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Yes, Acid Reflux Can Cause Nausea. Here’s How.

Heartburn and pain may be the most common symptoms of this GI problem, but nausea sometimes joins the party, too. Here’s what to know to get relief.

If you’ve been diagnosed with acid reflux, you probably know that heartburn and esophageal pain are common symptoms of this digestive condition. But did you know reflux can also make you feel like you’re going to throw up?

“Acid reflux can cause nausea when the esophageal lining becomes irritated,” says Omid Mehdizadeh, M.D., an otolaryngologist at Providence Saint John’s Health Center in Los Angeles. “Nausea may also happen as a result of what’s called a gastric erosion”—a raw or sore area on the inner lining of the stomach, he adds. Acid reflux can contribute to such erosions, and if left untreated—particularly if acid reflux is chronic—gastric erosions may develop into stomach ulcers, Dr. Mehdizadeh says.

Fortunately, treatment for acid reflux can often alleviate both the nausea and other symptoms of this disorder, as well as help keep the condition under control, Dr. Mehdizadeh says. If you’ve been struggling with nausea as a result of your reflux, here’s what you need to know—and how to find relief.

What Is Acid Reflux?

To understand how nausea may be prompted by acid reflux, it’s helpful to take a look at how reflux affects the body. According to the American Gastroenterological Association (AGA), acid reflux occurs when the contents of your stomach—mainly undigested food and stomach acid—flow upward out of the stomach and into the esophagus, the tube linking your mouth to your stomach.

When that acid goes into the esophagus, it can damage the tissue all the way up into the mouth and sinuses. Sometimes, acid reflux may even affect the respiratory system, adds Dr. Mehdizadeh. When reflux happens several times a week on an ongoing basis, it’s called gastroesophageal reflux disease, or GERD.

According to the AGA, symptoms of acid reflux can include:

  • Burning pain behind the chest that may move up toward the neck and is worse when you’re bending over or lying down
  • Cough that won’t go away
  • Difficulty swallowing
  • Feeling like food is stuck in your throat
  • Hoarse voice
  • Nausea
  • Pain or ache in the chest
  • Persistent sore throat
  • Sleep disturbance

You may experience only one or two of these symptoms, says Joseph Shami, M.D., a gastroenterologist at Gastroenterology Associates of New Jersey in Montclair, NJ, and Wayne, NJ. If symptoms are happening regularly, or if they are getting worse or increasing in frequency, it’s important to get checked out so you can start treatment.

“Untreated GERD can lead to serious complications in terms of your health,” Dr. Shami says. “For example, long-term damage to esophageal tissue can lead to bleeding that raises your risk of anemia. You’re also at higher risk for developing asthma. Don’t wait for [symptoms] to become chronic and debilitating to get this checked out.”

Symptoms of Reflux-Induced Nausea

On its own, nausea can be unpleasant, giving you a queasy and unsettled feeling. But it may be intensified if you’re also experiencing other symptoms of reflux. In addition, reflux-related nausea be accompanied by other unpleasant symptoms, Dr. Mehdizadeh says, such as:

As with the other symptoms of acid reflux, you may have these signs only occasionally—for example, when you eat something that upsets your stomach.

“Nearly everyone tends to get acid reflux at some point in their lives, often related to what they ate,” says Dr. Mehdizadeh. In minor cases, the symptoms may resolve on their own and no treatment is needed, he says. If reflux-induced nausea and its accompanying symptoms are making you seriously uncomfortable or affecting your ability to do everyday activity, however, that warrants treatment.

Treating Acid Reflux-Induced Nausea

Even if nausea is your only symptom—meaning you don’t have the other common signs of acid reflux like burning pain in the chest, bloating, and pain in the esophagus—medication designed to treat reflux can often help resolve the nausea, says Dr. Mehdizadeh.

Options include over-the-counter (OTC) remedies if you have only occasional acid reflux with nausea, or prescription options if you have GERD, says Hiten Patel, M.D., a family medicine physician at The Ohio State University Wexner Medical Center in Columbus, OH. He says there are three classes of medications to consider:

Acid Reducers

Also called antacids, these OTC medications work by neutralizing stomach acid, which can help with resolving nausea, says Dr. Mehdizadeh. They include:

  • Gaviscon (aluminum hydroxide and magnesium carbonate)
  • Maalox (aluminum hydroxide, magnesium carbonate, and simethicone)
  • Mylanta (aluminum hydroxide, magnesium hydroxide, and simethicone)
  • Pepto-Bismol (bismuth subsalicylate)
  • Rolaids (calcium carbonate and magnesium hydroxide)
  • Tums (calcium carbonate)

Antacids often work quickly, he adds, so your nausea should be alleviated soon after taking one of these meds. If not, it’s possible there could be another reason for your nausea that’s not related to your acid reflux.

H2 Blockers

Also known as histamine H2-receptor antagonists, H2 blockers work by reducing the amount of stomach acid secreted by glands in the lining of your stomach. They come in both OTC and prescription-strength versions. On this list are:

  • Axid (nizatidine)
  • Pepcid (famotidine)
  • Tagamet (cimetidine)
  • Zantac (ranitidine)

One way to reduce the incidence of nausea is to take H2 blockers before eating foods that tend to give you problems, Dr. Mehdizadeh says.

Proton Pump Inhibitors

Known as PPIs, these medications also work on the acid secretion cells of the stomach to reduce the amount of acid produced. Three PPIs are available OTC:

  • Nexium (esomeprazole)
  • Prevacid (lansoprazole)
  • Prilosec (omeprazole)

As with the H2 blockers, these meds are also available in higher-strength prescription versions.

Which to choose? Picking a PPI or a H2 blocker is often a matter of personal preference, says Dr. Patel. You may find that one works better for you than other options when reducing reflux-related nausea. If your symptoms require daily medication, your doctor will most likely recommend a prescription-strength version of one of the drugs above—usually one of the PPIs, Dr. Patel says.

Preventing Acid Reflux-Induced Nausea

If medications geared specifically toward acid reflux aren’t doing the trick, there are other approaches that may help reduce your chances of experiencing nausea. Some strategies to consider:

  • Avoid liquid at mealtimes; drink 30 to 60 minutes before or after eating instead.
  • Don’t lie flat for at least two hours after eating.
  • Eat slowly and consume smaller portions at a time since they’re easier to digest.
  • Avoid overly sweet food. You might find salty foods (think crackers) more palatable.

Medications that treat or prevent nausea and vomiting, called antiemetic medicines, may also be helpful. Over-the-counter examples are Dramamine (dimenhydrinate) and Kaopectate or Pepto-Bismol (bismuth subsalicylate). A prescription option you can ask your doctor about is ondansetron, sold under the brand name Zofran.

With any type of acid reflux symptoms, including nausea, lifestyle habits can play an important role in reducing the frequency of episodes and the intensity of the nausea when it does occur, says Dr. Mehdizadeh. He suggests strategies such as:

Even if you’re on medication for GERD, adopting behaviors like these can help you lower your risk of complications—such as chronic coughing, wheezing, or difficulty swallowing—as well as make your medication more effective, he adds.

When to See a Doctor About Acid Reflux-Induced Nausea

In general, medications to treat acid reflux should minimize or alleviate symptoms, including nausea, but if the problem is persisting, check with your doctor. If you’ve begun vomiting in addition to experiencing nausea, that may indicate that your acid reflux has progressed into GERD, Dr. Patel says, which may require more treatment than you’re currently getting.

“If your symptoms are interfering with your everyday life and you find yourself taking over-the-counter medications often, it’s advisable to get an appointment to see what’s going on,” he adds. “That way, you can create a management plan that can help get this issue under control.”>

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