# insomnia



## starfishgina (Nov 16, 2003)

helloi have gerd and it has been very awful. i ahve not been able to sleep or work this entire week and it's very aggravating to me. it seems to have worsened greatly the past few weeks to the point that i wake up many times during the night AFTER i finally fell asleep. i take medicine, but the pressure and buring is unbearble. i feel like i can't breath and i need to belch. i am taking ambien, but that doesn't help me sleep, i just feel groggy in the morning. luckily i'm married and not the breadwinner, but i've always taken pride in working and helping out. does anyone out there have any ideas? cold it be something i'm eating before bed? i've really been trying, but i feel i am getting worse and more depressed. i know this sounds whiny, but i am writing feeling very tired and home from work once again.Star


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## em.london (Dec 11, 2001)

Here is some information that might help:Lifestyle modifications involve avoidance of factors that may aggravate symptoms, such as dietary changes or changes in daily routine. Diet does not cause GERD. Nevertheless, gastroesophageal reflux and its most frequent complaint of heartburn can be aggravated by foods. Certain medications can aggravate symptoms. Disclose the use of any medications to your physician. Heartburn is a burning sensation in the chest behind the breastbone. If you have this symptoms, there are a number of things that you may be doing that promote gastroesophageal reflux and cause you to experience heartburn. Positionï¿½Gravity plays an important role in controlling reflux. Those of us who have a less than perfect lower esophageal sphincter (LES) find that if we lie down after a large meal, food comes back into the esophagus and heartburn occurs. If you experience heartburn, think whether it occurs after meals, when you lie in bed at night, or if you take a nap after a meal. Maintaining an upright posture until the meal is digested may prevent the heartburn. If heartburn occurs regularly at night, consider raising the head of the bed or inserting a triangular wedge to keep your esophagus above the stomach. Avoid exertion after a meal. It contracts the abdominal muscles and forces food through a weakened sphincter. This is especially true of tasks that require bending such as lifting or cleaning the floor. How you eatï¿½How is perhaps more important than what you eat. A large meal will empty slowly from the stomach and exert pressure on the LES. A snack at bedtime is well positioned to reflux when you lie down. It is best to eat early in the evening so that the meal is digested at bedtime. You might try having the main meal at noon and a lighter one at dinnertime. All meals should be eaten in relaxed stress-free surroundings. Trips to the kitchen to fetch food or the performance of other tasks such as minding children should be suspended during, and for a time after, eating. Smaller meals and an upright, relaxed posture should help minimize reflux. What you eatï¿½Certain foods compromise the sphincter's ability to prevent reflux, and are best avoided before retiring or exertion. These differ from person to person, but many recognize fats, onions, and chocolate as particularly troublesome. Alcohol often provokes heartburn, by compromising the LES, irritating the esophagus, and by stimulating stomach acid production. Certain other foods may bother some people; upon their discovery a period of avoidance or reduction may be of benefit. Some oral medications such as potassium supplements or the antibiotic tetracycline will burn if allowed to rest in the esophagus. To be safe, one should always swallow medication in the upright position and wash it down with lots of water. Other factorsï¿½Being overweight can promote reflux. Excess abdominal fat puts pressure on the stomach and the loss of even a moderate amount of weight makes many people feel better. Pregnancy is often troubled by heartburn, particularly in the first three months. Certain hormones appear to weaken the LES, and the increasingly crowded abdomen encourages reflux. Generally, if there has not been too much weight gain, a woman's heartburn improves after delivery. Stress or strong emotion can also influence heartburn. Antacids may temporarily relieve heartburn by neutralizing stomach acid. Other over-the-counter drugs that reduce acid production are available for short term and occaisional relief of heartburn.If heartburn occurs on two or more days per week despite the measures discussed above, you should consult your family doctor.


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