Does Acid Reflux Cause Headache? 6 Facts From Research.

 

1- Does acid reflux cause headaches?

 

Headache is not pronounced among the symptoms of chronic acid reflux (GERD). However, some studies have found a link between headache and acid reflux. Possible causes are Altered pain sensation by your brain, food allergy, abnormal autonomic nervous system,  or abnormal blood vessels. (ref).

Today we will simply explain the link between headache and GERD. We will try to answer common questions that are likely raising in your head.

  • How common is a headache with acid reflux?
  • what is the link between acid reflux and headache?
  • Will headaches go away after acid reflux treatment?
  • Can a disordered gut cause headache?

 

2- How common is a headache with acid reflux?

 

No solid evidence that acid reflux can cause a headache. But some studies linked headache to multiple gut diseases (including GERD). The research is still deficient.

The following studies will give you an idea about this association:

  • large Norwegian study (involved 43,782 patients) found a higher prevalence of headache among acid reflux patients. The risk of headache with acid reflux was more than double the usual risk of healthy people (The Odds ratio was 2.4).

  • Another USA-based study investigated the incidence of GERD (chronic acid reflux) and heartburn in 1,832 migraine patients. The investigators found a higher prevalence of GERD and heartburn among migraine patients.

  • Third study found that Headache is strongly correlated with GERD (chronic acid reflux). The study was conducted in Iran and involved 1956 patients.

  • Another 2019 study found that migraine is significantly common with GERD. 78 patients out of 109 GERD patients had a migraine (71.6%). 

  • Another study found that Migraine is more frequent with GERD (26.8%) than Tension-Type headache (10.7%).

 

The chicken or the egg?

 

Although the above studies linked GERD and headache together, They didn’t provide an explanation for this association.

Does headache cause acid reflux? or The reverse? is it a causal relationship, or just a coincidence?

Keep reading the section below, to learn about the theories about headache and acid reflux.

 

3- What is the possible link between headache and acid reflux?

 

If you ask your doctor about headache and acid reflux, you probably won’t obtain a sufficient answer. That’s because the headache is not an established symptom or complication of acid reflux. (ref).

The studies linking headache to acid reflux or GERD are relatively few, poorly designed, and didn’t provide consistent results.

Association between headache and acid reflux doesn’t necessarily mean one caused the other. “Association doesn’t mean causation”.

Here are some theories that may explain the link between headache and acid reflux. (ref).

 

A- Your brain.

 

Heartburn is not only due to acid reflux. Many conditions can cause heartburn without “pathological acid reflux”. For example:

  • Functional Heartburn: a functional disease of the esophagus. With functional heartburn, you may feel symptoms identical to GERD but without actual acid reflux.

  • Reflux hypersensitivity: in this type, you can feel heartburn with normal “physiological” levels of acid reflux (a small amount of acid reflux occurs to almost everyone).

Learn more about Functional heartburn and reflux hypersensitivity.

The possible explanation of the above two conditions is your brain. Your brain may have a higher sense of pain. You may feel pain in conditions that are not normally painful.

This low threshold to pain is originally inside your brain, not your gut. People with a low pain threshold may experience multiple pain-related symptoms. The presence of headache together with heartburn can be related to low pain thresholds in your brain. (ref).

 

B- Your autonomic nervous system.

 

From its name, The “autonomic” Nervous system is the autonomous part of your nervous system. It is not under your conscious control.

Your autonomic nervous system controls your basic vital functions such as:

  • Heartbeats.
  • Breathing.
  • Body temperature. 
  • Digestion.
  • And more importantly, sensation.

Any damage to the nerves of the ANS (autonomic nervous system) can lead to autonomic dysfunction. This dysfunction can lead to:

  • Disordered digestion: including GERD or acid reflux.
  • Altered sensations: including headaches and pain sensation.

Long term alcohol drinking, diabetes, and Parkinson’s disease are some of the common causes of autonomic dysfunction.

Learn more about the symptoms of autonomic dysfunction.

 

C- Your blood vessels.

 

Abnormalities in your blood vessels can lead to migraine headaches (ref). Also, abnormal blood vessels in the gut can lead to multiple gut diseases including heartburn and acid reflux (ref).

The abnormalities may include abnormal dilatation, abnormal narrowing, or inflammation of the blood vessel wall (vasculitis).

Vasculopathy (disordered blood vessels can be a cause of your headache and gut symptom is under-researched and under-recognized. We need more research to prove this association.

 

D- Referred pain.

 

Pain from your Gastrointestinal tract can be felt in various locations outside your abdomen.

You can feel pain from your Gut (including acid reflux pain) in various locations:

  • Shoulders.
  • Neck.
  • Over your scapular bones.
  • Mid-back. 
  • Low-back.
  • Your pelvis.

Esophageal pain can be referred to your neck and shoulders and cause headaches. (ref).

 

E- Food allergy.

 

Food allergy is a hot topic in gut health. Several foods can produce allergic symptoms, which are different from food intolerance.

Certain food allergies can trigger both abdominal and extra-abdominal symptoms. The abdominal symptoms may include diarrhea, abdominal pain, bloating, and heartburn (acid reflux).

The extra-abdominal symptoms may include skin rashes, fever, shortness of breath, dizziness, and headaches. (ref).

Histamine, a substance produced in reaction to food allergy, causes vasodilation. Histamine release can cause headaches.

Common foods that may cause an allergy:

  • Aged cheese.
  • Artificial sweeteners.
  • Chocolate.
  • Nuts.
  • And others. 

learn more about food allergy, headache, and acid reflux.

 

F- Medications.

 

Your medications (whether for headache or acid reflux) may be the link.

Most migraine and tension-type headache medications can induce gastritis and acid reflux.

Taking NSAIDs such as aspirin, Ibuprofen (Advil), and diclofenac can trigger gastritis and acid reflux.

Also, Caffeine-containing migraine and headache medications can trigger GERD.

On the other hand, Proton Pump Inhibitors (PPIs) are linked to acute headaches.

A large, nationwide study in Taiwan concluded that PPI use increases the risk of acute headache. The study involved more than 300,000 participants. Headache with 1.4x more likely to happen within a week of PPIs treatment.

 

4- Will headaches go away after acid reflux treatment?

 

We currently don’t know the effect of acid reflux treatment on headache. It is unclear whether acid reflux treatment will result in the resolution of headache or not. Data from the research are few and conflicting.

A small study in the USA (included only 2 patients), linked migraine to tooth pain from reflux. anti-reflux treatment resulted in a complete cure of migraine.

Another study mentioned above, linked PPIs (anti-reflux) treatment to increased risk of acute headache.

Our conclusion is that your condition is unique. No single answer about headache and acid reflux fits all patients. It is better to work with your doctor to investigate the causes of reflux symptoms and headaches.

 

5- What to take for Headaches while you have acid reflux?

 

Most headache medications may trigger gastritis and acid reflux. Avoid the use of non-steroidal anti-inflammatory medications such as Ibuprofen (Advil) and Diclofenac.

The only headache medication that is possibly safe with acid reflux is Paracetamol (Tylenol). Work with your doctor to determine the best treatment, especially if you have a migraine.

Learn more