Heartburn: why extra pillows can make it worse
The NHS suggests raising the head of the bed instead, but the authors of a 2021 review of trials say the research is too limited for definitive recommendations.
Using extra pillows to prop up the head can make heartburn worse, the NHS says, because they can increase pressure on the belly.
Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat, and symptoms are often worse when lying down.
Instead, the NHS page says, people may find that raising the head of the bed by around 10 to 20cm helps relieve symptoms. Wood, bricks or books can lift it, keeping the chest and head above the waist.
Does raising the bed work?
A 2021 review in BMC Family Practice covered five controlled trials with 228 adults who had reflux disease. Two used blocks under the bed legs, one used a wedge pillow and two used both. The NHS page does not mention wedge pillows. The four trials that reported on symptoms all found an improvement.
All five were judged to be at high risk of bias, and the results were measured too differently to be combined, the review’s authors wrote. Limitations in the literature “preclude definitive recommendations”, they said, though raising the head of the bed “could be still considered as a cheap and safe alternative to drug interventions with unfavourable safety profiles”.
A separate 2022 review in Neurogastroenterology and Motility covered 31 articles on treatments for night-time reflux symptoms. It found five studies on raising the head of the bed, two on a longer gap between dinner and bedtime and two on sleeping on the left side. Its authors recommend a step-by-step approach that combines all three with acid-reducing medicine.
The NHS page on heartburn lists other changes that can help stop or reduce it:
- smaller, more frequent meals
- losing weight, for people who are overweight
- finding ways to relax
- avoiding food and drink that trigger symptoms
- not eating within three or four hours of bedtime
- not wearing clothes that are tight around the waist
- not smoking
- not drinking too much alcohol
- not stopping prescribed medicine without speaking to a doctor first
Warning signs the NHS lists
The NHS says to see a GP if lifestyle changes and pharmacy medicines are not helping, if it happens most days, or if it comes with other symptoms such as food getting stuck in the throat, frequently being sick or losing weight for no reason. If symptoms get worse at any time, it says to contact a GP, go to 111.nhs.uk or call 111.
Its separate page on indigestion, often caused by acid reflux, lists more reasons to see a GP:
- indigestion that keeps coming back
- severe pain
- losing a lot of weight without meaning to
- difficulty swallowing
- being sick again and again
- iron deficiency anaemia
- a feeling of a lump in the stomach
- bloody vomit or poo
The page says these symptoms can be a sign of something more serious.
