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Heartburn affects about 25% of people at night. In those with gastroesophageal reflux disease (GERD), over 50% of sufferers reported trouble sleeping and interference in their ability to work and relax. GERD is a serious problem which can lead to cancer of the esophagus and pneumonia from inhaling stomach contents at night. Nocturnal GERD represents a more serious subset of afflicted people with a higher risk for such complications.
A study in the March 2010 issue BMC Gastroenterolgy offers a novel, cheap, readily available potential treatment for GERD, melatonin. The authors found that melatonin, 3 mg at bed-time, could be used alone or in combination with omeprazole, 20 mg twice a day. When used by itself, melatonin resulted in a marked improvement in GERD as assessed by gastroscopy and a significant improvement in symptoms (heartburn and pain) after 8 weeks. When combined with omeprazole even better results were attained faster, in 4 weeks.
Melatonin has been used as a sleep aid for years. It is produced by the pineal gland in the brain and is converted back to serotonin in the daytime which changes back into melatonin in a circadian rhythm at night. Surprisingly, researchers have found more than 400 times more melatonin in the gut (gastrointestinal tract) then in the brain (pineal gland). This insight lead to trials of the compound in GERD. It is a potent antioxidant which is likely the way it protects the esophageal lining from acid burns and damage. Unlike antacids, It has no effect on acid levels in the stomach. It has been found to be safe with an acceptable side effect profile and is available over the counter.
The combined efficacy for sleep maintenance and stomach protection makes melatonin a fascinating and novel therapy for nocturnal GERD. Further studies are needed to confirm these findings. In the meantime, it seems like a safe, effective and readily available option to explore with your physician.
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