Burping lots and feeling sick: what it can mean

Acid reflux can bring stomach contents upwards and cause repeated burping, sour fluid or burning. Gastritis irritates the stomach lining and may cause nausea, discomfort and reduced appetite. Food poisoning or gastroenteritis may add vomiting, diarrhoea, cramps or fever. Gallstones can cause nausea with pain under the right ribs, especially after a rich meal. Heat exhaustion may cause nausea, weakness, sweating and dizziness. Hepatitis A can cause nausea, tiredness and yellowing of the skin or eyes. Low blood sugar may cause nausea with shaking, sweating, hunger or confusion.

Take small, regular sips of water or an oral rehydration drink if you have been vomiting or have diarrhoea. Eat small plain meals when able, and pause fizzy drinks, alcohol, very fatty foods and foods that clearly trigger symptoms. Eat slowly, avoid gulping air and remain upright after meals. Keep a brief record of timing, food, medicines and other symptoms; this can help a clinician identify a pattern.

Get urgent medical help for severe or worsening abdominal pain, chest pain, trouble breathing, fainting, confusion, blood in vomit or stool, repeated vomiting, or signs of dehydration such as very little urine. Seek prompt assessment if the skin or eyes look yellow, you cannot keep fluids down, or symptoms follow significant heat exposure. Arrange a medical review when symptoms keep returning, interfere with eating, or do not settle.

Could reflux, gastritis, an infection, a medicine or low blood sugar explain this pattern? Which warning signs should prompt urgent care? Do I need an examination, blood tests or other tests? What foods and drinks should I avoid while symptoms settle?