I am a 55-year-old man and I suffer from a painful burning sensation in my chest and sometimes in my throat. I have noticed this is worse when I go to bed and sometimes I wake with acid in my mouth. What is causing this and what can be done about it?
Conventional Remedy: From your description it sounds like the symptoms of a hiatus hernia. This occurs when the upper part of the stomach which is joined to the oesophagus or gullet moves up into the chest cavity through the diaphragm. This happens when the muscle ring at the bottom of the gullet no longer works properly as a valve. The burning sensation you experience is as a result of acid in the stomach being pushed back up into the gullet. This process is called reflux which can occur when you lie down or bend forward. If, as in your case, this happens while you were asleep, you will wake up with an unpleasant burning in your throat and a mouthful of acid. Other symptoms can include pain on swallowing hot liquids, belching and a sensation of food sticking in the throat.
Although a hiatus hernia is not usually serious, it can, however, cause inflammation of the lower end of the oesophagus. This is called reflux oesophagitis and bleeding and anaemia can result. It can also cause a stricture or slight closing of the inflamed area of the gullet.
This condition is most common in overweight middleaged women and the elderly, but also occurs in men. So if you are overweight, then losing any excess will help. Eating small frequent meals throughout the day will also reduce the symptoms. Smoking and alcohol will aggravate it, as will coffee, so cut back on all of these. Using an extra pillow to prop yourself up at night or raising the head of the bed by about four inches will also help prevent reflux at night.
You should visit your GP for a full check up to rule out any other cause. If it is a hiatus hernia there are several different types of preparations which can help, each working in a different way. Some neutralise the stomach acid and reduce irritation to the gullet. Others float on the surface of the stomach contents and protect the inflamed part of the gullet. Drugs called H2 blockers reduce the production of acid. If the condition does not settle with medication and losing weight, you may be referred to a gastroenterologist for investigation.
Dr Muiris Houston
Alternative Remedy :These symptoms often happen in hiatus hernia, reflux oesophagitis patients, especially when associated with acid in the mouth in the morning. One should always exclude cardiac conditions. The acid will give a "burning sensation" (patients often complain of pain) and acid can go upwards to the throat when lying flat during sleep - especially when sleeping on a low pillow. In traditional Chinese medicine, the diagnosis is Wind (gas) and Dampness (acid) disorder in digestive system. In T.C.M. there are three ways of treating this condition. Firstly, acupuncture is the best therapy in my opinion. This gives faster and more effective results in reducing acid excretion and relieves the pain. Secondly, herbal treatment involves use of a simple herb - ginger root soup or juice (as a food therapy) or as a herbal remedy (Pin wei san or Xian sha yang wei tang). Each of these contain ginger root. Finally, one advises such patients to alter their diet - to cut out citrus fruits (rhubarb, oranges, lemons) and to lower the amount of sweetened foods (cakes and biscuits).
Dr Katherine Chan Mullen.
Irish Medical Acupuncture Society. Tel: 01 2887616