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Reflux: A burning nighttime problem

  • Story Highlights
  • Common chronic heartburn complaints are acid taste in throat or mouth, chest pain
  • Lifestyle changes can help: Don't eat within 3 hours of going to bed
  • Avoid heartburn triggers: Chocolate, caffeine, acidic juices, peppermint, alcohol
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By Judy Fortin
CNN
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BOSTON, Massachusetts -- Elevating the head of her bed with bricks doesn't do much for the décor in Deborah Kronenberg's bedroom, but it has made a big difference in her persistent nighttime heartburn.

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Deborah Kronenberg is one of the 15 percent of Americans who suffer from nighttime heartburn.

Kronenberg, a 29-year old program coordinator at a teen center in Dorchester, Massachusetts, started having problems with gastro-esophageal reflux disease, or GERD, two years ago.

She's not alone. It's estimated up to 15 percent of Americans suffer from the condition, many of them during the night.

In a survey presented by the American College of Gastroenterology, almost half of those with acid reflux at night complained about sleep disturbances including everything from wakefulness to arousal from sleep to poor quality of sleep.

"I would have a dry cough at night," Kronenberg said. "I would wake up just to cough. I couldn't lie down and sleep."

Kronenberg's inability to get a good night's sleep drove her from one specialist to another. "I said I'm 29, I have so many years ahead of me. I couldn't keep going on like this."

She finally got some help from Dr. Ram Chuttani, chief of endoscopy at Beth Israel Deaconess Medical Center in Boston, Massachusetts. Video Health Minute: Watch more on battling nighttime acid reflux »

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"I see a lot of patients with heartburn at night," said Chuttani. "Many complain about acid in throats or mouths and chest pain."

The chest pain is so severe for some patients, Chuttani said, they think they are having a heart attack.

"Some symptoms of acid reflux mimic cardiac chest pain and pulmonary symptoms," he explained. "Teeth problems, bad breath, asthma and sleep apnea are all linked to reflux."

Chuttani warned that chronic reflux can lead to Barrett's esophagus, a pre-cancerous condition that can increase the chance of developing cancer by 30 to 40 percent.

He tells his patients that they don't have to suffer and they can often ease some of the symptoms by making simple lifestyle changes. One of the most important tips, according to Chuttani, is not having a large meal close to bedtime. "Smaller more frequent meals are better," he suggested.

He recommends waiting at least three hours after eating before lying down. Avoid foods that trigger heartburn such as chocolate, caffeine, acidic juices, peppermint and alcohol. Controlling your weight and not smoking are two other ways to help relieve acid reflux.

Then there's the furniture method that Kronenberg tried, elevating the entire head of the bed. "The higher you can go, the more relief," said Chuttani.

He said some patients make the mistake of propping themselves up on pillows and "it scrunches the stomach even more when they finally do fall asleep."

Kronenberg also tried different medications including over-the-counter antacids that help neutralize stomach acid. She said she would go through a bottle so fast that her doctors prescribed stronger drugs. Histamine-2 blockers stop acid secretions. Powerful drugs called proton pump inhibitors are considered by some experts to be the most effective drugs for reducing acid production.

Kronenberg tried them all and conceded they didn't offer much relief. After her initial visit with Chuttani, she had a more effective solution.

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Kronenberg was told that her problems weren't related to controlling stomach acid after all; rather, the sphincter on her lower esophagus wasn't working properly. Chuttani told her it was a mechanical issue. "He looked at my endoscopy and said we can fix this."

Six weeks ago, Kronenberg underwent a non-surgical, outpatient operation called the plicator procedure. The plicator is a flexible device that goes down the esophagus and tightens the faulty valve. Chuttani helped develop the procedure, which was approved by the FDA in 2003. Chuttani called it safe and efficient. "We have been doing it for about three years now and about 50 percent of the patients are off medications at the three- to five-year mark."

Kronenberg's recovery has been even quicker, and she said the procedure has changed her life.

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"I'm almost off my medications. I can pretty much eat and drink whatever I want now and I sleep straight through the night."

As for bricks under the head of her bed, Kronenberg said they're still there, but she is counting the days until she removes them. E-mail to a friend E-mail to a friend

Judy Fortin is a correspondent with CNN Medical News. Linda Ciampa of Accent Health contributed to this report.

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