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Acid Reflux Can Be a Night Stalker

Sleeping lets stomach acid collect in the esophagus

MONDAY, Oct. 21, 2002 (HealthDayNews) -- For people with acid reflux, the worst damage is often done while they sleep.

That's the conclusion of a new study presented today at the American College of Gastroenterology's anunual meeting in Seattle.

An estimated 15 million Americans experience heartburn -- a common symptom of acid reflux -- daily. Sixty percent of them have symptoms during the night, when their bodies are least prepared to deal with them, says lead researcher William C. Orr, a professor of physiology at the University of Oklahoma Health Sciences Center.

Acid reflux, also known as gastroesophageal reflux disease (GERD), is the return of the stomach's contents -- including acidic stomach juices -- back up into the esophagus, which carries foods and liquids from the throat to the stomach.

If not treated, GERD can lead to serious health problems. For instance, esophagitis may cause bleeding or ulcers in the esophagus. Some people also develop a condition called Barrett's esophagus, which is severe damage to the lining of the esophagus. Doctors believe this condition may be a precursor to esophageal cancer, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Acid reflux sufferers are particularly vulnerable at night, Orr says, because lying flat during sleep lets stomach acid collect in the esophagus. People also don't flush their system during sleep by frequently swallowing or salivating.

"If you have acid reflux during sleep, you have double trouble," he says. "Not only do you wake up at night and have trouble sleeping, but it's also much more risky. If this dwells in the esophagus, it may spill over into the lungs and create breathing problems."

In the study, Orr and other researchers from the Lynn Health Science Institute in Oklahoma City compared the sleep habits of healthy people with 20 patients who reported having heartburn at least four days a week and having woken up with heartburn at least one night a week. Those with heartburn had much more trouble sleeping, and felt drained during the day, Orr says.

Doctors started paying attention to the nighttime effects of acid reflux just a few years ago. However, while some drug makers have targeted advertising at the tossing and turning associated with acid reflux, most doctors don't ask patients with heartburn how they are sleeping, Orr says.

"If you wake up from sleep with acid in your mouth at least once a week, you have a problem and you should see your doctor," Orr says.

"Some people wake up at night sputtering. They can't even breathe," adds Dr. Patricia Raymond, an associate professor of clinical internal medicine at Eastern Virginia Medical School. "We know now that if they're refluxing at nighttime, the chances go up for them getting cancer."

About 80 percent of patients who experience acid reflux are treated effectively with the commonly prescribed reflux drugs, such as Prilosec, Raymond says. It's those who need further treatment that should be evaluated for sleep problems.

Raymond also recommends that people experiencing heartburn, particularly at night, should avoid eating heavy meals close to bedtime and should elevate their heads during sleep.

If symptoms persist, they should see their doctor, she says.

What To Do

For more information on stomach disorders, visit the American Gastroenterological Association. For help assessing and treating acid reflux, visit the International Foundation for Functional Gastrointestinal Disorders.

SOURCES: William C. Orr, Ph.D., professor, physiology, University of Oklahoma Health Sciences Center, and president, Lynn Health Science Institute, Oklahoma City, Okla.; Patricia Raymond, M.D., associate professor, clinical internal medicine, Eastern Virginia Medical School, Norfolk, Va.; Oct. 21, 2002, presentation, American College of Gastroenterology annual meeting, Seattle
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