Reducing Acid Reflux and Choking Spells


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Choking can be a very startling and upsetting experience for many acid reflux sufferers, both infants and adults alike.  The symptom of choking usually occurs at night when a person is sleeping, and choking is what tends to wake the person up who then usually violently coughs to clear their throat and catch their breath.

Why does acid reflux and choking occur?  When acid reflux occurs during sleep, the body’s natural defenses against reflux are deactivated.  For instance, you no longer have the ability to swallow saliva, which neutralizes acid, and the lower esophageal sphincter (LES) relaxes, so it no longer blocks stomach acid from flowing into the esophagus.  The deactivation of natural defenses can not only lead to heartburn, but can also allow stomach acid to creep up the esophagus and pool in the throat, enabling it to flow up into the mouth and nose.  When this happens, the acid can be aspirated (sucked in when breathing), causing it to dribble into the lungs and windpipe, resulting in choking, and possible damage to the lungs.

There are a few factors that can cause acid reflux and choking at nighttime in adults.  The following is a breakdown of what these major factors are, followed by what can be done to treat the problem:

• Sleeping supine – If you are sleeping in a supine position (laying flat on your back), stomach acid can freely flow into the esophagus and remain there for an extended period of time.  This can cause heartburn, and can also lead to the acid rising further up the esophagus into the throat.  

Prevention Tip – Sleep with your head and shoulders elevated, about 3-6 inches above the mattress.  Use pillows to prop yourself up.  The idea is to place your body on a slight incline so that acid cannot reach your upper esophagus.  Sleeping on your left side may also prove beneficial as studies have found sleeping on your right side can make the problem worse. 

•  Sleeping in constricting clothing – Tight clothing that gathers at your waist places pressure on your stomach, and can force acid up and into your esophagus.

Prevention Tip - Wear loose fitting clothing/pajamas to bed and avoid pants, shorts, or underwear with tight elastic waistbands.  While sleeping you don’t want to cause any unnecessary aggravation that increases the risk of reflux or makes it worse.

• Eating before bed – Many people make the mistake of eating or drinking directly before bed.  Lying down too soon after eating slows down the digestion process, and sleeping on a full stomach dramatically increases the risk of heartburn, as well as acid reflux and choking.

Prevention Tip – Eliminate foods that trigger acid reflux symptoms (I.E. fatty and spicy foods, alcohol, etc.) from your regular diet, and avoid eating or drinking 2-3 hours before going to bed.  If you are thirsty, only drink water slowly in small amounts.

How can I prevent acid reflux and choking in my child?  Unfortunately, infants are also prone to acid reflux and the symptom of choking.  The main reason for this is because the LES is not fully developed in many infants younger than 18 months.  Signs of acid reflux in your infant include:

• Frequent spitting up combined with poor sleeping
• Extreme fussiness
• Frequent back or neck arching or stretching
• Refusal of food
• Slow weight gain
• Chronic sinus or ear infections

If your child has any of these symptoms you need to have him/her properly diagnosed by their pediatrician.  Acid reflux is very complicated to diagnose in children, and only your child’s pediatrician can make this diagnosis and determine what treatment is best for your child.  Never diagnose your child on your own.

Nevertheless should your infant have acid reflux and choking, the following are ways you can help prevent your little one from suffering:
• Modify the diet.  This may mean giving your child:
• Smaller and frequent meals
• Thickened formula with rice cereal
• No foods that trigger acid reflux such as citrus foods, tomato products, carbonated beverages, spicy foods, chocolate, etc.

• Hold the child in an upright position during feeding
• Keep the child in an upright position for a minimum of an half an hour after eating
• Lay the child so they are on an incline so their head and shoulders are slightly elevated.  This can be done using a wedge pillow.
• Your doctor may also prescribe medications.

Finally, anyone who is suffering from nighttime acid reflux and choking, or other symptoms, should speak to their doctor and obtain the necessary treatment to prevent symptoms from occurring, so that damage of the esophagus and/or lungs can be avoided. 


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5 Responses

  1. Patty
    May 8th, 2008 | 11:17 pm

    This was a very informative article. My 15-yr-old daughter was recently diagnosed with acid reflux. We were surprised with the diagnosis because she had never experienced “heartburn”. Her main symptom was the nighttime coughing/choking episodes which were very scarey for her to experience and for me, as her mom, to watch. X-rays yesterday confirmed that she does have a severe case of acid reflux. Over the past month she has made changes to her diet, eliminated evening snacking, and started taking 20mg of an OTC acid reducer daily. We’ve also raised the head of her bed. These changes have help alot, but it’s hard for a 15-yr-old to go without pizza and chocolate. I have read alot about acid reflux over the past month since this all started, but this was the only article mentioning choking. Somehow it was comforting to know we aren’t alone with this symptom and it follows the reflux diagnosis.

  2. Gail McKeague
    May 9th, 2008 | 12:36 pm

    Sometimes I am startled awake in the middle of the night choking to death. I cant breathe through my nose and I feel like I’m going to die before it finally subsides. What are you to do when you can’t talk to call 911? I’t’s the scariest feeling in the world. I take medication twice a day and I’m still a nervous wreck. Please respond if you can. Thank you, Gail

  3. May 9th, 2008 | 5:31 pm

    Gail -

    There are a number of steps you can take in this article which may help - And as Patty has done for her 15-year old daughter (see comment above) there are some lifestyle changes you can make as well.

    However, the first thing I would suggest is that you speak with your doctor to make sure that it is Acid Reflux that is causing the symptoms…

    I would also suggest you keep a diary of when the symptoms occur and what routine you followed during that day - Consider things like:

    - The food you ate
    - What you drank
    - How long you ate or drank before bed
    - What position you wake up when you have a coughing fit
    - What exercise or activity have you carried out
    - Has the day been stressful or did you have to hurry food
    - Did you have heartburn/ indigestion throughout the day - If so when

    If you do this you should start to see some trends and indications of what may be triggering some of your symptoms so you can take steps to avoid them.

    I hope this helps.

    Kind regards

    Kathryn.

  4. Paolo David
    May 10th, 2008 | 5:58 am

    All my friends and relatives who suffered Acid reflux had the same common symptom, heartburn. Mine was the less common, chocking. This is what happened to me.
    My acid reflux started with chronic coughing. Having the history of asthma and the usual coughing, I went to see a pulmo doctor.
    She gave me all the anti-coughing medicine plus antibiotics.
    My condition remained the same for 2weeks.
    On the first day of the third week, I woke up in one afternoon to cough.
    To my shock, I suddenly couldn’t breathe.
    I started to panic and went frantic. I thought I was going to die.
    My dad heard me banging the door for help and thought I was chocking, something I ate that blocked my throat. He tried to do first aid on me but was starting to panic when I didn’t get relieved.
    it was the scariest moment in my life as I really thought I was going to die.
    i was brought to the ER and was diagnosed with bronchitis, unbelieveable.
    My chocking went on so we decided to see the ENT and Internal medicine.
    They said I had acid reflux.
    It has been 2mos already and I’m on my way to recovery, after shedding 15lbs in a month. I’m on a medical diet (only steamed and grilled fish, alkaline water) plus medicine (nexium, anti dypepsia etc).
    It was only this week that my chocking stopped.
    It was a very hard experience, a traumatizing one.
    Its not over but I try to control it.
    I share the hardship of those who experience the same symptoms and pray for everyone’s recovery.

  5. vikram
    June 18th, 2009 | 4:39 pm

    Iam having similar and i need some permamnent medical treatment

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