Don’t Lie Down!
By Teresa Biber M.S., CCC-SLP
Remember when our mothers used to warn us to “wait thirty minutes before going into the water before eating or you might get a cramp and drown.” Fortunately for those rebellious youngsters who refused to listen, there has yet to be a documented death attributed to swimming right after eating. Yet to this day most people probably will refrain from doing so. What our mothers should have told us was, “Don’t lie down for at least 2 hours after eating.” That warning would have been much more biologically correct and ultimately saved a lot more lives! I am amazed at the number of patients I encounter daily, both young and old, who admit to lying down right after eating. The simple truth is, this is not only unwise but potentially very dangerous.
When we eat a meal, our digestive system begins the process of breaking down the food, using acid pumps. This pumping action is meant to stay in the stomach where the lining is especially designed to manage the highly acidic environment. This is achieved by a closed valve like structure at the top of the stomach called the lower esophageal sphincter or LES. This acid is not meant to travel beyond that sphincter because the more delicate lining of the esophagus can be seriously damaged as a result. Normally, as long as the body is upright, as in sitting or standing, the acid stays in the stomach and does its job. This process can take up to a couple of hours depending on the amount and type of food being digested. When we lie down before this process is completed, the pressure and pumping action in the stomach will push through the lower esophageal sphincter and propel the acid right into the esophagus often times all the way up into the throat. It can even enter our lungs. None of us would ever dream of pouring acid down our throats or into our lungs, but that is what we are doing when we lie down too soon. This phenomenon is called gastroesophageal reflux or
GER. It is also commonly referred to as simply, acid reflux. The scary part is many of us never feel anything until it is too late. The constant damage to the lining of the esophagus and throat has been linked to esophageal cancer as well as other cancers of the throat, mouth and tongue. Erosions in the esophagus can also cause strictures and internal bleeding. Other problems include bad breath, difficulty swallowing, chronic sore throat, chronic cough, voice changes, laryngitis and hoarseness. GER has been linked to asthma and lung damage causing nocturnal suffocation, increased cough and wheezing. The constant pressure and inflammation of the acid at the top of the esophagus may cause the formation of a pouch called a Zenker’s diverticulum. This “sac” forms in the throat and fills with food and liquid. The consequence is an uncomfortable lump like feeling during eating and drinking often combined with coughing and choking. The result can be a very serious and life threatening aspiration pneumonia. You will have GER if you lie down after eating and many times if you simply “follow the rules” and wait 2 hours you can avoid many of these serious health consequences. However, sometimes the lower esophageal sphincter becomes relaxed and stays open instead of closed. When this happens, your esophagus, throat and lungs are no longer protected from the pumping up of acid. This is a condition known as Gastroesophageal Reflex Disease or GERD. This is more serious and you shouldsee a physician, typically a gastroenterologist,if you suspect you have GERD. GER can also occur as a result of other factors even when sitting up. Some people may experience this as the classic “heartburn” but just because you don’t feel it doesn’t mean it is not happening. In fact many people are asymptomatic” meaning they have no symptoms. Common causes of GER include: ? Carbonated beverages? Chocolate? Caffeine? Fried and fatty foods? Spicy foods? Citrus products? Tomato products? Peppermint? Smoking? Alcohol? Excess weight or pregnancy If avoid these things you will significantly decrease your chances of
GER.
The bottom line is GER and GERD can cause some extremely serious and life threatening health consequences. The
American
College of Gastroenterology reports that
60 million Americans report frequent heartburn.
So;
“Don’t lie down for at least 2 hours after you eat or drink”. Your mother told me to tell you so!
Special thanks to Hari Singh, M.D.Images courtesy of National Library of Medicine