Why Do I Have Heartburn In The Morning
Why Do I Have Heartburn In The Morning? Heartburn isn’t fun — it’s that burning sensation in your chest or throat that spreads out as far down your esophagus as possible. It may be mild enough to ignore (and it usually will be) but if left untreated, especially over time, heartburn can cause more serious problems like ulcers or even cancer.
So what causes heartburn? The most common culprits are stomach acid refluxing upward from the lower part of your digestive tract into your esophagus and causing inflammation, which leads to pain. But this doesn’t mean everyone gets it every day; for some people, it only happens once in their lifetime. And the good news is that there are things you can do to minimize its effects.
“Heartburn is caused by gastric juice coming back up through the esophageal sphincter valve,” says Dr. Mark Bertilsson, M.P., FRCPC, spokesperson for the American College of Gastroenterology (ACG). “It’s not always going to occur during sleep because we don’t go completely silent while sleeping.”
The normal resting position of the lower esophageal sphincter (LES), where the two layers of muscle meet, keeps the food pipe open so nothing goes back toward the stomach. This is important because anything that makes it backward could potentially lead to something called reflux disease — when the LES malfunctions, allowing stomach contents to move backward.
Reflux occurs when the LES relaxes, either due to an increase in pressure within the stomach itself, increased abdominal pressure or reduced ability of the LES to contract. When this occurs, the stomach acids and other substances come back up the esophagus instead of staying contained within the stomach.
What Causes Reflux Disease?
There are many different reasons why reflux disease occurs. One reason is hiatal hernias, which means the upper portion of the stomach protrudes outside the body and pushes on the diaphragm, leading to relaxation of the LES. Another reason is obesity, which puts added stress on the abdomen and reduces the space between the organs and the spine.
Some people are genetically predisposed to reflux disease, meaning they have an anatomical configuration that predisposes them to it. If you’re one of these people, you should know that the problem is often related to how much you eat before bedtime.
“People tend to overeat late at night, and then go right to bed without eating enough earlier in the evening,” explains Dr. Bertilsson. “This leaves room for food to sit in the stomach overnight and create excess pressure on the stomach. That pressure can push the stomach contents past the LES and into the esophagus.”
That doesn’t mean you shouldn’t enjoy those midnight snacks, though. Eat smaller portions and avoid heavy foods after 5 p.m. Also, try drinking water with meals rather than alcohol or sodas, both of which stimulate the production of saliva, which can help neutralize stomach acid.
And speaking of heartburn remedies, the first step is identifying the source of the problem. Once you’ve determined whether it’s acid reflux versus another cause, you’ll need to develop a treatment plan based on your specific needs.
For example, if you suffer from chronic heartburn, lifestyle changes such as smoking cessation, weight loss (if applicable), avoiding large meals prior to bedtime, sticking to liquids, taking antacids regularly, limiting spicy foods and avoiding nighttime beverages containing caffeine might improve symptoms.
Other treatments include medications, surgery and endoscopy, which involves inserting a lighted tube the size of a camera lens up your nose and into your stomach using sedation or general anesthesia. During the procedure, doctors inject dye into the fluid inside the stomach to make it easier to view any abnormalities.
Sometimes, a combination of therapies works best. For instance, you may find yourself better off wearing a special type of sleeve to keep the stomach closed at night, combined with medication to decrease stomach acid levels.
Heartburn Is Common
Heartburn affects about 30 percent of Americans, according to the ACG. More women than men report experiencing heartburn, although the numbers aren’t too surprising considering that 80 percent of heartburn sufferers are overweight and obese.
In addition, older age groups seem to be affected more frequently than younger ones. About 70 percent of patients diagnosed with gastroesophageal reflux disease (GERD) are over 40 years old.
Heartburn is considered a benign ailment, but prolonged bouts of heartburn or severe episodes can lead to scarring of the esophagus, increasing risk of bleeding and/or narrowing of the esophagus, leading to difficulty swallowing and, occasionally, death.
While heartburn is typically an annoying symptom, you should consult your doctor immediately if you notice blood in your vomit or notice signs of shortness of breath, nausea, vomiting, fever or swelling. These warning signs are indicative of more serious conditions, including pneumonia, lung infection, perforated ear drum, liver failure, blood poisoning, kidney stones, appendicitis, obstruction of the airway, stroke, tuberculosis, pregnancy-related complications and heart attack.
Heartburn can happen anywhere along the length of your digestive system, but it tends to occur most commonly in the middle section of your esophagus near the top of your stomach. Swallowing fluids helps dilute the amount of acid present, reducing the likelihood of painful symptoms.
Treatment options vary depending on the severity of the case. Over-the-counter medications, such as antacids, work well for lessening the discomfort associated with heartburn. If the problem persists, talk to your doctor. Your physician may prescribe a proton pump inhibitor (PPI), which inhibits the secretion of hydrochloric acid produced by parietal cells in the stomach. Although PPI therapy is widely used as an effective long-term solution against heartburn, it does have side effects, such as diarrhea, constipation, flatulence and headache.
To reduce the occurrence of heartburn, consider making dietary modifications. You can limit your intake of high fat foods (including fried foods), fatty meats and dairy products. Avoid greasy, spicy and acidic foods, since these can trigger heartburn. Try choosing more vegetables, fruits and whole grains over refined carbohydrates. Drink plenty of fluids throughout the day to combat dry mouth, which can aggravate the intensity of heartburn. Finally, take breaks from television watching and computer usage to give your eyes and muscles a rest.
For relief of heartburn symptoms, take an over-the-counter medicine containing aloe vera. Aloe vera gel has soothing properties, and it can be applied directly to the irritated area. A topical cream made with lidocaine can provide temporary relief. Ask your pharmacist or doctor about applying benzoyl peroxide, a strong antibacterial agent found in acne preparations, to your chest or neck to treat redness associated with heartburn.
Finally, remember that heartburn is a natural reaction to having eaten. Don’t feel ashamed if it bothers you. Take action to alleviate the problem, and drink lots of fluids. Most importantly, however, see your physician to get evaluated or receive further testing, and discuss treatment options with him or her.
Did you know that heartburn is sometimes accompanied by burping? People who experience this phenomenon are known as burpers. Burping is actually a defensive mechanism that protects the lungs from injury by preventing stomach contents from moving into the esophagus. However, excessive burping can be distressing to some people, particularly infants and small children. Burping can indicate a number of health issues, ranging from asthma to irritable bowel syndrome. Consult your physician if you suspect an underlying medical issue.
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