Vomiting and belching are two different processes involving the upper digestive tract. Vomiting is where the contents of the upper digestive tract (usually food, beverages, enzymes, mucus and water) are expelled forcefully. Belching is where gas is expelled from the upper digestive tract through the mouth into the environment. However, there are times when both vomiting and belching may appear to occur simultaneously.
Vomitus contains a number of different substances in the upper digestive tract. This includes food and beverages that were recently consumed and in different stages of digestion. Along with it are the digestive enzymes, stomach acid, mucus and water secreted by the digestive tract. Collectively it is referred to as chyme.
Sometimes there may also be bile which is secreted from the gallbladder to be mixed with the gastric chyme in the duodenum (small intestine). Given the various substances and the process of digestion, vomitus neither tastes nor smells pleasant. Often it is extremely offensive in both taste and odor.
Why do burps taste like vomit?
Movement of food and fluid is from the mouth, down the esophagus, into the stomach and then through the intestines to the rectum and anus. This is made possible by the action of the tiny mucles in the walls of the digestive tract. The pushing movement through the gut is known as peristalsis. Vomiting causes a flow in the opposite direction and this is known as reverse peristalsis.
The same muscles that are responsible for peristalsis are responsible for reverse peristalsis. However, it is coordinated in a manner that pushes the contents out of the duodenum, stomach and esophagus into the mouth. Belching is usually less active. If gas builds up in the upper gut, it can eventually push upwards into the mouth. Sometimes contracting the abdominal muscles and diaphgragm can also force out gas from the upper gut.
Although belching (burping) is not as forceful as vomiting, the expulsion of gas can sometimes carry chyme with it. Technically this is not vomiting but regurgitation or reflux. Similarly acid reflux may co-exist with excessive belching. If the chyme reaches the mouth, then the taste of vomitus may be perceived by the taste buds. In some instances where there is a gastrointestinal upset, belching may continue into vomiting or even trigger vomiting.
Causes of Vomiting Belches
Every person belches several times in a day and it is not always noticeable as a loud long burp. This expulsion of gas is usually not accompanied by regurgitation or reflux that is substantial or forceful enough to cause the gut contents to reach the mouth. However, in some people and with some conditions there may be vomit tasting burps. It is more likely to occur when belching is forced or excessive. Nausea and heartburn are common accompanying symptoms.
Read more on excessive belching.
The lower esophageal sphincter (LES) normally prevents backflow of stomach contents into the esophagus. When it is does not close properly, the stomach contents enter the esophagus and may also reach as high as the mouth. This is known as gastroesophageal reflux disease (GERD) or commonly as acid reflux. It may be caused by weakening of the muscles that comprise the sphincter, problems with nerves supplying these muscles and conditions like a hiatal hernia.
Overeating, Alcoholic and Carbonated Drinks
Overeating is another common cause of belching and acid reflux. The excessive stretching of the stomach can affect the normal functioning of the lower esophageal sphincter (LES). Vomit tasting burps with overeating are also more likely to occur if alcoholic and large amounts of carbonated beverages are consumed. Certain foods are also more likely to cause belching and reflux, particularly spicy and greasy foods.
Read more on foods and drinks that cause acid reflux.
Gastroenteritis is a common infection of the digestive tract due to viruses, bacteria, protozoan and the toxins of these infectious agents. Viral gastroenteritis is usually referred to as stomach flu. Often it is spread through contaminated food or water, hence the term food poisoning. Vomiting is a common symptom along with nausea, diarrhea and abdominal pain. Belching may also occur and this can be accompanied by vomiting at times.
Gastric Outlet Obstruction
After food is both partially digested (both mechanically and chemically) within the stomach, it is slowly passed out into the duodenum of the small intestine. If the stomach outlet is too narrow or blocked then the gastric chyme may ferment in the stomach. This can lead to excessive belching and reflux. Obstructions may be caused by tumors (both bening or cancerous), hardening of the stomach tissue, peptic ulcers, infections and damaged nerves.
Belching and reflux are common in pregnancy. Apart from morning sickness in early pregnancy where these symptoms are common, the enlarged uterus in late pregnancy may also cause belching with reflux as there is pressure on the stomach. Furthermore the pregnancy hormones are believed to weaken the lower esophageal sphincter (LES) which increases the risk of reflux.
Other Causes and Risks
A number of other conditions and risk factors may increase the risk of excessive belching and acid reflux. This includes:
- Aerophagia (excessive air swallowing)
- Bile reflux
- Food intolerances or malabsorption syndromes
- Hiatal hernia
- Small intestine bacterial overgrowth (SIBO)
Sometimes the stomach contents do not reach the mouth during a belch. Instead the odor from the gut is carried up to the nose during a belch where it is perceived as a vomit tasting or smelling burp.
Read more on sulfur burps.
Remedies for Vomit Tasting Burps
Underlying diseases and disorders that cause vomit tasting burps need to be diagnosed and medically treated. However, a few simple dietary and lifestyle measures may help ease these burps.
- Do not eat or drink too fast as this increases air swallowing and therefore leads to excessive belching.
- Avoid foods and beverages that may lead to reflux or excesive belching, especially spicy and greasy foods.
- Do not lie down or sleep immediately after meals. Light physical activity after meals may help prevent reflux.
- Minimze the consumption of alcohol or carbonated beverages with and immediately after meals.
- Avoid overeating. Several small meals are less likely to cause acid reflux than fewer large meals.