For people living with chronic acid reflux or GERD, also known as gastroesophageal reflux disease, bedtime can be the worst time of day.
That’s when, as many people with the condition lie down to sleep, they feel the burning begin behind their breastbone.
GERD symptoms can get worse at night for several reasons. The primary cause is a weak sphincter between the stomach and esophagus that allows stomach acid to escape and irritate the sensitive lining of the esophagus. When people lay down, gravity no longer keeps the stomach contents, including stomach acid, in place.
Timing and size of meals can also play a role.
“Eating a large meal in the evening then going to bed can make your symptoms worse,” says Dr. James Givens, a general surgeon at Tidelands Health.
Plus, people tend to swallow less as they sleep, reducing a force that helps keep acid down, and we tend to produce less saliva, which can help neutralize stomach acid.

To help people struggling with GERD, Dr. Givens performs a surgical procedure known as Transoral Incisionless Fundoplication (TIF) that strengthens the sphincter and keeps stomach acid where it belongs. The procedure is incisionless so there is less pain and reduced recovery time, and there is no visible scar.

During the TIF procedure, the patient is put under anesthetic before Dr. Givens inserts a specially designed device down the throat and into the upper part of their stomach. Using the tool, he’s able to gather stomach tissue around the valve and staple it in place, similar to gathering in a sail or hemming a pair of pants.
“That effectively re-establishes the pressure of the sphincter,” Dr. Givens says.
In some cases, patients may have a hiatal hernia – a bit of their stomach poking up through their diaphragm – that must be addressed before undergoing the TIF procedure.

The TIF procedure isn’t for everyone, Dr. Givens says. People with sporadic heartburn or reflux related to pregnancy can often resolve their problem with changes in their diets or medication.
But it has been shown to be a very effective solution for people with GERD.

“Some may want to find relief through the TIF procedure so they can stop relying on medications such as H2 blockers or proton pump inhibitors, also known as PPIs, which may not help related reflux conditions such as asthma, chronic clearing of the throat and other symptoms,” Dr. Givens says. “There are a variety of people out there having multiple symptoms, and we have a wonderful treatment for them that has life-renewing benefits.”
Dr. Givens recommends people who think they may be interested in the procedure contact Tidelands Health Surgical Specialists at Murrells Inlet for more information and an evaluation, Dr. Givens says. 
Through the TIF procedure, Dr. Givens is able to shut down the leaking and allow his patients to get a good night’s sleep without having to take special precautions.
“It almost immediately resolves issues of nighttime reflux,” he says.