Your throat — medically known as the esophagus — is a long, narrow tube that carries food and water from your mouth to your stomach. The esophagus also carries them away from your stomach in the form of vomit. There are many causes of vomiting, and some are even purposeful. Regardless of the reason, vomiting repeatedly or even once can be painful.

In some cases of illness or other conditions that can upset your stomach, your throat serves as an exit route for vomiting. When you vomit, what you ate or drank can be forced back up through the esophagus. They can be joined by the natural acids and enzymes that your stomach contains to help digest food.

Find out why vomiting hurts your throat, what it could mean, and what you should do about it.

The esophagus is strong, but also delicate. Experts at the National Cancer Institute say that the esophagus is made up of layers of smooth muscle and an inner layer coated with mucous membranes. This layer is tough enough to help pass rougher foods from your mouth to your stomach, but it’s also easy to damage it.

As you throw up, physical or chemical damage can occur in the throat, causing pain. Below are some of the common causes of this pain.

Gastric liquids

Stomach acids are very strong acids that help break down the food in your stomach for digestion. In the wrong places, these acids can cause a host of problems. They’re even capable of damaging teeth and bones.

When your stomach produces too much acid, or when the valves that separate the stomach and the esophagus have problems, stomach acids can bubble into your throat. These acids can corrode or damage the tissue that lines your esophagus.

After one episode of vomiting, you may notice some throat pain from the force of vomiting combined with the stomach acids the vomit carries. These effects were studied in a 2021 research review. Repeated episodes of vomiting can increase the level of this damage. These episodes may occur from conditions like bulimia or as a side effect of medications like chemotherapy.

If you have frequent heartburn or gastroesophageal reflux disease (GERD), the structures that separate different parts of your digestive tract don’t work properly. This may cause acid to backflow into areas where it doesn’t belong, like your throat. This leaking into the throat, known as reflux, can cause uncomfortable and lasting effects.

Inflammation

Esophagitis and gastritis are conditions where the throat or stomach can become inflamed.

With esophagitis, the throat becomes inflamed for a number of reasons, including:

Gastritis doesn’t directly cause throat pain, but it does cause nausea and vomiting, which can lead to damage to the esophagus.

Alcohol and your throat

You may get a sore throat after a night of drinking, possibly from vomiting. However, long-term heavy alcohol use can also cause other throat problems. For these throat problems, you may not have any symptoms.

Alcohol use can lead to liver problems like cirrhosis. Cirrhosis may also be caused by non-alcoholic liver conditions. When cirrhosis makes it harder for bile to flow through the liver — whether from alcohol-related damage or other causes — this backup increases pressure in your blood vessels.

This includes the blood vessels in your esophagus. As these vessels swell with the extra pressure, they can rupture and cause bleeding. These veins are known as esophageal varices.

While esophageal varices have many causes, frequent vomiting and heavy alcohol use are commonly associated with them. Symptoms often show up late and include vomiting blood. See a doctor or healthcare professional immediately if you see blood in your vomit.

Speak with your doctor about prevention strategies if you are at risk for esophageal varices.

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Barrett’s esophagus

Repeated exposure of the delicate tissues in your throat to strong stomach acids can permanently change the cells that make up your esophagus.

The cells that line the intestines are used to being exposed to strong stomach acids. But the cells that make up the lining in your throat are not. Over time and with repeated exposure to stomach acids, the tissues that line your throat begin to change. Eventually, these cells begin to resemble those in the intestines instead of what is typically found in the throat.

When these cells change, you may develop some degree of Barrett’s esophagus. This is the condition that occurs when these cells change. Barrett’s esophagus has different degrees of seriousness depending on how many cells have changed. But the more serious concern with this condition is the increased risk of developing esophageal cancer.

Other symptom of Barrett’s esophagus include:

  • chest pain
  • vomiting blood, or vomit that resembles coffee grounds
  • difficulty swallowing
  • passing black, tarry, or bloody stools

To diagnose Barrett’s esophagus, your doctor will perform a biopsy, which involves taking a tissue sample from your throat. The doctor will then diagnose your condition based on how much your cells are damaged. Treatment options usually focus on lifestyle changes like diet planning and weight management, but you may need more treatments if your condition is more severe.

Physical tears

The act of vomiting is intense and forceful. While stomach acids are one factor in the damage caused by vomiting, this force is another.

Vomiting involves many structures in your digestive system. When you vomit, these structures contract and create negative pressure that can lead to physical injuries or tears in organs like the esophagus. Depending on the specific location and cause, there are a few types of physical tears that can result from vomiting. Two of these are:

  • Boerhaave syndrome. This occurs when increased pressure on the esophagus — usually a result of vomiting — causes the esophagus to rupture, based on this 2021 study. It may also be called esophageal perforation. This is a medical emergency and requires immediate treatment. Symptoms include vomiting, chest pain, and bubbling or air under the skin, which is known as subcutaneous emphysema.
  • Mallory-Weiss syndrome. Similar to an esophageal rupture, the tears that occur with Mallory-Weiss syndrome can be caused by forceful vomiting, as shown in a 2021 study. The increased pressure damages the esophagus, but causes tears instead of a full rupture. Bleeding from these tears may stop on its own but could also require emergency treatment or repair.

A sore throat is usually more of an inconvenience or discomfort than a medical problem, unless it’s linked to a more serious underlying condition. You can try a variety of options for treating sore throat, depending on the cause.

Natural remedies

Whether your sore throat is caused by heartburn, gastric reflux, or other conditions, you can try some soothing, natural remedies at home to make yourself more comfortable. These include:

  • gargling with warm salt water
  • honey
  • lemon
  • warm liquids or teas
  • increasing fluids

Over-the-counter (OTC) treatment

If natural remedies aren’t helping, you may be able to try some OTC medications to ease your pain. These include:

If you have a stomach ulcer or other condition that’s causing reflux and a sore throat, speak with your doctor about the risks of using some pain relievers like ibuprofen. To reduce throat pain caused by heartburn and reflux, a number of OTC antacids could help.

Prescription and medical treatment

If a more severe condition is causing your throat pain or vomiting, your doctor may prescribe you medication designed to:

  • control vomiting
  • manage acid reflux
  • relieve pain

If the pain is from damage caused by vomiting, including a tear, you may need surgery to repair it. In some cases, you may need to get surgery to fix a valve in your stomach, if backflow from a faulty valve is leading to reflux, vomiting, and sore throat.

Speak with your doctor if natural and OTC treatments don’t help your sore throat.

Sometimes, the problems that lead to vomiting and a resulting sore throat are not preventable. If you were born with gastric valves that can not do their job, or if you develop cancer and require chemotherapy, these situations can not be prevented.

You can, however, prevent conditions that lead to vomiting, acid reflux, GERD, and esophageal pain from acid or physical trauma. Some lifestyle changes that can help include:

Maybe you’ve already made lifestyle changes and tried natural or OTC treatments. If you continue to have throat pain after vomiting, contact a doctor to determine if there is another chronic issue causing these problems.

Medical emergency

Call 911 or go to the nearest emergency room if you experience pain in your throat and:

  • shortness of breath
  • chest pain
  • vomiting blood

Vomiting is a physically and chemically intense process. The force and acids that pass through your throat during vomiting can cause a sore throat, plus more severe damage. If you have lasting pain in your throat after vomiting or find that you have frequent vomiting and sore throat, speak with a healthcare professional to rule out serious complications or chronic disorders.

Natural remedies can give short-term relief for a sore throat after brief episodes of vomiting, but if these problems won’t go away, discuss them with a doctor.