Nighttime Symptoms of Reflux Esophagitis: What You Need to Know

Reflux esophagitis can indeed worsen at night, with many patients experiencing a noticeable increase in acid reflux during sleep. Some individuals may even wake up choking on stomach acid due to severe nighttime reflux episodes. This pattern is often linked to changes in body position and natural decreases in esophageal defenses while lying flat.

To help reduce nighttime symptoms, experts recommend avoiding meals 3-4 hours before bedtime. This allows the stomach to empty partially and lowers the likelihood of acid flowing back into the esophagus during sleep. Additionally, lifestyle modifications such as elevating the head of the bed or using a wedge pillow can significantly reduce nighttime reflux episodes by using gravity to your advantage.

When symptoms become more severe at night, adjusting medication timing may be beneficial. Taking proton pump inhibitors (PPIs) or H2 receptor antagonists in the evening can help control acid production during the night. In some cases, short-term use of antacids or mucosal protectants can provide quick symptom relief by neutralizing stomach acid and forming a protective barrier in the esophagus.

Nighttime worsening of reflux esophagitis is often related to late-night eating habits, decreased lower esophageal sphincter pressure, and increased vagal activity during sleep. These factors combine to make nighttime a particularly vulnerable period for acid reflux symptoms. Understanding these patterns can help patients better manage their condition and improve sleep quality.