Many people suffer from reflux and vertigo. Heartburn is another term for reflux. If reflux gets to be a chronic problem, it can eventually lead to GERD. That stands for gastro-esophageal reflux disease.
What is the Link between Reflux and Vertigo?
Refluxed food particles and stomach acid can affect your ear through the eustachian tube, which connects your ear to your throat. This is why you may wake up with vertigo after having reflux. I have met many patients who complain of a new onset of vertigo after a great Italian dinner!
Food Triggers for Reflux and Vertigo
To reduce the recurrence of vertigo attacks and reduce inflammation in your ears, you should pro-actively manage your reflux. Focus on dietary changes. The foods that cause reflux vary person to person.
You can reduce your intake of spicy foods, fatty foods, and tomato. Other foods that can cause reflux include mint, onions, garlic, coffee, tea, alcohol, and chocolate.
Everyone is unique, so you need to determine your triggers. Avoid carbonated beverages and soda, since they can cause burping.
Positional Triggers for Reflux and Vertigo
- Avoid lying down for at least 3 hours after you eat. No midnight snacking.
- After you eat, avoid vigorous exercise and bending over. Walking is fine.
- Prop up at least 30 degrees in bed using a wedge to reduce reflux and vertigo.
- You can also use extra tall bed risers under the legs at the head of your bed.
- Lie on your left side to reduce reflux, as opposed to lying on your right side.
- Reflux Most Often Causes Vestibular Problems in the Right Ear
I had a conference call with my physical therapy colleague Lesley Bludworth from Phoenix, Arizona. We both treat patients with vertigo, so we discussed the treatments that we are both pioneering.
Lesley shared with me that she has observed most patients with reflux and vertigo have vestibular problems affecting their right ear. She offers vestibular physical therapy and visceral manipulation for deep neck fascia as part of her comprehensive treatment plan.
I thought that was a very interesting observation about reflux and vertigo, so I started to track which side was the problem for my patients.
After a few months of tracking this informally, I concur with her observation that the right side is usually either the only problem or the worse side, if both ears are involved.
Our Working Hypothesis
I was discussing this idea about reflux and vertigo with Shelby Shinkle, DPT, an employee at Kim Bell Physical Therapy Inc. Dr. Shinkle added her own insight to our working hypothesis. Dr. Shinkle reflected that when the patient with reflux lies on their left side, the sphincter should remain closed, unless they have developed GERD. Therefore, she hypothesized that when the patient with reflux sleeps on their right side, the sphincter leaks more often.
Since they are lying on their right side, the refluxed stomach acid and food particles would pass through the right eustachian tube. That sequence of events would affect the right ear due to sleeping on the right side, in most cases of reflux and vertigo. Of course, reflux can also affect the left ear!
If the patient starts off sleeping on their right side and refluxed particles get into the esophagus because the sphincter is open. Then the patient rolls onto their left side in the middle of the night. The stomach acid and refluxed food particles may also pass through the left eustachian tube in some cases, but not all cases of reflux and vertigo.
Also, the left ear can also be affected due to sleeping on the left side after the patient has reflux while they are upright. This may occur due to burping, coughing, or regurgitating food while upright.
Talk to your Doctor
Talk to your doctor about medication that may be appropriate. You may only need to take medication for a couple weeks, if you make the necessary dietary changes.
- Quit smoking cigarettes, if you smoke.
- Lose weight, if that is advised by your doctor.
I have met many people who feel that gastric vertigo is part of their story! Maybe you also now think reflux and vertigo may be part of your story?
If you want to learn more about the gut and vertigo, click here. That is my most popular article, with over 250 comments to date.
Disclaimer
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
Hi Dr kim,
I completely agree with vertigo and gerd. I suffer since jan 6th 2021 Bppv after so many visit to ER they did maneuvers which settle, however i never had acid reflux or burping issue prior to vertigo. It started right after maneuvers not sure if my vagus nerve acting funny. Also i have low iron so Dr gave me fera max not sure if that triggers more i stop n started eat ing iron rich food. Every night between 12 n2 am ,im up with burping n vertigo it just come quickly n goes away. Now past two weeks i changed diet i stop spicy,no oil, i started high on probiotics yogurt n kefir which is helping. I see reduce some days not at all,, i stop on med to acid medication no more since i start kefir one cup a day, hoping it will stop completely. Same time i have neck arthritis as well so all rated to each other. I will appreciate if you have and additional advise which can help me fight with vertigo. I wish you visit canada i would love to be your patient. I always follow your blog amazing information. Thanks a lot.
Hi Samira,
I am happy to help!
In case you have not seen the first blog I published about the link with the gut, here is a link.
People have posted some very interesting comments on that blog as well.
For your neck, I would recommend an orthopedic manual physical therapist. You can search the provider directory at this link if you want.
I hope you feel better soon!
Kind regards,
Kim Bell, DPT
My symptoms are very similar and have been looking for answers for some time. Doctor thinks might have silent reflux Wake up in night feeling dizzy nauseous need to go to toilet
Have BPPV as well but is a different feeling and that doesn’t happen too often .
Get migraines and recently had a neck x ray and discovered have osteoarthritis
Sick of feeling sick !!
Thank you for sharing your story, Carol!
Hi Dr. KIM,
Thank you for your article and to all the Helpful comments. I can relate in 2020 I was told I had hpylori i took antibiotics to get rid of hpylori which helped however, ever since then for the past two years I have had acid reflux were I feel tired, shortness of breath, dizzy, dry mouth at night, white tongue, hoarse voice, light headed, from all these symptoms what really bothers me and keeps me from living a normal life is the dizziness. In 2020 i was also diagnosed with sleep apnea yet ever since I have always felt that maybe the symptoms that led to me getting a sleep apnea test were all along acid reflux? I use a cpap religiously however, I question if acid reflux was the cause all along. Back to the dizziness this year I was also told I had a mild neck herniation c6 therefore, I am not sure if that can also be causing my dizziness? I was told by multiple neurologist that it is very minor and shouldn’t worry about it I am getting physical therapy. I don’t like feeling dizzy, with foggy brain, tired and out if breath or taking weeks off of work due to symptoms. I will be taking acid reflux pills, nasal spray, and allergy pill to see if that helps. Did I mention that the right side of the back of my head seems to feel heavier, with headaches, my right nostril gets congested, and my right eye seems to tear up more. I hope and pray for a solution to all of us suffering with dizziness. I have also had an EKG and that came back fine as well as other blood work. I will try to be more strict with my diet more than I already are being. DR. KIM does my case sound like the vestibular can be playing a role here due to avid reflux? Thank you for your insight any feedback is greatly appreciated.
Hi Ana,
All root causes should be considered if you have a mystery case.
This blog on dizziness from the neck and this blog with more information on the topic of cervicogenic dizziness may be helpful for you.
I have many seen patients with cervicogenic dizziness who were told by their neurologist that the symptoms could not possibly be from their neck.
Even so, you need to do whatever it takes to feel better. You may still choose to seek out physical therapy or chiropractic care for your neck to see if it helps.
Upper cervical care is an advanced area of practice within physical therapy or chiropractic care that can help patients with dizziness from their neck.
You may also need to read up on the side effects of any medications you are taking, because symptoms like dizziness and dry mouth are common medication side effects.
If you have any concern that your medication side effects could be causing discomfort, talk to your doctor about it before you make any changes. You should always take your medication as prescribed by your doctor.
The shortness of breath is not caused by vestibular problems or neck problems. You should seek medical care as needed for that symptom.
This article is about dizziness due to respiratory problems.
Your case sounds complicated, but certainly consulting a vestibular physical therapist is a good step for anyone with dizziness.
Some antibiotics are ototoxic, which means they can cause vestibular problems.
Antibiotics can also affect digestion, so you may want to read this article and the comments below.
You can use this article to search for a vestibular provider in your area.
You may need to see more than one health care provider for a full recovery due to the complexity of your case.
The best way to clearly present your case to your team of health care providers is to answer the questions I ask in this blog.
I hope you feel better soon!
I have had vertigo with throwing up and tying me to the bed for 4-5 days. I have started doing keto and the throwing up has gone since a year but I have ongoing BPPV at the slightest movement of the neck position, mostly while lying down or immediately upon laying my head to the pillow or getting up from bed or a chair. Everything spins which is debilitating. Will the AIP diet help as I read inflammation can cause this disorder. I get this more when I sleep on left side and move position to the middle or right. But my ongoing ringing noise is in the right year and suddenly gets crazy loud in the right ear also though right ear perpetually rings. I have Hashimotos from past 26 yrs and the vertigo started 17 yrs ago; are the hypothyroidism, vertigo and tinnitus all related? I read high oxalates’ foods can cause these ear issues. Is there truth to this? ENT said calcium crystals fall off and get back, while another said acid reflux. Do we have to ‘feel’ the acid passing up the esophagus or can it occur without us experiencing the acid feel? Mostly I donot get it but occasionally can feel the burn as it goes up my throat. But my BPPV happens ehrn I donot feel the acid also. Am afraid to go to bed as the spinning nightmare begins and I have conditioned my brain to shift sides extremely cautiously and slowly for fear of another spin. Is AIP healing this or needs physical therapy also in conjunction?
Hi Samantha,
You can have silent reflux. It’s called LPR. That may be a factor.
I suggest you find a vestibular physical therapist.
You can use this article to search for someone near you.
I hope you feel better soon!