What causes stomach acid reflux and heartburn at night?

Generally, nighttime acid reflux and heartburn may be caused by various factors such as dietary habits, body position, functional dyspepsia, gastric ulcers, and hiatal hernia. It is recommended to seek medical attention promptly, identify the underlying cause, and receive symptomatic treatment under the guidance of a qualified physician. Specific analysis is as follows:

1. Dietary Habits

Consuming excessive oily or spicy foods at dinner or drinking alcohol can easily increase gastric acid secretion, leading to acid reflux into the esophagus and causing symptoms of acid regurgitation and heartburn. Adjust your diet by reducing intake of greasy and spicy foods during dinner, and avoid lying down immediately after meals.

2. Body Position

When upright, gravity helps prevent gastric acid reflux. However, when lying flat or prone, the effect of gravity is reduced, making it easier for stomach acid to flow back into the esophagus and trigger the aforementioned symptoms. Try elevating the head of your bed by 15–20 cm to use gravity to help prevent acid reflux.

3. Functional Dyspepsia

Functional dyspepsia is primarily caused by gastrointestinal motility disorders. Abnormal gastric acid secretion and gastrointestinal peristalsis in patients may lead to nighttime acid reflux and heartburn, often accompanied by symptoms such as bloating and belching. Treatment may include medications such as omeprazole enteric-coated capsules, ranitidine hydrochloride tablets, or domperidone tablets, taken as directed by a physician.

4. Gastric Ulcer

Gastric ulcers are often associated with Helicobacter pylori infection. Excessive gastric acid secretion and damage to the stomach lining make acid reflux and heartburn more likely during peak nighttime acid production. Symptoms commonly include stomach pain and postprandial fullness. Medications such as famotidine tablets, omeprazole enteric-coated capsules, and clarithromycin capsules may be used under medical supervision.

5. Hiatal Hernia

Hiatal hernia may result from an enlarged esophageal hiatus. When the diaphragmatic opening around the esophagus widens, part of the stomach may move upward, facilitating gastric acid reflux and causing heartburn and acid regurgitation. Additional symptoms may include retrosternal pressure and difficulty swallowing. It is recommended to take medications such as mosapride citrate tablets, rabeprazole sodium enteric-coated tablets, or lansoprazole enteric-coated tablets under the guidance of a healthcare professional to relieve symptoms.

Maintain healthy lifestyle habits, follow a light diet, and avoid consuming spicy or irritating foods.