Acid Reflux Can Be a Night StalkerSleeping lets stomach acid collect in the esophagus< October 22, 2002 > For people with acid reflux, the worst damage is often done while they sleep. That is the conclusion of a new study presented yesterday at the American College of Gastroenterology's annual 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. Physicians believe this condition may be a precursor to esophageal cancer, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH). Acid reflux sufferers are particularly vulnerable at night, Orr says, because lying flat during sleep lets stomach acid collect in the esophagus. People also do not 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 (small sample size noted) 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. Physicians 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 physicians do not 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 cannot 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 is 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, and/or for more information, always consult your physician. Online Resources(Our Organization is not responsible for the content of Internet sites.) American College of Gastroenterology American Gastroenterological Association International Foundation for Functional Gastrointestinal Disorders Centers for Disease Control and Prevention (CDC)
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For more information on gastroesophageal reflux disease (GERD), please visit the Digestive Disorders information module on this Web site. Surgery Does Not Always Do the Trick for GERDStudy finds many patients still need drugs to ease their chronic indigestion At least 50 percent of those who have surgery for gastroesophageal reflux disease (GERD) still need drugs to ease their chronic indigestion, according to new research. The finding means the assumption that surgery for GERD patients is a more economical option than long-term medication therapy is not necessarily true. In a study comparing the expenses for patients one year before and 18 months after surgery, researchers at the Boston Scientific Corp. found that "surgery costs were not offset by the reduction in medication costs during an 18-month follow-up period," says lead author Erin Sullivan. GERD symptoms occur when the valve between the stomach and esophagus lets stomach acid leak into the esophagus. When drugs make little difference or when patients do not want to depend on a lifelong medication regime, some sufferers opt for surgery. A successful operation eases symptoms because the valve is modified to work the way it should. The Boston researchers reviewed a national database of publicly and privately insured patients. They matched the records of 123 surgical patients to the records of 246 GERD patients managed without surgery. Their findings, presented yesterday at the American College of Gastroenterology's annual meeting in Seattle, revealed that although medication costs for people who selected surgery were lower than those on drugs, the outlay for the operation pushed the price up so that in the final tally, surgery was the more expensive option. "Our results indicate that we need to follow GERD patients over a longer follow-up period to determine the actual cost effectiveness of surgery," Sullivan says. Always consult your physician for more information. |