Heartburn every few days became almost a way of life for Georgie Robbins.
It started at age six, and she could barely remember a time when she didn’t have a burning sensation in her throat.
Georgie, now 26, also had “terrible” regular headaches every few days.
But she never connected them. That is, only 18 months ago, when she “cured” her heartburn by eliminating certain foods from her diet – wheat, eggs and dairy products.
“I was blown away,” says Georgie, a restaurant owner in Wells, Somerset. “Not only did the burning pain stop every time I ate, but my migraines, which had become daily, just disappeared—almost overnight. It was an absolute miracle.
“I never had one without the other,” she says. “But it never occurred to me that they might be related.
Heartburn every few days became almost a way of life for Georgie Robbins. It started at age six, and she barely remembered a time when she didn’t have a burning sensation in her throat.
The idea that heartburn, known as reflux, and headaches are related may seem unlikely. Heartburn occurs when stomach acid backs up into the esophagus.
There are several reasons. For example, a weakening of the sphincter, which is supposed to block the entrance to the stomach, or certain foods, can provoke it.
Other triggers include hiatal hernia (when part of the stomach is pushed into the chest), medications such as antibiotics, and iron supplements. If the problem is long-term, it is called gastroesophageal reflux disease (GERD).
Dr. Steve Alder, consultant neurologist at Re:cognition Health, says studies show that 30 to 50 percent of people with chronic headaches also have GERD.
And those with GERD seem to experience more headaches. A study of 3,600 patients published in the Saudi Journal of Gastroenterology found that 16% also had daily headaches, and 26% had them once or twice a week.
The researchers concluded that there is a “significant correlation between headaches and GERD symptoms.”
Many gastrointestinal disorders, such as celiac disease (where the small intestine is hypersensitive to the protein gluten) and irritable bowel syndrome, are associated with headaches.
In a 2016 review of 900 articles investigating the association with headaches published in the Archives of Academic Emergency Medicine, the researchers stated that the association with gastrointestinal problems is often “overlooked.” They added that headaches can be “cured or relieved by management” of the condition.
Georgie, now 26, also had “terrible” regular headaches every few days. But she never connected them. That is, only 18 months ago, when she “cured” her heartburn by eliminating certain foods from her diet – wheat, eggs and dairy products.
David Sanders, professor of gastroenterology at Sheffield Teaching Hospital and the University of Sheffield, says he often sees people with stomach problems who also experience headaches.
He cites a study of 195 children published in the European Journal of Pediatrics, which compared young patients admitted to hospital with migraines and those admitted with cuts and bruises. “Children with headaches and migraines were twice as likely to have reflux as children without headaches, so there’s a link.”
Professor Sanders adds: “Another thing I’ve seen with celiac disease is that when people go on a gluten-free diet with it, their headaches go away.
“This is something that has been recognized, however, this is an area where we find our way in terms of fully understanding the causes, but it seems to come down to what is called the gut-brain axis.”
The gut-brain axis is a way of communication between the brain and the gut. It is increasingly believed that our gut bacteria may play a role in this.
Professor Sanders explains that the gut has its own nerve sheath that “provides communication with the brain, and it can be a two-way street,” and these messages can lead to changes in the gut or around the brain.
“Thus, GERD or acid reflux can lead to headaches, and headaches can contribute to gastrointestinal problems,” says Prof. Sanders.
This may help explain why heartburn and headaches often occur when someone is stressed, suggests Dr. Alder. “Studies have shown that people who suffer from stress at work have an increased risk of GERD, and that symptoms worsen with increased levels of stress, even when taking medication,” he says.
Peter Godsby, professor of neurology at King’s College London, says that in some cases, headaches can lead to heartburn caused by medications such as non-steroidal anti-inflammatory drugs taken to relieve them.
Another explanation is that because gastric emptying is slowed down before and after a migraine, it would “make GERD more noticeable to the patient,” Prof Goadsby says.
Looking back, Georgie realizes that her heartburn and headaches were inextricably linked.
By age ten, Georgie had acid reflux after every meal. “But at the same time as the burning sensation in my throat, I started to have a headache. It was so exhausting that sometimes I had to go to bed and hide my head in a blanket. It was agony,” she says.
During her school years, her mother took her to the doctor several times. “But the therapist just told us to try eliminating certain foods, suggesting that it might be caused by allergies, and keep a food diary, which we did for a few days. But it was such a random test for us at home that we never figured out what could be causing it.”
She took Gaviscon for reflux and paracetamol for her headaches, but the problem kept coming back.
“Two years ago I went to my therapist asking for help. I told him I had terrible reflux and terrible migraines. He told me it was stress. He told me that women get stressed sometimes and I should go for a walk and talk to my friends. It made me so angry.”
About 18 months ago, Georgie’s pain after eating was so severe that it felt like someone was “pouring fire down her throat”; she also now vomited after every meal. “I stopped eating because I knew what was going to happen — a burning sensation in my throat followed by an excruciating migraine,” she says.
During lockdown, she sent for an allergy test package — faster than trying to make an NHS appointment at the time. A few days later, Georgie was diagnosed with an allergy to wheat, eggs, and dairy products. She cut them out, and after a few days her acid reflux was gone, as were her headaches.
People experiencing heartburn are usually advised to first try to change their lifestyle.
Losing weight can help, as it reduces pressure on the sphincter in the upper stomach, as does smoking cessation—smoking causes the sphincter to relax; the same effect can be seen with alcohol, tea, coffee and spicy foods.
Another suggestion is to sleep with more pillows or tilt the head of the bed up to relieve pressure on the sphincter.
OTC agents include Gaviscon, which forms a protective layer over stomach acid, and the drug omeprazole, a PPI, or proton pump inhibitor, which reduces stomach acid production (low doses are available).
Professor Sanders says there are anecdotal reports of patients who have been prescribed omeprazole for reflux and report that their headaches have stopped.
He suggests that anyone who thinks their reflux and headaches may be related should keep a symptom diary, noting when they occur, and then show them to their therapist.
Now Georgie never had a headache or reflux.
“Just by changing my diet and stopping my reflux, my headaches disappeared too,” she says.
“I thought I felt disgusting with headaches and stomach problems randomly occurring, even though they were so clearly related all along.”
Too much good?
Healthy habits that you can really overdo. This week: brazil nuts
Brazil nuts are a good source of the mineral selenium, which helps prevent cell damage and supports the immune system.
Many foods, from grains to fish, contain selenium. However, men need only 75 mcg per day, women need 60.
Any doses in excess of 350-400 micrograms in addition to the diet can be “toxic” and cause nausea and vomiting. This is due to the fact that excess selenium destroys the intestinal mucosa.
Too many Brazil nuts, each containing about 90 micrograms of selenium, can lead to a buildup of this nutrient.
Aisling Pigott, a nutritionist and spokesman for the British Dietetic Association, says: “I wouldn’t recommend more than two or three Brazil nuts a day.”
Jin watch
Amazing things that depend on genetics
This week: procrastination
Tend to procrastinate? This may be due to genetics, according to a 2014 study by the University of Colorado in the US.
The researchers surveyed 663 of 181 identical and 166 fraternal same-sex twins about procrastination, impulsivity, and goal setting.
They found that procrastination is 46% genetic, making it “moderately heritable.”
Further research linked this to tyrosine hydroxylase (TH), an enzyme that helps regulate the production of dopamine, one of the body’s “happiness hormones” but which is also associated with motivation and attention. Elevated dopamine levels are associated with impulsive behavior and distractibility.