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.

Some patients have silent reflux, which is called LPR. This may occur without any noticeable heartburn, but can be detected due to damage to the esophagus over time.

Acid reflux, GERD, and LPR may all be linked with vertigo, if not properly managed. I wrote this blog to share my clinical observations with you about this widely overlooked connection.

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!

A new onset of vertigo due to reflux can present with acute acidic labyrinthitis and/or BPPV.

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.

The Left Ear Can Also Be Affected by Reflux

Of course, reflux can also affect the left ear! The left ear is affected in some cases, but not all cases of reflux and vertigo.

If the patient starts off sleeping on their right side or experiences reflux while upright, the refluxed particles and stomach acid can get into the esophagus. If the patient then 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.

Also, the left ear can be affected due to sleeping on the left side after the patient has reflux while they are upright. This may occur due to bending over, burping, coughing, or regurgitating food while upright, then lying down on the left side. .

Talk to your Doctor and Make Lifestyle Changes

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.

Some people can resolve acid reflux without medication by drinking alkaline water and eating a Mediterranean diet.

My doctor recommended a natural supplement for reducing my stomach acid called Aci-Balance, so I use that supplement as needed. On a daily basis, I drink alkaline water everyday and try to avoid my food triggers whenever possible. I also sleep on my left side as much as possible.

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 400 comments. Many people have a breakthrough in their vertigo case when they recognize the unnoticed link between their gut and vertigo.


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.

Accessibility Toolbar