Heartburn, Sour Taste, and Spicy Food- A common combination of symptoms with gastric reflux. But reflux presenting as night sweats is a rare case!

A middle-aged male was having drenching night sweats for the past 3 months. He finally decided to seek medical attention. In the medical world, night sweats can be a symptom of any cancer. The doctors took a thorough history to find out if the patient has any symptoms indicating underlying cancer. However, they found out that the patient has only gastroesophageal reflux disease which is causing his symptoms. A rare symptom of GERD!

During the history, the patient denied any weight loss, appetite change, fever, fatigue, smoking, and intravenous drug use. He had no recent travels and was an occasional alcohol consumer with 1 to 2 beers per week.

However, on further inquiring, he revealed that he was having progressively worsening heartburn for the past 6 months for which he never sought any professional help for that.

He described his heartburn as a burning sensation that is worst in the mornings but persists throughout the day.

The patient was a known case of obstructive sleep apnea for which he was on CPAP, i.e., continuous positive airway pressure. The rest of his relevant history was unremarkable.

On examination, he had no abnormal findings. However, he weighed 128 kgs.

Night sweats are a rare symptom of reflux disease. Therefore, the doctors where bound to rule out any malignancy considering that these are way more common in cancers. To do so, they decided to perform advanced contrast imaging.

However, they, along with the patient, mutually decided to first treat his heartburn with omeprazole. At 1-month follow-up the patient’s heartburn resolved and so did his night sweats.

His drenching night sweats were completely resolved!

All his blood tests including the viral markers and HIV test, and chest X-ray came out unremarkable.

He continued the treatment for 3 months and had no similar symptoms again. This confirmed that night sweats were in fact due to GERD and not due to any cancer. Had it been due to malignancy, omeprazole would not have resolved the sweats.

Since there are no formal trials to establish a link between night sweats and GERD, it is imperative for clinicians to be aware of this rare manifestation to avoid unnecessary investigations. Physicians must rely on their clinical judgment as no definitive evidence is present at the moment.

Source: The Journal of the College of the Family Physicians of Canada