [3].

If heartburn occurs at night, there are reasons that provoke an attack:

• eating just before bedtime;
• drinking at night;
• uncomfortable sleeping position.

First aid for heartburn can be provided by yourself by taking drugs that fight high acidity.

Pitfalls of nocturnal heartburn

An intense burning sensation begins in the stomach, behind the sternum (along the esophagus) or in the throat. Night attacks are characterized by their duration. In severe situations, the patient cannot sleep, there is an acute pain in the stomach.

If the cause of heartburn is gastritis, bloating and flatulence may occur. Tolerating such symptoms is unhealthy, because frequent heartburn leads not only to lack of sleep [4], but can also be a sign of serious diseases of the stomach and esophagus.

In such cases, evening or nocturnal heartburn may be accompanied by other alarming symptoms[5]:

• vomiting;
• blood in stool;
• anemia;
• fast satiety;
• difficulty swallowing food.

Heartburn is easily mistaken for a heart attack. Therefore, if in the evening there is a burning sensation behind the sternum, which does not go away after taking antacids, is accompanied by a feeling of squeezing and pain, you need to call an ambulance.

Determining the causes of heartburn

In case of complaints of frequent nocturnal heartburn, the doctor may prescribe a number of tests aimed at determining the underlying ailment:

• Laboratory tests. Examine feces, blood, sometimes urine. Biochemical parameters are determined, as well as the presence of Helicobacter pylori bacteria.
• Fibrogastroduodenoscopy (FGDS). Using a special probe, the stomach is examined.
• Esophagomanometry. Measure intraesophageal pressure.
• pH meter. Determine the pH level of gastric juice, monitoring is carried out throughout the day.

With frequent attacks of heartburn during sleep, it is also necessary to exclude diseases of other internal organs (heart, blood vessels, bronchi, lungs, etc.), in which burning sensations similar to heartburn can also occur.

Treatment

Heartburn at night can be relieved by proper diet and lifestyle:

• eat 2-3 hours before bedtime;
• do not drink alcohol at night;
• do not overload the stomach in the evening with fatty, spicy foods and flour products.

To alleviate the condition, you can raise the head of the bed by 20-25 cm. This will keep food in the stomach and prevent it from entering the esophagus. Gastroenterologists also recommend reducing weight if there are extra pounds. They are risk factors for the development of heartburn.

Antacids may help with heartburn at night. These drugs are recommended for the relief of heartburn in reflux [6], as well as to combat heartburn in pregnant women [7]. They do not harm the mucous membrane, but absorb excess acid, which is neutralized to normal pH values ​​within a few minutes.

Antacids are substances that can neutralize excess hydrochloric acid in the stomach. For example, Rennie ^® from Bayer contains calcium and magnesium carbonate. Together, they aim to neutralize excess hydrochloric acid within 2-5 minutes. Rennie ^® chewable tablets have been helping patients with heartburn for decades. The safety profile of Rennie ^® is quite high, it is allowed to be taken by pregnant and lactating women.