What It Means When Heartburn Makes You Nauseous

Heartburn has a way of sneaking up on you, often after you eat a meal that's fatty, acidic, or just plain heavy. Since it's a normal physical response, you don't need to worry when you feel an occasional burning sensation in your chest. Per the National Institutes of Health (NIH), 60+ million people in America experience heartburn each month.

But when heartburn keeps striking, it can be a warning that you might have a more chronic problem. After all, heartburn can be a symptom of a variety of conditions and diseases, including gallstones and angina. However, one way to narrow down what's actually happening is whether or not you're also having nausea.

First, though, you might wonder why you're getting heartburn at all. The underlying cause is that the muscle at the bottom of your esophagus, which is called the lower esophageal sphincter (LES), is getting too relaxed. Your LES is designed to open enough for food and liquids to enter your stomach. However, once they've passed, the LES is supposed to shut. That way, all that food gets trapped in your stomach along with the acidic juices that are necessary for digestion.

Heartburn occurs when the LES loosens up enough for partially digested foods and acids to make their way back up the esophagus. As they travel toward your mouth, they're bound to irritate and inflame the sensitive tissues along the way. This is where the "burn" in heartburn comes into the picture.

Why would heartburn make you want to vomit, though? For one, all those substances rising up your esophagus can make you burp, which may trigger you to vomit or, in the case of nausea, want to throw up. (Learn more about the causes, symptoms, and treatment of heartburn.)

When you get bouts of heartburn and nausea, you may want to contact your physician or a gastroenterologist to figure out what's happening. For instance, there's a condition called GERD (gastroesophageal reflux disease) that can cause both symptoms. If you're diagnosed with GERD — the NIH says about 20% of Americans have it — you may need to take medications like antacids or make changes such as quitting smoking or avoiding lying down for a couple of hours after eating. After getting proper treatment, you may have fewer unpleasant heartburn-nausea experiences in the future.

GERD isn't the only medical issue that can lead to heartburn and nausea, though. Gastritis can as well. Gastritis occurs when the typically tough lining of your stomach becomes inflamed. (Incidentally, gastritis makes you more susceptible to getting stomach ulcers, which can also give you nausea after eating.)

Since tissue inflammation makes your stomach and digestive system more sensitive to the presence of high-acid or fatty foods and beverages, you may start to feel queasy due to lingering heartburn pain if you have gastritis. Pain can trigger the desire to throw up anyway, so it's a natural consequence. Accordingly, the more painful your gastritis and heartburn become, the more likely you may be to want to run to the nearest bathroom.

As with GERD, gastritis can be addressed with medications and lifestyle modifications. (Actually, many of the same medications can be used on each of those conditions.) In addition, your doctor may recommend that you limit your alcohol intake and try a different type of painkiller.

Fortunately, most of the causes of heartburn and nausea aren't life-threatening. But there is a cause that is serious and needs to be noted: a heart attack. Some individuals who are having heart attacks report feeling both heartburn and nausea. Accordingly, they may delay getting emergency care because they misread their stomach pain signs. In fact, a 2019 review in the Journal of Emergency Medicine estimates that one-quarter of individuals who experience chest pain wait at least 12 hours before seeking treatment.

Therefore, be on the lookout for symptoms in addition to heartburn and nausea that could be indicators of a possible heart attack. These include pain radiating through the shoulders, neck, and upper arms; lightheadedness; respiratory issues; and chest tightness.