Middle of Night Heartburn

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mystang52

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I haven't changed my diet, but 5 of the last 6 nights I've awakened in middle of night with painful heartburn. Apparently there are 2 main types of OTC acid reducers - H2 receptors (e.g., Tagamet/Zantac) or proton pump (e.g., Prilosec/Prevacid).
I had this problem many years ago when I was 50 pounds heavier, but not since I took off, and kept off, the weight. I can't get in to see my Gastro MD until 3 weeks from now. I don't eat anything past 7 PM, and go to sleep somewhere between 10 PM and 1 AM. Don't eat spicy foods. Anyone with insight on this issue, and which medication is more appropriate?
 
I use generic Tums for occasional bouts... hit it at the first sign of something coming on.
but 5 out of the last 6 nights is a concern.
 
Any drinking after dinner. I know red wine will sometimes do that to me.
 
When I had that problem I could usually make it go away by sitting up straight for a minute then turning to sleep on my left side.
 
I was using omeprazole (Prilosec) and found it to be very effective, but quit after reading warnings about long term effects of lowered stomach acid levels, including increased susceptibility to diseases like C-Diff.

Now I take Tums and occasionally ranitidine when I eat a triggering food or beverage. So far, so good.
 
DW also seems to get it from greasy food or caffeine.


I get it occasionally from full racks of ribs.... :D
 
Yeah possibly drinking red wine or coffee perhaps?
Usually the big weight loss does solve the problem fairly well.
 
mystang52 said:
Anyone with insight on this issue, and which medication is more appropriate?
Click to expand...

This happens to me sometimes, as well, especially when I eat certain foods and/or eat later in the evening. I've learned which foods are most likely to trigger it, and if I think there is a decent chance of an incident, I'll take a 20mg tablet of famotidine at bedtime. This works 100% of the time for me, and, from what I've read, has a much better efficacy/risk profile than the PPI medications. Plus, PPIs are not really intended for incidental treatment of acid reflux, since they take as much as 24 hours to kick in. Famotidine (and other H2 blockers) start working within 30 minutes or so.
 
This happens to me after eating anything with tomatoes, vinegar, and maybe a few other things. Lemonade and orange juice seem more calming, so I don't think it's just acidic foods. I always sleep on my side.

Watching what I eat is most effective. When I cheat, sleeping with a pillow under me from just above the hips to above the shoulder is also very effective. If I don't feel like using the pillow, just turning over to the other side for a while helps, until the side on the bottom starts to hurt. Sucralfate has helped. Nexium did not.

Good luck!
 
I had this problem last night from a late dinner. I ended up having to stand up, which would allow me to belch (which reduced the pressure.
 
ckelly78z said:
I had this problem last night from a late dinner. I ended up having to stand up, which would allow me to belch (which reduced the pressure.
Click to expand...

If one is able to belch at will, it can help quite a bit.
 
Elimination diet. MIL had this problem, went on the elimination diet. Can't confirm what finally was re-introduced that re-introduce the heart burn but she ended up changing diet a bit. Salads instead of burgers, organic, really kinda went nuts and probably eats healthier than I do and I run 5mi a day. I used to have HB constantly back when I was drinking wine and hard alcohol. I could seemingly drink a case of beer without issue though hah.
 
I avoid eating after 6pm. Never heartburn problems.

But it definitely could be a food.

OK - I see you are not eating after 7pm. Try to give yourself more time?
 
Dtail said:
If one is able to belch at will, it can help quite a bit.
Click to expand...
If you can't belch, you can take simethicone. Relieving the pressure relieves the pain.
 
Once you're on those meds they are tough to stop since the stomach produces even more acid to compensate. Baking soda, a half teaspoon or so in water, at bedtime will offset the acid and it's easy to taper the dose.
 
The ppi type is probably more effective and you could certainly try either while you wait to see your doctor. The ppi type may take a few days to reach full effectiveness. It's odd that it would flare up so suddenly and over many nights and it's good that you're seeing a GI specialist. You might try a wedge pillow too. Heartburn like this is not something to be ignored. I have Barrets Esophagus and have been on ppis for years. Still get the heartburn but apparently whatever is coming up is not causing further damage (I'm on a regular schedule of endoscopies.)
 
OP here. Can't believe I didn't think of this obvious first step: I called my doctor, spoke with the nurse about which to start with. She said they always recommend Zantac as a first step. So, I just bought a package and will take one 30 minutes or so before sleep.
As I mentioned in my first post, I haven't changed my diet in any way. I usually eat dinner early, about 5/5:30. Then, about 6:45 I have my daily cup of low fat chocolate ice cream. Yes, I read that chocolate can be a trigger, but I've had this dessert for 25 years.
Thanks all for your input.
 
Nurse notwithstanding, as mentioned by others, it is likely better to start with Tums as needed. Gavison and sulcrate are also good options. Also pay attention to inciting factors including diet and sleeping position. If you can tolerate it a couple of blocks under the head of the bed bedposts. Also, make sure you don't have any other signs or symptoms of heart issues or a ton of risk factors. If you do get that checked out asap.
 
Last edited:
mystang52 said:
As I mentioned in my first post, I haven't changed my diet in any way. I usually eat dinner early, about 5/5:30. Then, about 6:45 I have my daily cup of low fat chocolate ice cream. Yes, I read that chocolate can be a trigger, but I've had this dessert for 25 years.
Click to expand...


Here is what has changed --- You're getting Older.
 
I had the same symptoms, sometimes in the day but especially at night. My gastroenterologist put me on Zantac twice a day, and said I could take it for the rest of my life without harm. I follow similar suggestions as above, avoid eating late, sleep on left side, etc. It's worked well for me the last 5 years or so, and now that I've lost 20 lbs., I find I can skip a dose now and then without a problem. Unless I have Italian food with red sauce and red wine ...
 
6miths said:
Nurse notwithstanding, as mentioned by others, it is likely better to start with Tums as needed.
Click to expand...

Tums is fine for an isolated instance of heartburn/reflux. The problem here is that it's occurring while the OP is asleep and repeating over a number of nights in a row. By taking Zantac or one of the ppis instead of something like Tums, there is a good chance that the episodes will be prevented entirely. In any event, a flareup like this in the absence of changes in one's diet or activities requires a GI specialist's opinion and diagnosis and the OP is right to get there ASAP.
 
Yeah, getting older. I never had this problem 10 years ago either. Now I've got plenty of annoying aches and pains. Although my DM says she wishes she were my age...
 
I suspect the ice cream, complicated by the chocolate. Skip it a couple nights and see what happens
 
My wife has had reflux problems for many years, and heartburn and GERD is nothing to fool around with. He problem was a hiatal hernia. After having her 4th bout of pneumonia caused by reflux, she finally had the hernia repaired last month.

She said she had no idea that she had felt so bad. She'd been eating Nexium for years, and sleeping in an adjustable head with her chest elevated. She'd given up on eating ice cream and eating spicy foods of any kind.

She's doing great now. If you're having problems with heartburn or esophageal problems, be sure to see a doctor about it before the damage is done where you cannot recover.
 
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