NEW YORK (Reuters Health) - Stomach acid reflux can trigger migraines in people prone to the debilitating headaches, the cases of two patients suggest.

On the flip side, if their responses are any indication, better control of acid reflux might ease migraine symptoms in such patients.

Reporting in the September issue of the journal Cephalalgia, Dr. Egilius L.H. Spierings of Harvard Medical School in Boston, Massachusetts, describes the cases of two patients with long-standing migraines and gastroesophageal reflux.

In reflux disease, stomach acids chronically back up into the esophagus, leading to heartburn and other symptoms. For these two patients, acid reflux had made their teeth and gums sensitive enough to sometimes trigger their migraines, according to Spierings.

"It caused pain to radiate from the upper gum/teeth into the cheek and from there, into the eye, a common location of migraine headache," he explains in the report.

For one patient, a middle-aged man who had suffered migraines several times a month since age 19, migraine bouts that struck the left side of his head had been more resistant to his headache medication than his right-sided symptoms.

These left-side migraines originated from the upper gum and extended through the cheek to the eye, and the man's left upper gum was sore to the touch and sensitive to temperature changes. The patient has also had acid reflux for years.

Simply increasing the dose of the man's current acid-reflux medication--a type of drug known as a proton-pump inhibitor--quelled his gum soreness and reduced the frequency of his left-sided migraines, the report indicates. The same tactic worked for the second patient, an older woman with right-sided migraines originating from the upper teeth.

According to Spierings, the "dramatic improvement" in headache symptoms his patients showed confirms acid reflux as a trigger of their migraines. It is possible, he notes, that proton-pump inhibitors have some unknown powers against migraines.

"However," he adds, "I consider this possibility remote."

SOURCE: Cephalalgia 2002;22:555-556.

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