Brief Answer: You are apparently suffering from GERD Detailed Answer: Hi Mr. XXXXXXX Thanks for your query. I wish you had described your problems in more detail. However, your headache seems to be due to either, Gastro-esophageal-reflux-disease (GERD) ; Hiatus hernia; or, Migraine. An endoscopy will pinpoint the exact cause. Further, chronic gastritis/GERD is usually due to H.pylori infection of the stomach/duodenum. A 2-weeks' course of anti-H.pylori therapy + domperidone; followed by, 3-6 months of a PPI, such as, Rabeprazole/Lansoprazole will completely cure acidity. Also, chronic alcohol intake is the commonest cause of chronic acidity with persistently elevated Liver enzymes, which indicate a persisting mild liver inflammation. Stoppage of alcohol, avoidance of fatty and spicy food; weight reduction if overweight; regular exercises will revert the liver enzymes to normal range. Get an ultrasound of liver, gall-bladder and Pancreas done to rule out/detect any lesion in these organs. Mental stress/anxiety or post-alcohol hangover are common causes of early morning headaches (either hangover or Migraines). More details about the nature of headache, dietary habits and alcohol intake would pinpoint the cause. Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Have a nice day, Col (Dr.) Rakesh Karanwal

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Brief Answer: MRI Brain and Endoscopy need to be done Detailed Answer: Hello Mr. XXXXXXX Nice hearing back from you. The fresh information provided by you, changes the possible causes of early morning headaches. It appears more likely to be either due to GERD; a cluster headache or a remote possibility of a sinus or a brain lesion. Headaches in center of forehead are not indicative of Migraines, which are otherwise characterized by one-sided or both sided throbbing headaches followed by vomiting or nausea. Further , alcohol is one of the known triggers of Migraines. It is therefore recommended that you get an # Endoscopy done for GERD/chronic gastritis or ulcers; and, # MRI Brain done to rule out/detect a sinus/brain lesion. Consult a local doctor who will refer you for the advised investigations and also prescribe anti-H.pylori kits + Domperidon by their brand names, as available in the chemist's shop. Take care, Dr. Rakesh Karanwal

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