Bad heartburn at night: causes and relief

Lying down removes gravity’s help in keeping stomach contents below the food pipe. A large or late meal, alcohol, smoking, tight clothing and certain foods can add to reflux. Gastritis, a hiatus hernia, obesity or a peptic ulcer may cause similar upper-body discomfort. Heartburn can feel like burning behind the breastbone or a sour taste, but chest symptoms are not always digestive.

Keep a brief record of dinner time, bedtime, foods, medicines, symptom position and whether sitting up helps. This pattern can guide a clinician without assuming the diagnosis.

Finish dinner well before lying down and choose a smaller evening meal. Raise the upper body safely with a suitable wedge or bed adjustment rather than stacking loose pillows. Avoid personal triggers, remain upright after eating and keep water nearby. Ask a pharmacist or doctor about an appropriate acid-reflux medicine; do not take someone else’s prescription or rely on frequent self-treatment without review.

Get emergency help for crushing or spreading chest pain, severe breathlessness, fainting, sweating with chest discomfort or sudden weakness. Arrange prompt medical review for vomiting blood, black stools, trouble swallowing, persistent vomiting, unexplained weight loss or symptoms that repeatedly wake you despite sensible changes.

Ask whether your symptoms fit reflux, how long a treatment trial should last and whether another cause needs checking. Discuss medicines that may irritate the stomach, alarm symptoms, and when a test or specialist review would be appropriate.