Why Is Nighttime Heartburn More Dangerous?
Day or night, chronic reflux can gradually damage the esophagus. It may lead to inflammation and scar tissue that narrows the esophagus. In some people, chronic heartburn can lead to Barrett’s esophagus, changes in the cells that increase the risk of esophageal cancer. But nighttime heartburn tends to leave acid in the esophagus longer, and therefore may cause more damage than daytime heartburn. “A good part of the explanation is gravity,” says Lawrence J. Cheskin, MD, co-author of Healing Heartburn and associate professor of medicine at the Johns Hopkins School of Medicine in Baltimore, Md. During the day, acids from the stomach may briefly force their way into your esophagus. But gravity quickly pulls them back down to the stomach. When you’re lying down, gravity isn’t pulling in the right direction. Instead, the stomach contents are pressing on the sphincter muscle that connects the esophagus to the stomach. In people with GERD – which means nearly everyone with chronic heartburn –