Acid Reflux When Waking Up In The Morning
Acid Reflux When Waking Up In The Morning: When we are awake and moving around, our body produces saliva to protect it from gastric juices that can be highly corrosive. But if you stop moving for an extended period, especially during sleep, the reflux will come out in the form of acid, which is very irritating. This is called nocturnal gastroesophageal reflux disease (GERD). It’s not just adults who have this problem; children also experience GERD as well.
In fact, most people who suffer from heartburn or acid reflux experience it at some point in their lives. Although there may be many causes of GERD, one of them is lying down after meals or eating too much food at once.
There are two main factors that cause reflux: gravity and relaxation of the lower esophageal sphincter. When you’re sleeping on your back, the lower esophageal sphincter relaxes and allows the acidic contents of the stomach to flow into the lower parts of the esophagus. While lying on the opposite position, the lower esophageal sphincter contracts, preventing reflux.
Acid reflux usually occurs when the stomach isn’t producing enough hydrochloric acid to neutralize the alkaline content of the stomach. If you eat a meal within 45 minutes before going to bed, the amount of gastric juice will increase significantly. Therefore, it’s best to wait until 4 hours before retiring to go to bed. Also, avoid drinking beverages such as coffee, tea, or alcohol late at night because they contain caffeine and carbonation, respectively, both of which stimulate the production of gastric juices. Smoking is another factor that increases acid reflux.
If you do find yourself experiencing nighttime acid reflux, try changing your diet. Avoid spicy foods, fatty foods, fried foods, chocolate and citrus fruit. You should also drink more water throughout the day. Water helps strengthen the walls of the esophagus and stomach lining by coating them with mucus, thus protecting against stomach acids.
It’s important to note that while GERD affects about 20 percent of Americans over age 18, only 7 percent of those affected seek medical attention. However, it’s still important to treat the condition early so that the symptoms don’t become chronic. Treatments include lifestyle changes such as avoiding smoking, exercising regularly, losing weight and avoiding heavy meals late at night. Medications used to control acid reflux include antacids, proton pump inhibitors (PPIs) and H2 blockers.
On the next page, read about how stress can lead to acid reflux.
Stress can make acid reflux worse. Stress can reduce the secretion of saliva and decrease its ability to coat the inside of the digestive tract. Another way stress can affect acid reflux is through increased levels of stomach acid. Some studies show that stress stimulates the release of certain hormones, including cortisol, adrenaline and dopamine, all of which can trigger the production of gastric juices.
How does acid reflux occur?
While lying down, the lower esophageal sphincter opens up, allowing the stomach’s fluid to pass into the esophagus. At the same time, the diaphragm rises, pushing the stomach upward. This combination creates a negative pressure in the stomach, forcing the stomach’s contents up toward the chest where they eventually exit via the mouth. Acid reflux happens when these contents leak backward, traveling downward into the esophagus instead of exiting normally.
This process becomes even more complicated when you take medications such as aspirin, ibuprofen, naproxen and Motrin. These drugs inhibit prostaglandins, chemicals produced in response to pain and inflammation. Prostaglandin E2 protects the stomach lining from damage and enhances peristalsis or muscle contractions. By inhibiting prostaglandins, taking NSAIDs such as aspirin or ibuprofen actually increases stomach acidity.
Aspirin, however, has a different effect on stomach acid than nonsteroidal anti-inflammatory drugs like ibuprofen. Instead of reducing acid reflux, it can actually aggravate it. Taking aspirin with food can further irritate the stomach’s lining and allow stomach acid to seep into the small intestine. Other NSAIDs, such as diclofenac, indomethacin and fenoprofen are known to produce similar effects.
To relieve the discomfort associated with acid reflux, see your doctor. He or she may prescribe antacid tablets or recommend dietary changes and lifestyle modifications. Lifestyle changes include avoiding smoking, losing weight, exercising regularly and limiting late-night snacks. Your physician may also suggest using PPI medications or H2 antagonists.
Learn more about acid reflux and related topics on the next page.
Although it’s normal to feel bloated sometimes, having gas is never pleasant. Gas builds up in the large intestines, causing bloating and abdominal distention. One possible culprit is lactose intolerance — something found in approximately 70 percent of people. Lactose intolerance is the inability to digest lactose, the sugar in dairy products. People who are lactose intolerant often complain of bloating or flatulence after ingesting milk, cheese, or ice cream. If you suspect you might have lactose intolerance, consult your doctor.
What are Hiatal hernias?
Hiatal hernias occur when the upper part of the stomach protrudes through a hole in the diaphragm rather than being pushed below it. The stomach is then located in front of the diaphragm, creating what’s known as a “diaphragmatic hiatus.” A hiatal hernia doesn’t block the passage of food from the stomach to the small bowel, but it interferes with the movement of the lower esophagus and the diaphragm. Food stuck behind the diaphragm can push upward, creating a negative pressure in the abdomen.
This pushes stomach acid upward into the chest or mediastinum, resulting in acid reflux.
A hiatal hernia may seem harmless, but it can worsen over time. Left untreated, it could potentially cause complications such as ulcerations and pneumonia. Left untreated, a hiatal hernia can also interfere with proper digestion.
Because patients with Hiatal hernias can develop severe gastrointestinal problems, surgery is recommended for anyone diagnosed with them. There are several surgical procedures available for treating a hiatal hernia. Depending upon the severity of the patient’s condition, he may need to undergo a fundoplication procedure, Nissen fundoplication, or Belsey repair. Fundoplications involve wrapping the top part of the stomach around the bottom part, sealing off the area between them. Nissen fundoplication involves repairing the diaphragm. Belsey repairs involve suturing together sections of the diaphragm to create a tighter seal.
Other conditions that can contribute to acid reflux include obesity, pregnancy, and diabetes. Obesity puts added strain on the organs involved in digestion, including the lungs, liver, kidneys, and colon. Increased strain can put additional pressure on the stomach, leading to acid reflux. Pregnancy can put a woman at higher risk for developing GERD. Diabetes can affect blood glucose levels, which directly influence the function of the pancreas and muscles surrounding the stomach. Diabetics who have poorly controlled diabetes are more likely to develop GERD.
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