Belching (commonly known as burping) refers to the act of expelling the gas present in the stomach through the mouth. Medically referred to as eructation, belching is commonly caused by the presence of excessive air in the stomach. Belching releases the excessive air in the stomach and provides relief from the discomfort caused by the distension of the stomach. Belching happens in both normal and abnormal circumstances. Occasional belching that occurs several times a day is not usually a cause for concern. However, excessive belching may indicate some underlying problem in the digestive tract that may need further investigation and treatment.
Nausea refers to an involuntary urge to vomit. It usually indicates the presence of some problem in the digestive tract. In some cases, nausea can be temporary and might go away on its own without causing actual vomiting. In other cases, nausea may be severe and result in repeated bouts of vomiting. Persistent nausea needs to be investigated, since it may affect the appetite and normal functioning of a person.
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Causes of Belching and Nausea
Nausea and belching are common symptoms of problems within the digestive tract. However, non-digestive problems may also cause belching and nausea. Swallowing excessive amounts of air (caused by eating fast, overeating, and consuming certain foods and beverages) is one of the most common causes of belching.
On the other hand, nausea is commonly a result of irritation of the walls of the upper gut (esophagus, stomach and duodenum). In some cases, both upper gut irritation and excessive air in the stomach may occur. Nausea and belching may both be present in such conditions. The following are some of the most common causes of belching and nausea.
Certain foods and beverages
Belching and nausea can be caused by the consumption of a variety of foods and beverages. The most prominent examples include fatty foods, spicy foods, and carbonated beverages. Spicy and fatty foods can cause indigestion, resulting in the symptoms of belching and nausea. Nausea and belching can also occur due to consumption of fatty meals by a person suffering from gallbladder disease or those without a gallbladder.
Carbonated beverages can irritate the lining of the upper gut. Also, overeating any type of food can result in belching and nausea. Consumption of foods and beverages that a person cannot digest can also lead to nausea and belching. Food intolerance, caused by the inability to digest certain food components, is a common condition.
For example, lactose intolerance is caused by the inability to digest lactose sugar present in dairy products. Consequently, consumption of dairy products by a lactose intolerant person will lead to digestive problems, including symptoms of belching and nausea. Food intolerance to sorbitol, fructose, gluten and other nutrients can also occur.
Problems with the esophagus
Gastroesophageal reflux disease (commonly abbreviated as GERD) is a common cause of belching and nausea. Gastroesophageal reflux refers to a backward flow of stomach acid into the esophagus. This backward flow of stomach contents occurs when the lower esophageal sphincter between the esophagus and the stomach becomes weak. Contact with stomach acid irritates the walls of the esophagus, causing pain that is commonly referred to as heartburn. A bloating sensation and loss of appetite may also occur in this condition.
Problems with the stomach
Problems within the stomach, such as stomach ulcers and inflammation of the lining of the stomach (gastritis), can also cause belching and nausea. These conditions also cause a gnawing pain in the upper abdominal region. Vomiting may accompany nausea, and loss of appetite may ensue. The most common causes of these stomach problems are infection with the Helicobacter pylori bacteria and excessive consumption of painkillers (non-steroidal anti-inflammatory drugs or NSAIDs).
Belching and nausea may also be caused by delayed gastric emptying. In this condition, partially digested food in the stomach moves at an abnormally slow pace. The cause of delayed gastric emptying could be a narrowing of the stomach outlet (technically referred to as pyloric stenosis). Weakening or paralysis of the muscles of the stomach wall (technically referred to as gastroparesis) could also be the cause of delayed gastric emptying. Vomiting, bloating, acid reflux and loss of appetite usually accompany delayed gastric emptying.
Problems with the small intestine
A variety of conditions affecting the small intestine can cause belching and nausea. Examples include peptic ulcer disease (duodenal ulcers) and small intestinal bacterial overgrowth (abbreviated as SIBO). In addition, diseases affecting the gallbladder and the pancreas could also cause belching and nausea. Examples include gallstones and pancreatitis. Bile reflux from the duodenum into the stomach and the esophagus may also occur in these conditions.
Obstruction of the small intestine can also cause nausea, belching, and projectile vomiting. Small intestine obstruction may occur due to the presence of tumors (both benign and malignant), twisting of the bowels, compression by nearby structures in the abdomen, and presence of a foreign body. Obstruction of the large intestine is less likely to cause belching and nausea.
Gastroenteritis is a common infection of the gut caused by a variety of bacteria, viruses, and protozoans. Gastroenteritis is usually an acute infection, which resolves on its own within a few days. The symptoms associated with gastroenteritis include excessive belching, nausea, vomiting, diarrhea, and abdominal cramps. Gastroenteritis is caused by consumption of food or water contaminated with the pathogens. For this reason, gastroenteritis is also commonly known as food poisoning.
Belching and nausea can also be caused by the intake of certain drugs. Drugs can cause nausea by stimulating the chemoreceptor trigger zone in the brain, which triggers the nausea centers in response. Repeated acts of swallowing while suffering from nausea (to try to hold off vomiting) can lead to excessive air in the stomach, which can result in belching.
Some medications can also cause belching and nausea by irritating the stomach lining and causing or worsening gastritis or peptic ulcer disease. Taking certain drugs on an empty stomach may increase the risk of upper gastrointestinal disturbances, which are marked by belching and nausea. In case of simultaneous intake of multiple drugs, drug interactions may also contribute to the development of upper gastrointestinal disturbances.
Alcohol and other substances
Consumption of alcoholic beverages can irritate the stomach and cause belching and nausea. Carbonated beverages also have the same effect. The gas in the carbonated beverages frequently causes excessive belching. Apart from alcohol and carbonated beverages, a variety of toxic and illicit substances can also cause belching and nausea after consumption.
Pregnancy: Nausea and belching are common symptoms of pregnancy. Nausea during pregnancy often manifests as morning sickness, especially during the early stages of pregnancy. Changes in eating habits, pressure on the stomach exerted by the growing uterus, hormones, shortness of breath and excessive air swallowing during pregnancy can all contribute to the nausea and belching symptoms.