Nighttime heartburn or acid reflux can be a painful disruption to a good night’s sleep. For some, it’s only an occasional nuisance, but for others it’s a common condition known as GERD, or Gastroesophageal Reflux Disease. According to the American Gastroenterological Association, some 25 million people have chronic heartburn, and for many of them the pain is worse at night.

While reasons for developing GERD vary widely, it is more common with age and obesity. As the baby boomers get older and as our country experiences a rise in obesity, GERD will likely become even more prevalent.

Premier Surgical Associates general surgeon David J. Harrell MD FACS surgically treats many GERD patients. He explains, “When the muscle valve between the esophagus and the stomach weakens, stomach acid goes back up into the esophagus. But the lining of the esophagus is not created to handle acid like the stomach can, which is why you feel the heartburn. Some people have occasional bouts of reflux, but it’s not too drastic. But for others, the reflux is so bad that they can’t even bend over to pick something up.”

When you are upright or when your torso is elevated, gravity aids digestion. But when you lay flat, gravity is working against any reflux. If your stomach is full of acid after you eat, and the valve between your stomach and esophagus is already weak, the reflux will worsen. This is why severe reflux symptoms often occur at night, and people may wake suddenly feeling like they’re choking. It’s difficult to go back to sleep after such an alarming incident, and those who suffer from acid reflux may even resort to sleeping in a recliner so they’re not flat on their back, or to elevating their upper body with pillows.

For those with mild acid reflux, symptoms can often by managed by not overeating, not drinking too much alcohol, and avoiding acidic and spicy foods, particularly before bed. Some people may find relief by waiting two hours for food to digest before they lay down or go to sleep.

Talk with your physician about the frequency and severity of your heartburn, particularly at night. He or she may recommend over the counter or prescription antacids. When a patient has tried lifestyle modifications and medications yet is still experiencing symptoms, or has determined that being on medications long term is too great a risk, surgery may be an option.

A procedure known as Nissen Laparosopic Fundoplication recreates the valve between the esophagus and the stomach by wrapping the upper portion of the stomach around the lower part of the esophagus and sewing it into place. This tightens the lower esophagus, helping to prevent acid from moving from the stomach up into the esophagus.

If you have heartburn or GERD symptoms despite lifestyle changes, dietary changes, and medication therapy, anti-reflux surgery might be considered in treating your symptoms. For more information on treatment options and the physicians at Premier Surgical Associates in Knoxville, visit our acid reflux page at