Heartburn and nausea

Heartburn is an intense, burning feeling (hence the name) which occurs as stomach acid travels backwards from the stomach into your oesophagus. Heartburn is fairly common and you may have experienced a bout after consuming a particularly heavy or fat-laden meal. But if the heartburn is accompanied by nausea is this normal? Could it be a sign of something else?

Indigestion, which basically means ‘poor digestion’ and the resultant acid reflux, are the most common causes of heartburn. The stomach has an important role in digestion and stomach acid is a key ingredient in this process.

After you swallow a mouthful of lunch, your oesophagus is responsible for transporting this food down into your stomach. A circular muscle called the lower oesophageal sphincter (LOS) opens up to let the food pass from you oesophagus into your stomach. It quickly contracts and closes again to prevent any food or gastric juices travelling back up.

The function of the LOS has a big part to play in the occurrence of heartburn.

The main ingredient of stomach acid is called hydrochloric acid. Hydrochloric acid is released from specialised cells in the stomach called parietal cells and has many important functions in the stomach.

It is particularly important for initiating the breakdown of protein by activating specific enzymes in the stomach. This potent acid is also vital for aiding the absorption of many of the vitamins and minerals we obtain from our food, for keeping bacteria in balance in the stomach and, finally, for stimulating the release of various pancreatic enzymes which specifically target the fat, carbohydrates and protein from your latest meal.

If your stomach acid or LOS isn’t functioning as it should, you can easily struggle to digest certain foods and be left feeling uncomfortable as a result. Particularly fatty foods or meat which is high in protein may be problematic as they are more taxing on the stomach. It has to work extra hard and produce extra acid to take these foods on.

Fat slows the rate at which your stomach empties, therefore, consuming a particularly fatty meal means that food will sit longer in your stomach. As a result of this your tummy produced more and more acid in an attempt to clear the backlog of food. If you have low levels of stomach acid to start with this process will take longer and the prolonged production of acid can be problematic.

A combination of these factors – the change in pressure in the stomach as it becomes overly full, the excessive production of acid and in many cases a vulnerable LOS – means that it is more likely you will suffer from some form of indigestion or heartburn.

Symptoms of heartburn to look out for include:

• An intense burning sensation in your chest behind your breastbone. This can travel up towards your throat
• It is important to consider when the pain is occurring. A tell-tale sign of heartburn is that it often occurs after a meal (particularly when you overeat or consume a very fatty meal or one high in animal protein)
• Belching, cough or hiccups (again as the acid acts as an irritant)
• Nausea or even vomiting.

As a result of indigestion, heartburn can often give rise to nausea. As the contents of your stomach irritate the lining of your oesophagus, this can easily give rise to belching, hiccups and an acidic taste in the mouth, and a combination of these symptoms can easily make you feel quite ill.

t is important to always consider your whole-body symptoms and any other circumstances in order to try and determine what might be causing your heartburn and nausea.

First of all, an individual without digestive troubles can easily experience heartburn and nausea if they simply consume far too much food! Completely overloading the stomach increases the pressure in the stomach which can cause the LOS to open and heartburn is likely to come about. An extra full tummy can make us feel quite uncomfortable and sick even if heartburn isn’t present. Therefore nausea can occur alone or in combination with heartburn if you just don’t know when to stop munching!

Pregnancy is another occasion when you may experience heartburn. This is often a result of hormones or as a result of the extra pressure the expanding womb puts on your stomach. Nausea is a normal part of pregnancy too due to the fluctuating hormones. Again, the nausea may not be directly related to the heartburn. Sickness during pregnancy tends to die down as you progress through the second and third trimesters although unfortunately the risk of heartburn can increase. Refer to the link above to read more about heartburn in pregnancy and simple steps you can take to help ease your discomfort.

Although indigestion, overeating and pregnancy are common causes of heartburn and nausea (either together or separately), feeling nauseous with a burning pain in your chest is something to watch out for as it could be the sign of something more serious.

If you regularly experience heartburn (and it definitely isn’t attributable to pregnancy or over-eating) you should be aware of gastro-oesophageal reflux disease (GORD). GORD is a result of the LOS function having become weakened or dysfunctional over time.

If GORD is present, frequent heartburn and the associated nausea can be debilitating and medication or even surgery may be required to keep it under control. Over time GORD can cause other more serious medical issues. Therefore, regular heartburn, especially accompanied by nausea should not be ignored and a visit to your doctor may be necessary.

Other conditions should also be considered. Gastritis, although an irritation of the stomach, can give rise to indigestion and heartburn.

As your tummy is inflamed, your digestion isn’t quite as efficient and heartburn can occur. When your stomach is particularly sensitive or inflamed you may also experience nausea. This is a result of your stomach acting in a protective manner in a bid to prevent you overwhelming it with any more food whilst it is trying to recover. You are left feeling nauseous and with little appetite, giving it time to heal.

The presence of Hiatal hernia is also something to be aware of. A hiatus or hiatal hernia occurs when part of the upper stomach squeezes through an opening in the diaphragm known as the ‘hiatus’. This can go relatively unnoticed but it may also give rise to heartburn if the hernia affects the functioning of the LOS. Always err on the side of caution if your heartburn occurs often and your upper abdomen is frequently bloated and uncomfortable after eating.

Although nausea can occur alongside heartburn and can be nothing too serious, it is important to pay attention to your overall symptoms. If you experience recurring episodes of heartburn and you often feel quite ill as it is occurring, it may be worth a trip to your doctor to check there is nothing more serious going on.

If your heartburn and nausea aren’t thought to be anything too serious and just occur occasionally there are some natural remedies which can help manage your symptoms.

• Ginger – If nausea is also a symptom of your heartburn; ginger can be an effective home remedy. Ginger is a natural anti-spasmodic so can be useful if your stomach is churning. Try grating some fresh ginger and mixing in a mug of hot water with a small amount of honey to sweeten, or invest in some ginger teabags or capsules to help beat the nausea
• How you eat – There are also some important eating habits and lifestyle tips which can be extremely beneficial if you suffer from heartburn. Click the link above to see our top tips and try some out for yourself
• Although Stomach bitters – Bitter herbs can be a useful remedy to relieve your symptoms of heartburn as they stimulate the release of digestive juices which help to prevent indigestion – often the root cause of heartburn. Try taking Digestisan before your meals. This is a licensed herbal remedy containing a synergistic combination of bitter herbs including artichoke, dandelion, peppermint and boldo; specifically formulated to support your digestion
• Try Silicol^® gel during a flare up of heartburn – Silicol^® gel contains silicic acid which acts as a protective barrier for the digestive tract, soothing and calming the walls of your oesophagus.

Although nausea can be a normal symptom of an occasional bout of heartburn, it is also something to keep an eye on.

Our advice would be to pay attention to the pattern of your symptoms. If home remedies and lifestyle tips don’t seem to be helping, your symptoms are recurrent or are occurring when you aren’t provoking the situation by eating too much or overly fatty or protein-dense foods, we would recommend you pay your doctor a visit.