Can Heartburn Make You Throw Up?

Until you have an encounter with heartburn (acid reflux), you might not realize just how intensely uncomfortable and worrisome the sensation can be. In fact, it can feel so intense that you might find it difficult to go about your daily business. That's problematic, especially if you're one of the estimated one-fifth of adults who said they had heartburn once a week, per a 2011 study in the World Journal of Gastroenterology. (Here are some foods you should avoid to prevent heartburn.)

Under normal conditions, the acids in your stomach efficiently break down food so your body can use the nutrients. But when you have heartburn, the acids — sometimes accompanied by partially digested particles — travel in the wrong direction: upward and into your esophagus. This phenomenon occurs because your lower esophageal sphincter (LES) muscle becomes too relaxed. The LES is supposed to prevent stomach contents from coming back up. However, when it begins to lose its tautness, it can't protect your esophagus and throat from acid reflux.

All that acid can precipitate a burning feeling that can seem to spread across your chest. The burning comes from irritation and inflammation of the esophageal tissues. Yet burning isn't the only symptom that can accompany heartburn; nausea can as well. And while nausea doesn't always lead to vomiting, it can.

Two other side effects of heartburn that can trigger the desire to throw up are burping and coughing. As you can imagine, food can easily start to make its way toward the mouth when you're wheezing or gagging. When it does, it may end up being fully regurgitated.

Should you be worried if you throw up because of heartburn? Not necessarily. If you experience heartburn once in a while and rarely vomit as a result, you might want to mention it to your primary care provider during your next visit. But it isn't necessarily an urgent matter. On the other hand, if you get heartburn more than twice a week and tend to throw up when you do, you might want to check in with a gastroenterologist. Frequent heartburn and vomiting can be signs of other conditions, including gastroesophageal reflux disease, or GERD. (For the record, constant vomiting is considered one of the reasons to worry about your heartburn.)

When you have GERD, your LES doesn't work properly. This means you're likely to have heartburn after eating certain foods (e.g., spicy, fatty foods), drinking alcohol, or bending over or lying down soon after a meal. Though vomiting doesn't always accompany the heartburn associated with GERD, it may.

Even if you get treated for GERD, you may still be at risk of vomiting as a reaction to therapeutic drugs. For example, proton pump inhibitors (a common medication suggested for the treatment of GERD and its symptoms) can lead to throwing up.

Heartburn can lead to vomiting for reasons other than just occasional acid reflux or chronic GERD. For instance, heartburn can be a symptom of a peptic ulcer, which is an ulcer that develops in the stomach and upper part of the digestive tract. Peptic ulcers can bleed, so if you have heartburn from a peptic ulcer, you'll want to watch for traces of blood in your vomit. If you believe you're vomiting blood (it may look black rather than red), get treatment immediately.

It's worth mentioning that heart attacks can echo the general feeling of heartburn. Plus, heart attacks can cause vomiting, particularly in women. Therefore, if you're having heart attack symptoms (e.g., shortness of breath, chest pain, chest tightness) in addition to what seems like heartburn, you may be in need of emergency care.