Acid reflux is when a person’s stomach contents flow back into their esophagus. Certain people who have acid reflux experience headaches or migraine.

Acid reflux can be a symptom of gastroesophageal reflux (GER). GER can cause symptoms such as heartburn or regurgitation. If a person has frequent and severe episodes of GER, they may have gastroesophageal reflux disease (GERD).

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that around 20% of people in the United States have GERD.

A person who has GERD may also experience headaches or migraine. A review from 2016 found that people with headaches or migraine can have reflux symptoms.

Read on to learn more about the connection between GER and headaches, as well as symptoms, treatments, and prevention.

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There is currently limited information on how or why acid reflux can cause a person to have headaches. Additionally, researchers are unsure whether acid reflux causes headaches or if headaches cause acid reflux.

It is also possible that acid reflux and headaches can simply occur together without one causing the other. There may also be certain conditions that have both headache and acid reflux as symptoms.

Current research

What researchers do know is that a person’s brain has a connection to their gut via the gut-brain axis.

The gut-brain axis allows the gut and the brain to communicate with each other. Additionally, the gut-brain axis links a person’s gut to their autonomic nervous system (ANS).

A person’s ANS deals with involuntary processes, such as respiration and digestion. The ANS contains three divisions:

  • Sympathetic nervous system (SNS): The SNS is in charge of a person’s “fight or flight” response. This is the body’s automatic reaction to threats.
  • Parasympathetic nervous system (PNS): The PNS controls a person’s “rest and digest” response. This response relaxes the body once the threat has passed.
  • Enteric nervous system (ENS): The ENS regulates certain digestive functions, such as muscle contractions and secretions.

A study from 2017 noted that there is a link between ANS dysfunction, headaches, and gastrointestinal (GI) disorders.

Another study from 2015 stated that GERD associates with impaired PNS function. This means that the link between GERD and headaches may be caused by a malfunctioning ANS.

There may also be a link between glutamate, GERD, and migraine. Glutamate is a neurotransmitter, which is a chemical that passes on signals from nerve cells to target cells.

Research from 2020 found that issues with glutamate levels, or transmission, can lead to GER or migraine headaches.

Currently, there is limited research regarding the link between GERD and headaches.

Studies indicate that GERD and headaches could be co-occurring symptoms of certain conditions or imbalances within the body.

However, researchers believe that that may be a link between proton pump inhibitors (PPIs) and headaches.

Doctors use PPIs to treat certain gastric conditions, such as GERD or gastritis. A person taking PPIs to treat their GERD could potentially develop headaches as a result, although more research is needed to confirm this effect.

Researchers believe that there may be a link between acid reflux and dizziness.

Research from 2015 noted that within a study group of 153 patients, peripheral vertigo was more common among those who had GERD, compared with those who did not. However, further research is required to explore why this might have been the case.

Peripheral vertigo occurs due to a problem inside a person’s inner ear. Peripheral vertigo can cause:

  • dizziness
  • spinning sensation
  • loss of hearing in one ear
  • ringing in one or both ears
  • difficulty focusing eyes
  • loss of balance

The authors of the study mentioned above theorize that a possible cause of peripheral vertigo is stomach acid moving up the throat and into the Eustachian tubes. However, it is important to note that this is only a theory and has not been scientifically proven.

The Eustachian tubes are small passages that connect a person’s throat to their middle ear. The Eustachian tubes pass through a person’s inner ear, which contains fluid and sensors that help a person maintain their balance.

According to the researchers’ theory, disruption to the inner ear due to stomach acid moving through the Eustachian tubes may cause peripheral vertigo symptoms. Again, more research is needed to test this theory.

Dizziness may occur due to shortness of breath caused by GERD. Reflux can cause inflammation and irritation of a person’s airways, which may lead to shortness of breath. If a person is unable to take in enough oxygen, they may feel dizzy.

Headaches can also cause a person to feel dizzy. The American Migraine Foundation notes that between 30⁠–50% of people who experience migraine also have dizziness or loss of balance.

These latter two factors could potentially lead to the occurrence of acid reflux, headaches, and dizziness alongside each other.

GERD symptoms can make it difficult for a person to fall asleep. If a person is unable to sleep properly, they may become fatigued.

When a person is sitting or standing, their stomach contents are at the bottom of their stomach. However, when a person lies down, their stomach contents may travel back into their esophagus.

Information from the International Foundation for Gastrointestinal Disorders (IFFGD) states that up to 4 out of 5 people with GERD have nighttime symptoms. Additionally, 75% of people who had heartburn as a symptom stated that it affected their sleep.

Research from 2017 found that there was a link between tension headaches and lack of sleep. This connection worked both ways, with sleep deprivation causing headache and headache causing sleep deprivation.

Acid reflux can cause symptoms such as:

  • chest pain
  • nausea
  • difficulty swallowing
  • pain when swallowing
  • symptoms of additional complications, such as chronic cough or hoarseness

Current research does not mention specific symptoms of headaches that occur alongside GERD.

Since the relationship between acid reflux and headaches is not yet known, it is hard to know how it can be treated.

If a link does exist between reflux and headaches, treating reflux symptoms may also result in headache relief. However, further research is required to confirm this.

According to the United Kingdom’s National Health Service (NHS), the following can be treatments for acid reflux:

  • eat smaller, more regular meals
  • try and lose excess weight if a person has obesity
  • try and find ways to relax
  • elevate the head and chest when sleeping
  • antacids
  • PPIs

Remedies for headaches can include:

  • pain medication
  • drinking water
  • rest

If there is a link between headaches and GERD, a person may have headache relief by treating their GERD symptoms.

Treatments for GERD include:

Medications

There is a variety of over the counter and prescription drugs that can help with GERD and headache symptoms, such as:

  • antacids, which help relieve mild GERD symptoms
  • H2 blockers, which reduce stomach acid production
  • PPIs, which reduce stomach acid levels

Surgery

A doctor may recommend surgery if a person’s GERD does not respond to treatment or lifestyle changes.

Surgery for GERD includes:

  • fundoplication, a procedure where a surgeon wraps the top of a person’s stomach around their lower esophagus to increase pressure and reduce reflux
  • weight loss surgery
  • endoscopy, which is when a surgeon inserts a tube with a camera attached into a person’s throat to examine their esophagus and stomach

If a link does exist between headaches and GERD, a person may benefit from preventing or reducing their GERD symptoms. However, there is currently no scientific evidence for this.

Avoiding certain foods

A person who has GERD should limit or avoid foods that trigger their symptoms. Food and drinks that research has associated with GERD include:

  • acidic foods, such as citrus fruits
  • alcohol
  • chocolate
  • coffee
  • caffeine
  • high fat food
  • mint
  • spicy foods

The NIDDK suggests that people who have GERD when lying down do not eat for at least 3 hours before sleeping.

Routine adjustments

There are various changes a person can make in their daily routines to help improve their GERD symptoms, such as:

  • losing weight if a person has obesity
  • elevating the head during sleep by 6–8 inches
  • quitting smoking

A person should speak with their doctor if they have GERD symptoms and headache that does not go away with treatment.

Additionally, a person should see a doctor if they develop complications such as:

  • chest pain
  • loss of appetite
  • persistent vomiting
  • difficulty or pain while swallowing
  • vomit that contains blood or resembles coffee grounds
  • stool that contains blood or is black and tarry
  • unexplained weight loss

Acid reflux can occur alongside headaches. However, researchers do not know the nature of the link between these conditions. One theory is that problems with a person’s ANS or glutamate levels may link acid reflux and headaches.

GERD and headaches may cause a person to experience fatigue or dizziness.

There are various treatments and lifestyle changes a person can use to treat GERD or acid reflux. If these do not work, a person can speak with their doctor about surgery.

A person should speak with their doctor if they have GERD alongside any serious symptoms.