Gastric vertigo is a type of dizziness that is thought to be caused by disorders in the gastrointestinal tract. It is a controversial diagnosis, as there is debate about whether vertigo can truly originate from the digestive system. However, some doctors believe gastric vertigo is a real phenomenon.
What are the symptoms of gastric vertigo?
The main symptom of gastric vertigo is dizziness or a spinning sensation. This dizziness may come and go or be more constant. Other possible symptoms include:
- Nausea
- Vomiting
- Abdominal pain or discomfort
- Feeling faint or lightheaded
- Headache
- Unsteady gait
The dizziness associated with gastric vertigo can make it difficult to stand or walk properly. It may lead to a loss of balance or falling. Episodes of vertigo may last for seconds, minutes, or hours.
What causes gastric vertigo?
There are a few theories on what leads to gastric vertigo:
Gastroparesis
Gastroparesis is a condition where the stomach does not empty properly. Food sits in the stomach for longer than normal before passing into the small intestine. This can lead to bloating, nausea, and loss of appetite. It’s believed that delayed stomach emptying can press on the vagus nerve, which runs from the brain to the abdomen. This stimulation of the vagus nerve may then lead to dizziness or vertigo.
Dyspepsia
Dyspepsia refers to a group of upper gastrointestinal symptoms including stomach pain/burning, bloating, nausea, and burping. Dyspepsia is sometimes called indigestion. It may be caused by irritation of the stomach lining, stomach ulcers, or acid reflux. Dyspepsia may potentially trigger symptoms of lightheadedness or vertigo in some people.
Vestibular neuritis
The vestibular system in the inner ear controls balance and spatial orientation. When it becomes inflamed due to a viral infection, this is known as vestibular neuritis. It can cause persistent dizziness or vertigo. Some researchers believe vestibular neuritis episodes may sometimes be initiated by stomach issues like gastritis. The inflammation spreads to affect the vestibular nerve.
Migraine headaches
Migraine headaches are thought to reduce blood flow to the brainstem and inner ear. This could potentially disrupt the vestibular system and its regulation of balance. As migraines are often preceded or accompanied by gastric symptoms like nausea, this offers an explanation for how gastrointestinal disturbances could lead to dizziness and vertigo.
How is gastric vertigo diagnosed?
Diagnosing the cause of vertigo and dizziness can be complex. Doctors may conduct several tests to help determine if gastric vertigo is the reason:
- Medical history – The doctor will ask about your symptoms and any related conditions like dyspepsia, gastritis, or gastroparesis.
- Physical examination – This includes assessing balance, coordination and neurological function.
- Caloric reflex testing – Warm and cool water are introduced into each ear canal, which stimulates the vestibular system and eye movements.
- Vestibular function tests – These evaluate the inner ear and central nervous system parts that control balance.
- Gastric emptying study – You eat food mixed with a radioactive tracer. Images then show how quickly it passes through the stomach.
- Endoscopy – A tiny camera on a tube is used to visually examine the upper digestive system.
- Blood tests – These check for signs of infection or underlying conditions.
Identifying delays in gastric emptying or abnormalities in the stomach may provide support for linking vertigo to gastrointestinal dysfunction.
How is gastric vertigo treated?
The treatment approach depends on the suspected cause. Possible gastric vertigo treatment options include:
- Diet changes – Eating smaller, more frequent meals to minimize impact on digestion.
- Prokinetic medications – These help speed up delayed stomach emptying.
- Antibiotics – Used to treat bacterial infections causing gastric issues.
- Antiemetics – To control nausea and vomiting.
- Over-the-counter acid blockers – For acid reflux and dyspepsia.
- Vestibular therapy – Balance exercises and training.
- Medications for dizziness – Such as antihistamines, anti-nausea, and sedatives.
If an underlying condition like dyspepsia, gastroparesis, or migraine is found, treating that root problem may resolve the vertigo symptoms.
What are the complications of gastric vertigo?
Potential complications of ongoing gastric vertigo include:
- Frequent falls and injuries
- Dehydration from severe vomiting
- Malnutrition from poor gastric emptying or appetite loss
- Social isolation
- Depression
- Disability from severe balance impairment
The dizziness and unsteadiness associated with vertigo also increase the risk of falls and fall-related injuries. This includes bruises, cuts, hip fractures and head trauma. Falls can also lead to long term complications like disability, fear of walking, and loss of independence.
Can diet help improve gastric vertigo?
Dietary modifications may help minimize symptoms in some cases:
- Low fat – Fatty foods delay stomach emptying. Avoiding fat can improve gastric vertigo.
- Low fiber – High fiber foods are harder to digest. Limiting fiber intake makes digestion easier.
- Small meals – Eating smaller meals puts less pressure on the stomach.
- Stay hydrated – Fluids help digestion. Dehydration can make vertigo worse.
- Avoid trigger foods – Certain foods like caffeine, chocolate, onions, beans, cabbage, and broccoli can aggravate gastric vertigo. Eliminating them from the diet may provide relief.
Following an anti-inflammatory diet with fresh fruits, vegetables, lean proteins, and healthy fats may also minimize stomach irritation. Keeping a journal of symptom triggers can help identify problem foods to avoid.
What lifestyle changes help gastric vertigo?
Lifestyle adjustments that may help reduce gastric vertigo episodes include:
- Quitting smoking – Smoking impairs stomach function and worsens symptoms.
- Limiting alcohol – Alcohol can irritate the stomach lining and inhibit digestion.
- Managing stress – Stress slows gastric emptying and may exacerbate vertigo.
- Resting after eating – Lying down or reclining for 30-60 minutes aids digestion.
- Sleeping with head elevated – This reduces exposure to stomach acid that may fuel nausea and dizziness.
- Avoiding triggers – Things like rapid head movements, flashing lights, and visual motion can make vertigo worse during gastric episodes.
Regular exercise, good sleep habits, and stress management techniques like meditation or yoga can also support healthy digestion and reduce flare ups.
Can vertigo be prevented with a gastric vertigo diet?
While there’s limited evidence that diet changes can prevent gastric vertigo, eating a ‘vertigo diet’ tailored to improving digestion may help reduce episodes. A gastric vertigo diet plan focuses on:
- Eating smaller meals – Large volumes overstretch the stomach, smaller portions avoid this.
- Low fat foods – Fatty foods delay stomach emptying which could worsen nausea.
- Low fiber choices – High fiber is harder to break down, low fiber eases digestion.
- Staying hydrated – Fluids assist digestion and prevent dehydration that exacerbates dizziness.
- Limiting food triggers – Things like caffeine, chocolate, fizzy drinks, onions, beans, cruciferous vegetables and spicy foods may provoke symptoms.
- Lean proteins – Such as chicken, fish, eggs and tofu – easier to digest than red meat.
- Vitamin D foods – Vitamin D deficiency is associated with dizziness. Include oily fish, egg yolks, fortified dairy and mushrooms.
A gastric vertigo diet aims to reduce digestive workload and minimize triggers of nausea and dizziness. While not definitively proven, this dietary pattern could potentially decrease the frequency or intensity of vertigo episodes.
What foods should you avoid with gastric vertigo?
Foods most commonly reported to exacerbate gastric vertigo and should generally be avoided include:
- Caffeine – Found in coffee, tea, soda and chocolate. Can delay gastric emptying.
- Alcohol – Irritates the stomach lining and causes dehydration.
- Spicy foods – Chili, peppers and curries. Can provoke stomach inflammation.
- High fat foods – Fatty and fried food takes longer to digest.
- Gas-producing foods – Onions, garlic, beans and cruciferous veggies promote bloating.
- High fiber – Raw vegetables, whole grains, bran, nuts and seeds.
- Sugar and artificial sweeteners – Linked with nausea and diarrhea.
- Monosodium glutamate (MSG) – Added to Asian food for flavor. Can cause stomach upset.
- Nitrates and nitrites – Found in processed and cured meats like bacon or deli meat. Associated with headaches.
Identifying and removing foods that seem to aggravate vertigo is recommended. An elimination diet supervised by a doctor or dietitian can help discover individual trigger foods.
Gastric vertigo case study
Here is an example case study of gastric vertigo:
Mary is a 55 year old woman who developed episodes of dizziness and nausea. She experiences recurring vertigo that is sometimes brought on by meals. Symptoms last from a few minutes to several hours.
An endoscopy found mild chronic gastritis in her stomach. Other tests for neurological causes were normal. A gastric emptying study showed delayed emptying consistent with gastroparesis. Based on her symptoms of dizziness after eating and the test results, she was diagnosed with gastric vertigo secondary to gastroparesis.
Treatment focused on dietary changes to help manage the delayed gastric emptying. Mary eats 6 small low fat meals daily. She avoids caffeine, alcohol, onions, beans, cabbage, chocolate and high fiber grains. This regimen has reduced the frequency and severity of vertigo episodes. Prokinetic medication also helps accelerate stomach emptying after meals.
With dietary modification and medication, Mary’s gastric vertigo is now better controlled. While episodes still occur, they are less frequent and tend to be milder in intensity. Ongoing follow up continues to monitor and optimize her treatment plan.
This case illustrates how gastric vertigo can stem from identifiable stomach conditions like gastritis and gastroparesis. Tailoring treatment to address the underlying gastric dysfunction can help minimize debilitating symptoms of dizziness and nausea.
When to see a doctor
You should consult a doctor promptly if you experience any of the following:
- Prolonged or severe vertigo episodes
- Vertigo along with slurred speech, loss of balance, vision changes or weakness
- Head injury or trauma before onset of vertigo
- Hearing loss or ringing in the ears
- Persistent headache, nausea or vomiting
- Unexplained weight loss
- Vertigo interfering with work, school or daily activities
- Recurring falls or difficulty walking due to dizziness
Sudden and severe vertigo could signify a stroke or neurological issue requiring emergency care. Seeking timely treatment is key, as the cause of gastric vertigo can often be identified and managed with appropriate interventions. Your doctor can connect you with specialists like audiologists, neurologists, or gastroenterologists to assist in diagnosis and tailored treatment.
Conclusion
Gastric vertigo is dizziness thought to originate from stomach abnormalities interfering with the balance system. Gastroparesis, dyspepsia, migraines or gastritis may disrupt signals to the brain, triggering sensations of spinning along with nausea and vomiting. Diagnosis involves ruling out neurological causes and identifying gastric conditions that could contribute to vertigo.
Treatment targets any underlying gastric disorder through diet changes, prokinetic drugs, antiemetics and acid blockers. Avoiding dietary triggers like caffeine, fat, and gas-producing foods may help lessen episodes. While gastric vertigo is still debated, many people find their vertigo symptoms improve significantly when they follow management strategies focused on optimizing stomach function.
