Belching and nausea are two common symptoms of a digestive upset. These symptoms can occur on its own or may sometimes arise together. Belching is a normal process that occurs several times in a day. However, when it is excessive then belching can be considered to be a problem. Nausea as well may occur momentarily but if it persists or is severe to the point that it affects appetite and causes vomiting then it needs to be investigated.
Belching and nausea may occur together. While this can arise for short periods without there being any problem, sometimes belching and nausea are symptoms of an underlying digestive problem. Most of us associate both of these symptoms with indigestion, which is often due to overeating, eating too quickly, certain foods and beverages and lifestyle factors. However, there are several digestive and non-digestive conditions which may also be responsible for both belching and nausea.
Read more on excessive belching and causes of nausea.
Causes of Belching and Nausea
Excessive belching is mainly due to excessive air swallowing while nausea is largely a result of irritation of the upper gut (esophagus, stomach and duodenum of the small intestine). Some conditions can contribute to both excessive air swallowing and upper gut irritation thereby giving rise to belching with nausea simultaneously. Some of the more common causes of both belching and nausea have been discussed below.
Foods and Beverages
A number of foods and beverages can contribute to both belching and nausea. Firstly, spicy foods and fatty foods are known to cause indigestion, of which belching and nausea are symptoms. Secondly some drinks contain gas like carbonated beverages as well as ingredients that may irritate the upper gut thereby leading to nausea. Any food or drink may lead to belching and nausea if it is consumed in excess as is seen with overeating.
Intolerance to foods may arise when the body cannot digest certain types of foods or absorb some of its nutrients. This may be seen when dairy is consumed as is the case in lactose intolerance or after eating a fatty meal in the backdrop of gallstones. Problems with fructose, sorbitol and gluten, among other nutrients, may cause symptoms like nausea and belching in people who have underlying food intolerance conditions.
A common cause of belching and nausea arising from the esophagus is acid reflux. Also known as gastroesophageal reflux disease (GERD), it also presents with heartburn, loss of appetite and a sensation of fullness (bloating). It occurs when the lower esophageal sphincter (LES) becomes weak. Normally this sphincter only allows food and beverages to pass from the esophagus to the stomach but when it is weak the flow may be also be in the reverse direction. Stomach acid and the digestive enzymes may then enter the esophagus and irritate it.
Gastritis and stomach ulcers are the more common causes of belching and nausea. In addition, there is usually a gnawing to sharp upper abdominal pain, bloated feeling, change in appetite and sometimes even vomiting. The stomach wall becomes inflamed with H.pylori bacteria infection or with the excessive use of NSAIDs. This also weakens the mucus barrier that protects the stomach wall from the acid within it. Eventually this may lead to the formation of opens sores.
Delayed gastric emptying is another condition that may present with belching and nausea. This is where the emptying of partially digested food from the stomach is slower than normal. It may occur with a mass at the end of the stomach, hardening of the area (pyloric stenosis) or when the muscles of the stomach become weak or paralysed (gastroparesis). There may also be bloating, loss of appetite, reflux and even vomiting.
Several conditions involving the small intestine can cause belching and nausea. This includes duodenal ulcers (peptic ulcer disease), small intestinal bacterial overgrowth and conditions affecting the organs that empty secretions into the small intestine, such as the gallbladder (gallstones) and pancreas (pancreatitis). Bile reflux is another condition that may also arise when bile in the duodenum (small intestine) flows backward into the stomach and esophagus.
Small intestine obstruction may also give rise to belching, nausea, projectile vomiting and related symptoms. The obstruction can occur for a number of reasons, such as tumor (benign or malignant), compression from outside the small intestine, strangulated hernia, twisting of the bowels, adhesions and/or a foreign body. Belching and nausea are less likely to occur with an obstruction lower down the gut, like in the large intestine.
Gastroenteritis is a common infection caused by viruses, bacteria and protozoan. These infections are usually acute meaning that it persists for a few days. Often it self resolves within a few days after experience intense nausea, vomiting, excessive belchig, abdominal cramps and diarrhea. These infections are also referred to as food poisoning if the cause of the infection is consumed in contaminated food or water.
Read more on gastroenteritis.
Certain drugs can cause belching and nausea for various reasons. Drugs may stimulate the chemoreceptor trigger zone in the brain which in turn may trigger the nausea centers. This leads to nausea but may not necessarily cause excessive belching. However, repeated swallowing when nauseous in a bid to prevent vomiting can lead to excessive air swallowing which in turn can lead to excessive belching.
Some medication may also irritate the stomach and cause or exacerbate conditions like gastritis and peptic ulcer disease. Belching and nausea are common symptoms of these conditions. Furthermore the use of certain drugs on an empty stomach may contribute to upper gastrointestinal disturbances leading to symptoms such as belching and nausea. It may also occur when more than one drug is taken simultaneously which leads to drug interactions.
Apart from medication and certain supplements, alcohol may also cause both belching and nausea. Alcoholic drinks, and carbonated alcoholic beverages in particular,can irritate the upper gut. In addition the gas in carbonated beverages is a contributor to excessive belching. A host of other non-edible, toxic and illicit substances can lead to nausea and belching after it is consumed.
Belching and nausea are common symptoms of pregnancy. Nausea is often seen in early pregnancy as a result of morning sickness and belching may also occur. In late pregnancy, belching is a common symptom for several reasons and may be accompanied by nausea. This can be due to changes in eating habits, excessive air swallowing with shortness of breath, pressure on the stomach due to the enlarged uterus, pregnancy hormones and so on.