Nighttime Chest Discomfort: Is It GERD? - Gastroenterology and Hepatology

Waking up in the middle of the night with a burning sensation in the chest, palpitations, and chest tightness, followed by a white-coated tongue, a bitter taste in the mouth, and a feeling of something stuck in the throat upon waking?

I initially thought it was a heart issue, but later realized that the sensation of heat in the chest is generally not related to heart disease.
Currently, my height and weight are 178 cm and 74 kg, respectively.
I do not smoke or drink alcohol, but I have a bad habit of lying down to watch TV and eating sweets and drinking tea half an hour after dinner, going to bed at eleven o'clock.
Dr.
Chen, could this be typical of gastroesophageal reflux disease (GERD) causing chest tightness and palpitations? Thank you for your response.

Mr. Wang, 30~39 year old female. Ask Date: 2021/05/14

Dr. Chen Shidian reply Gastroenterology and Hepatology

If the symptoms are consistent, medication treatment can be initiated, and it is advisable to reduce the intake of sweets, tea, coffee, and late-night snacks.

Reply Date: 2021/05/14

More Info

Nighttime chest discomfort can indeed be concerning, and your description suggests that it may be related to gastroesophageal reflux disease (GERD). GERD occurs when stomach acid flows back into the esophagus, leading to symptoms such as heartburn, chest pain, and discomfort, particularly after eating or when lying down. Your habit of lying down shortly after eating, especially after consuming sweet foods and tea, can exacerbate this condition.
When you eat, your stomach produces acid to help digest food. If you then lie down, gravity no longer helps keep that acid in your stomach, which can lead to it flowing back into the esophagus. This can cause a burning sensation in the chest, often mistaken for heart-related issues. The fact that you experience this discomfort after eating and while lying down is a strong indicator that GERD could be the culprit.

Your height and weight suggest that you are within a healthy range, which is a positive factor when considering potential health issues. However, lifestyle habits play a significant role in gastrointestinal health. Eating late at night, especially heavy or rich foods, can increase the likelihood of experiencing reflux symptoms. Additionally, consuming caffeinated beverages like tea close to bedtime can also contribute to discomfort, as caffeine can relax the lower esophageal sphincter, allowing acid to escape from the stomach.

It’s important to note that while GERD is a common cause of nighttime chest discomfort, it is essential to rule out other potential causes, especially if the symptoms persist or worsen. Conditions such as anxiety, panic attacks, or even cardiac issues can present with similar symptoms. If you experience severe chest pain, shortness of breath, or other alarming symptoms, it is crucial to seek immediate medical attention.

To manage your symptoms, consider making some lifestyle changes. Here are a few recommendations:
1. Avoid Late Meals: Try to eat dinner at least 2-3 hours before bedtime. This allows your body time to digest the food before you lie down.

2. Modify Your Diet: Pay attention to foods that trigger your symptoms. Common culprits include spicy foods, fatty foods, chocolate, caffeine, and alcohol. Keeping a food diary can help identify specific triggers.

3. Elevate Your Head While Sleeping: If you experience nighttime symptoms, elevating the head of your bed can help prevent acid from flowing back into the esophagus.

4. Maintain a Healthy Weight: While you are currently at a healthy weight, if you notice any weight gain, consider adopting a more active lifestyle and a balanced diet to help manage your symptoms.

5. Consult a Healthcare Professional: If your symptoms persist despite making these changes, it may be beneficial to consult a healthcare provider. They can evaluate your symptoms, possibly recommend lifestyle modifications, and if necessary, prescribe medications to help manage GERD.

In summary, while your symptoms may be indicative of GERD, it is crucial to monitor them closely and consult with a healthcare professional for a comprehensive evaluation. Making lifestyle adjustments can significantly improve your quality of life and reduce discomfort.

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