If you experience heartburn 2 or three times at night, talk to your doctor. You may have GERD if you get heartburn at least twice a week. Other problems that may point to GERD include difficulty swallowing, regurgitating food into the mouth, hoarseness, and cough or wheezing. You shouldn't put up with acid reflux, because it can do a lot of damage. GERD can cause ulcers, bleeding, and narrowing of the esophagus. Some GERD sufferers develop changes in the lining of the esophagus that may lead to cancer.

As many as one in four Americans may suffer heartburn at night, according to a study published in 2005 in the journal CHEST. The figure is even higher among people who say they suffer chronic heartburn, or gastroesophageal reflux disease (GERD).

In a separate 2005 survey of 1,900 people with GERD in the U.S. and Europe, 55% said they had trouble sleeping at night. The people estimated that their symptoms caused a 22% impairment of leisure activities and a 15% impairment of their ability to work.

Frequent heartburn is the key symptom of gastroesophageal reflux disease (GERD), the chronic reflux of stomach acids into the esophagus. Take it seriously. Talk to your doctor about the different treatment options:

Over-the-Counter Medicines

The Stretta Procedure

Prescription Medicines

Heartburn Surgery

Think you may have nighttime heartburn or GERD? Look for these signs.

One of the problems with chronic heartburn or GERD is that you may not know you have it. Many people aren't completely woken up by the symptoms at night. In some cases of GERD, there may be no symptoms at all, even when you're awake. However, there are a number of things you should look for.

Waking up to a bitter, acidic taste in your mouth

Sharp, burning pain in your chest that can extend up to your neck and throat

Fatigue during the day

Chronic cough or fits of coughing that wake you up in the night

Sore throat, hoarseness, or asthma attacks.

In some cases of GERD, the acid can rise so high in the esophagus that a person can actually breathe it in. This can lead to respiratory problems, such as cough or hoarseness.

There are other symptoms that experts call "warning signs." Any of them should be checked out right away.

Trouble swallowing or painful swallowing

Coughing up or vomiting blood

Blood in the stool

Unexplained weight loss

Fever

Keep in mind, the symptoms of heartburn are similar in some ways to the symptoms of heart trouble. If you're experiencing pain that feels different from your usual heartburn, get it checked out immediately. Pain after physical activity -- as opposed to after a spicy meal -- is also a worrisome sign. If you have even the slightest doubt about your chest pain, err on the side of caution. Treat it as a medical emergency and go to the nearest emergency room.

Does heartburn keep you up at night? Follow these tips for better sleep. If you've been waking up at night with heartburn, here are tips to help you sleep better:

Raise the head of the bed by 4 to 6 inches, so you can sleep with your head and chest elevated. You can lift the top end of the bed by sticking blocks underneath -- although your spouse may object once he or she has slid out of the bed a few times. You could also lie on special wedge pillows designed to help you sleep on an incline.

Eat meals two to three hours before bed, since this will reduce the risk of nighttime heartburn. Avoid bedtime snacks.

Don't wear clothes that fit tightly around the waist, since they can aggravate your symptoms.

Chew gum during the evening. This can boost the production of saliva, which neutralizes stomach acid.<

Try sleeping on your left side. Some studies have shown that this helps with digestion, simply because of a quirk of the body's design. Sleeping on your right side seems to be most likely to aggravate symptoms.

Avoid foods that can trigger reflux or irritate the esophageal lining. These include alcohol, chocolate, peppermint, coffee, carbonated drinks, citrus fruits and juices, tomatoes, pepper, vinegar, catsup and mustard, and spicy or fatty foods.

Don't use medicines that can worsen reflux. Examples include aspirin, other painkillers, and calcium-channel blockers. Check with your doctor about alternatives if you are currently taking any reflux-worsening medications. Never stop a medication without first talking to your doctor.

If you smoke, stop.

If you're overweight, try to lose some of your excess pounds.

Heartburn is almost always caused by spicy foods. True Or False?

False - Many foods relax the esophageal sphincter, the ring of muscle that acts as a “valve” between the esophagus and the stomach. Alcohol, caffeine, citrus, tomatoes, chocolate, and spearmint are among them. A relaxed esophageal sphincter lets harsh stomach acid “reflux”, or wash, back into the esophagus. This causes the discomfort of heartburn, and the sour or burning taste in the back of your throat. Spicy and fatty foods can trigger heartburn just like these other foods, but they are by no means the primary trigger. That said, a big, spicy meal, washed down with coffee or beer, is a perfect setup for heartburn. A very full stomach from a big meal puts pressure on the sphincter, making it more likely that stomach acid will burble up. If you think food is triggering your heartburn, first start eating small meals. Then, cut out each suspected trigger food from your diet for a week or two to see which, if any, is causing the trouble.

Heartburn is uncomfortable, but never a serious health problem. True Or False?

False - Heartburn can be a symptom of a serious problem called gastroesophageal reflux disease (GERD). It's estimated that 60 million Americans have heartburn once a month, and somewhere around 20 million have it daily. Over-the-counter medicines such as antacids, H2 blockers (Axid, Pepcid, Tagamet and Zantac), and the proton-pump inhibitor Prilosec may be enough to relieve heartburn. But many people find that prescription medication is needed to control symptoms. These include the H2 blockers Axid, Pepcid, Tagamet, and Zantac and the proton pump inhibitors Aciphex, Nexium, Prevacid and Protonix. Other drugs are also available. In some cases surgery is an option to treat more severe disease.

Pregnancy and heartburn often go hand-in-hand. True Or False?

True - About 50% of pregnant women get heartburn at least once a month, and one-quarter suffer from it every day. There are two reasons why: First, hormones released in early pregnancy can relax the esophageal sphincter. Later on, the growing baby puts pressure on the stomach. To ease heartburn, pregnant women can take antacids that contain calcium carbonate (such as Tums). They should not take antacids that contain sodium bicarbonate, which can cause fluid retention. Pregnant women should consult with their doctor before considering any other medicine to relieve heartburn.

Chewing gum helps relieve heartburn. True Or False?

True - Chewing gum stimulates saliva production, and saliva can help neutralize acid reflux. Don't chew peppermint or spearmint gum, however. Peppermint and spearmint are known heartburn triggers.

Heartburn is often worse at night. True Or False?

True - When you're lying down, gravity doesn't let acid drain back into the stomach. A survey by the American Gastroenterological Association showed that 80% of heartburn sufferers had severe heartburn at night. Three-quarters of those surveyed said that heartburn kept them awake at night.

Heartburn can signal a heart attack. True Or False?

False - Heartburn has nothing to do with your heart. Acid reflux and heart disease aren't related in any way, except that the symptoms of both involve chest pain. Often heartburn pain can be so bad that people rush to the emergency room, thinking they're having a heart attack.