Acid reflux in the morning

Pro Research Analysisby

Searched over 200M research papers

Analyzed relevant papers

Morning Acid Reflux: Causes and Treatments

Prevalence of Morning Acid Reflux

Morning acid reflux, often characterized by a sour or bitter taste upon waking, is a common complaint among patients with gastroesophageal reflux disease (GORD) . Studies have shown that acid reflux events are more frequent immediately after awakening compared to other times of the day . This phenomenon, sometimes referred to as "riser's reflux," highlights the unique vulnerability of individuals to acid reflux during the early morning hours.

Acidic and Non-Acidic Reflux During Sleep

Research indicates that individuals are particularly susceptible to acid reflux during sleep. A study involving participants treated with esomeprazole, a proton-pump inhibitor (PPI), revealed that while PPI treatment significantly reduced total and acid reflux events, non-acidic reflux events were relatively more common . This suggests that even with effective acid suppression, non-acidic reflux can still occur, potentially explaining persistent symptoms in some patients despite PPI therapy .

Mechanisms Behind Morning Reflux

Transient lower esophageal sphincter relaxations (TLESRs) are a primary mechanism behind reflux events. A study on the effects of lesogaberan, a gamma-aminobutyric acid type B receptor agonist, found that this medication reduced the number of TLESRs and reflux episodes in patients who continued to experience symptoms despite PPI treatment . Lesogaberan also increased lower esophageal sphincter (LES) pressure, further supporting its potential as an add-on treatment for managing reflux .

Conclusion

Morning acid reflux is a prevalent issue among GORD patients, often exacerbated by the unique conditions of sleep. While PPIs are effective in reducing acid reflux events, non-acidic reflux can still occur, necessitating additional treatments like lesogaberan to manage symptoms effectively. Understanding the mechanisms and treatment options for morning acid reflux can help improve patient outcomes and quality of life.

Sources and full results

Most relevant research papers on this topic

Riser’s reflux – an eye‐opening experience

GORD patients experience more acid reflux events before and after awakening from sleep in the morning compared to normal subjects.

Observational StudyVery Rigorous Journal

2010·

16citations

·C. Pohet al.

Neurogastroenterology & Motility

Acidic and non-acidic reflux during sleep under conditions of powerful acid suppression.

PPI treatment reduces overall reflux events, but non-acidic reflux events are more likely to occur, potentially explaining why some individuals continue to have symptoms after PPI treatment.

RCT

2007·

43citations

·W. Orret al.

Chest

Effects of lesogaberan on reflux and lower esophageal sphincter function in patients with gastroesophageal reflux disease.

Lesogaberan reduces reflux episodes and increases lower esophageal sphincter pressure in patients with gastroesophageal reflux disease despite proton pump inhibitor treatment.

RCTHighly Cited

2010·

107citations

·G. Boeckxstaenset al.

Gastroenterology

Gastroesophageal reflux disease and sleep disturbances

GERD is associated with sleep disturbances, and lifestyle modifications and proton pump inhibitors can improve nighttime symptoms and quality of life.

Rigorous JournalHighly Cited

2012·

101citations

·Y. Fujiwaraet al.

Journal of Gastroenterology

Lifestyle Intervention in Gastroesophageal Reflux Disease.

Weight loss and tobacco smoking cessation can reduce esophageal acid exposure and symptoms in GERD patients, while avoiding late evening meals and using bed elevation can help with nocturnal GERD.

Systematic ReviewHighly Cited

2016·

280citations

·E. Ness-Jensenet al.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

Ambulatory pH monitoring of gastro-oesophageal reflux in "morning dipper" asthmatics.

Morning dipping in asthmatics is not associated with gastro-oesophageal reflux, and a randomized, double-blind trial of ranitidine versus placebo showed no significant difference in peak expiratory flow rates or patient well-being.

RCTHighly Cited

1988·

93citations

·R. Bakeret al.

British Medical Journal

Effect of Food and Dosing Regimen on Safety and Efficacy of Proton Pump Inhibitors Therapy—A Literature Review

Proper administration of proton pump inhibitors (PPIs) depends on the drug type and formulation, with morning intake providing better daytime control of gastric acidity.

Systematic ReviewRigorous Journal

2021·

15citations

·A. Wiesneret al.

International Journal of Environmental Research and Public Health

The consumption of snacks and soft drinks between meals may contribute to the development and to persistence of gastro-esophageal reflux disease.

Snacking and drinking soft drinks between meals may contribute to the development and persistence of gastroesophageal reflux disease (GERD).

2019·

15citations

·E. Fiorentino

Medical hypotheses

Sedation and Afternoon Placement of the 48-Hour Wireless Ambulatory pH Capsule Results in More Reflux on the First Day

Afternoon capsule placement is associated with a significantly increased amount of acid reflux on day 1, suggesting that morning capsule placement is ideal for accurate results.

Observational Study

2017·

4citations

·Rupal Patelet al.

Journal of Clinical Gastroenterology

Characteristics of nighttime reflux assessed using multichannel intraluminal impedance pH monitoring and a portable electroencephalograph.

Nighttime reflux in GERD patients occurs in various phases during sleep, with liquid reflux more common in awakenings and nonrapid eye movements, potentially contributing to sleep disturbances.

Observational Study

2016·

6citations

·Y. Fujiwaraet al.

Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus

Try another search

space race pictures

what heart rate is too low on beta blockers

albuterol sulfate tablets

how to relieve nerve pain in arm

genome dna

gaba vs gabapentin