Heartburn, Vomiting. I hate to vomit. I used to have bad heartburn at night—it would make me cough and vomit. Vomiting is caused by heartburn. Sometimes heartburn directly causes vomiting. It can also cause the inhalation of gastric acid into the lungs.

Note:Acid reflux causes vomiting. In children, the stomach contents are vomited.

Note 2:Acid reflux causes coughing. This is called acid aspiration. It is most serious in those with neurological impairments.

Acid reflux. This first cause is more common in infants and small children experiencing heartburn. In an episode of acid reflux, an infant or child may often actually vomit the stomach contents due to the reflux itself.
This occurs when the lower esophageal sphincter is too relaxed due to the GERD condition. The stomach contents travel upwards, possibly resulting in vomiting. This was described on the University of Virginia Health System web site.

However:The page at the university health site was removed after this article was written.

University of Virginia Health System
Cough. There is another reason why heartburn can result in vomiting. Sometimes, the acid reflux flows into the esophagus and into the windpipe. This is termed aspiration of the acid. It can cause a chronic or even severe cough or choking.

Note:For some, this can lead to a cough that may result in vomiting the stomach contents.

Tip:For more information, try searching the Internet. Try the terms "GERD aspiration", keeping in mind the definition of aspiration.

Story. I have severe heartburn problems. In my experience with severe GERD or heartburn, I have vomited. This is because of the aspiration of acid contents. Usually, vomiting because of the heartburn itself (the LES sphincter) is less severe.
However, vomiting caused by aspiration of acid and coughing attacks is severe. This is the experience for an adult. For infants and small children, this problem should be further investigated.GERD PrevalenceHeartburn, Death
My problem with aspiration of acid due to nighttime heartburn was solved. I changed my sleeping habits to sleep in a recliner chair. I later used a wedge pillow. Physically, this prevented acid from flowing into my windpipe.
This meant no acid was inhaled and I did not cough. By eliminating the coughing, the vomiting was also eliminated. Nighttime sleep habits and positioning are important. Sleeping on a wedge pillow is effective.Sleeping in Chair: Medical Problems
Diagnosis. One reader wrote in to ask me if I received a diagnosis because of my nighttime vomiting. Melanie has similar problems. I answered that I did not receive a diagnosis from a doctor beyond simple acid reflux.

Instead:I solved the problem by changing my sleeping position. I also had food intolerances and side effects from medication.

Acid aspiration. Continuing on, let's look at acid aspiration. As noted above, acid aspiration due to reflux causes vomiting. Breathing and acid reflux are connected. Sometimes, people breathe in their acid reflux. This is called acid aspiration.

Note:Acid aspiration is a complication of heartburn. It is usually only serious in very sick people.

Research. Acid aspiration can cause you to vomit and cough. If you are in bad health, an immediate visit to the doctor is needed. However, aspiration of materials occurs often in healthy people. It doesn't cause them too much trouble.Pulmonary aspiration: Wikipedia

Note:In healthy people, aspiration of small quantities of material is common. It rarely results in disease or injury.

Is it serious? If coughing due to acid reflux frequently happens and you are unhealthy in general, it could be something critical. Acid reflux and acid aspiration once in a while is probably not a serious problem.

However:You are more likely to have acid aspiration if you have neurological problems.

Aspiration also is common in patients with neurological impairments as evidenced by events in approximately 50% of stroke patients.

Acid Aspiration: Inflammation and Resolution
Baking soda. There is another reason why heartburn might lead to vomiting. One home treatment for heartburn is baking soda. If you ingest too much baking soda, or drink it too fast, this can trigger vomiting.

Note:In this case, it is the baking soda that actually causes regurgitation, not heartburn.

Baking Soda and Vomit
Summary. Heartburn is related to vomiting. A conclusive medical diagnosis is found by extensive experimentation or objective tests. By changing nighttime habits, it is possible to reduce some aspects of acid aspiration and vomiting.

And:Changing habits can also eliminate vomiting directly caused by the heartburn.