We all get heartburn from time to time, often after we have overindulged. But heartburn becomes more familiar as we get older. Millions of seniors live with heartburn, especially nighttime heartburn that keeps them awake.
We’re going to look at what heartburn is, its relationship to acid reflux and Gastroesophageal reflux disease, and some non-pharmaceutical strategies to help keep heartburn under control.
Heartburn, Acid Reflux, and GERD
Heartburn, acid reflux, and Gastroesophageal reflux disease (GERD) tend to be lumped together, but they are not the same thing. Before we offer suggestions for managing heartburn, we should clarify what we mean.
- Heartburn, which has nothing to do with your heart, is a symptom of other conditions, including acid reflux and GERD. Heartburn is a feeling of discomfort or pain in your chest. It presents differently in different people, often as a burning or tightening sensation behind the breastbone and sometimes in the throat.
- Acid reflux is the “leaking” of stomach acids into the esophagus. It may cause heartburn, but seniors often experience acid reflux differently to younger people. They may not feel it as heartburn because their esophagus is less sensitive, but it can present as a wide array of symptoms including chest pain that feels like angina, sore throats, a chronic cough, vomiting, and weight loss.
- GERD is a disease defined as damage to the esophagus caused by the contents of the stomach and sometimes the upper intestine flowing into the esophagus. Acid reflux is part of GERD, but it also includes the reflux of stomach enzymes like pepsin, food, bile, and other materials.
GERD can cause complications that include esophageal damage, esophageal strictures, changes to the makeup of esophageal tissue (Barrett’s esophagus), and an increased risk of cancer. Seniors may have mild symptoms that mask a more serious problem.
If you occasionally suffer from heartburn that disturbs your sleep, it can often be managed naturally. If you suffer from chronic heartburn or the other symptoms of acid reflux and GERD, consult your physician.
What Is Heartburn?
When you swallow food, it travels from your mouth into your esophagus, which is sometimes called the food pipe. The esophagus connects your throat to your stomach. Just above your stomach is an antireflux barrier, which includes a sphincter—a ring of muscles—that keeps food and digestive acid in your stomach and out of your esophagus.
When the lower esophageal sphincter (L.E.S.) doesn’t do its job properly, stomach acids can reflux, move from the stomach into the esophagus, causing pain and tissue damage. As we age, the L.E.S. weakens, one reason seniors experience worse heartburn more often as they get older.
Natural Techniques for Fighting Night-Time Heartburn
Medications such as proton pump inhibitors (PPIs) and antacids lower the amount or strength of stomach acid. They are effective and safe. But seniors who suffer from occasional nighttime acid reflux and heartburn can often reduce symptoms and improve sleep by changing their behavior and making a few small lifestyle alterations.
Eat at Least Two Hours Before Going to Sleep
The more food and drink there is in your stomach, the harder it is for the L.E.S. to prevent reflux. That’s why people of all ages have heartburn when they eat a particularly big meal.
Eating earlier gives your stomach time to empty before you go to bed. You may also want to experiment with eating small meals more often. A person with a weak barrier between the esophagus and stomach risks heartburn whenever they have a lot of food in their stomach.
Sleep With a Raised Head
Lying down to sleep makes the L.E.S. work even harder. Now it has to fight against gravity as it increases pressure on the sphincter, making it more likely for stomach acid to squeeze through.
Raising the upper body by a few degrees helps to keep the stomach’s contents from sloshing against the barrier and into your esophagus. There are several ways to prop yourself up in bed, but the safest and most reliable is the head adjustment of a home hospital bed, which will let you adjust the angle to find the optimal position.
Sleep in Loose Clothing
Tight clothing constricts your abdomen, increasing the internal pressure and reducing the amount of space occupied by your stomach. Think of squeezing a toothpaste tube: the harder you squeeze, the more toothpaste comes out. Avoid tight pajamas, nightgowns, t-shirts, and heavy bedclothes that press on your lower torso.
Avoid Drinking and Smoking
The link between cigarettes and heartburn isn’t obvious, but smokers are more likely to suffer heartburn than non-smokers. The mechanism isn’t well understood, but scientists think nicotine relaxes the muscles of the lower esophagus, letting more acid out.
Alcohol affects heartburn in a similar way. There is strong evidence that alcohol worsens heartburn, and medical professionals often advise sufferers to avoid alcohol or to drink in moderation.
Heartburn is strongly correlated with obesity. It is the leading cause of heartburn in all Americans and especially in seniors who are already at increased risk. The excess weight pushes on the abdomen, squeezing the stomach and forcing acid into the esophagus. Lying down to sleep increases the pressure even more. Sleeping on an incline reduces the effect of obesity, but losing weight is the best way to combat heartburn.
We have looked at five ways to fight heartburn without reaching for the antacids. For many seniors, these techniques reduce the heartburn that keeps them awake at night.
However, some seniors may find that heartburn remains a problem. If frequent and persistent heartburn or other symptoms of GERD continue, speak to your doctor. Ignoring GERD could have a negative impact on your health.
About the Author: Aaron Goldsmith is the owner of Transfer Master. Transfer Master has built electric adjustable hospital beds since 1993. He started with the goal that hospital beds should allow wheelchair users to transfer independently in and out of bed. 25 years later, their customers are still at the center of everything.