{"version":"1.0","provider_name":"The Medical Xchange","provider_url":"https:\/\/themedicalxchange.com\/en\/","title":"Chapter 2: Nighttime GERD - Implications for Clinical Practice - The Medical Xchange","type":"rich","width":600,"height":338,"html":"<blockquote class=\"wp-embedded-content\" data-secret=\"bcifYF3CkI\"><a href=\"https:\/\/themedicalxchange.com\/en\/review\/unmet-needs-in-ppi-therapy-for-gerd-2\/\">Chapter 2: Nighttime GERD &#8211;&nbsp;Implications for Clinical Practice<\/a><\/blockquote><iframe sandbox=\"allow-scripts\" security=\"restricted\" src=\"https:\/\/themedicalxchange.com\/en\/review\/unmet-needs-in-ppi-therapy-for-gerd-2\/embed\/#?secret=bcifYF3CkI\" width=\"600\" height=\"338\" title=\"&#8220;Chapter 2: Nighttime GERD &#8211;&nbsp;Implications for Clinical Practice&#8221; &#8212; The Medical Xchange\" data-secret=\"bcifYF3CkI\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\" class=\"wp-embedded-content\"><\/iframe><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n\/*! This file is auto-generated *\/\n!function(d,l){\"use strict\";l.querySelector&&d.addEventListener&&\"undefined\"!=typeof URL&&(d.wp=d.wp||{},d.wp.receiveEmbedMessage||(d.wp.receiveEmbedMessage=function(e){var t=e.data;if((t||t.secret||t.message||t.value)&&!\/[^a-zA-Z0-9]\/.test(t.secret)){for(var s,r,n,a=l.querySelectorAll('iframe[data-secret=\"'+t.secret+'\"]'),o=l.querySelectorAll('blockquote[data-secret=\"'+t.secret+'\"]'),c=new RegExp(\"^https?:$\",\"i\"),i=0;i<o.length;i++)o[i].style.display=\"none\";for(i=0;i<a.length;i++)s=a[i],e.source===s.contentWindow&&(s.removeAttribute(\"style\"),\"height\"===t.message?(1e3<(r=parseInt(t.value,10))?r=1e3:~~r<200&&(r=200),s.height=r):\"link\"===t.message&&(r=new URL(s.getAttribute(\"src\")),n=new URL(t.value),c.test(n.protocol))&&n.host===r.host&&l.activeElement===s&&(d.top.location.href=t.value))}},d.addEventListener(\"message\",d.wp.receiveEmbedMessage,!1),l.addEventListener(\"DOMContentLoaded\",function(){for(var e,t,s=l.querySelectorAll(\"iframe.wp-embedded-content\"),r=0;r<s.length;r++)(t=(e=s[r]).getAttribute(\"data-secret\"))||(t=Math.random().toString(36).substring(2,12),e.src+=\"#?secret=\"+t,e.setAttribute(\"data-secret\",t)),e.contentWindow.postMessage({message:\"ready\",secret:t},\"*\")},!1)))}(window,document);\n\/\/# sourceURL=https:\/\/themedicalxchange.com\/wp-includes\/js\/wp-embed.min.js\n\/* ]]> *\/\n<\/script>\n","thumbnail_url":"https:\/\/themedicalxchange.com\/wp-content\/uploads\/2011\/12\/Picture6__.png","thumbnail_width":1502,"thumbnail_height":1127,"description":"Of patients who report at least once-weekly episodes of heartburn, most also report nighttime symptoms. Although both the daytime and nighttime subtypes of gastroesophageal reflux disease (GERD) are produced when acidic gastric contents reflux into the lower esophagus, nighttime reflux has the potential to be a more severe form. Probably due to the loss of gravity that increases acid dwell time in the esophagus in the supine position, nocturnal reflux is associated with a higher risk of esophagitis and its long-term complications. Effective treatment of daytime reflux is not necessarily effective for nighttime episodes for a variety of reasons, including diminishing pharmacologic effect from proton pump inhibitors (PPIs) that are typically taken once daily in the morning. In many patient groups, such as those with sleep apnea, nocturnal GERD can contribute substantially to complications such as daytime fatigue. Due to its distinct features and risks, nocturnal GERD should be addressed specifically with the goal of complete symptom control."}