Digestive Disorders / Gastroenterology Expert Forum
Desperate for help!
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Desperate for help!

I have been going to doctors for approx. 1 yr. I have had heart cath, Stomach and chest ct scan, endoscopy, gallbadder utrasound,etc. To no advail. My problem is that I started out just having a little discomfort in my mid stomach area and I was having a funny sensation in my chest well I finally figured out that the sensation was actually my heart skipping beats (or early beats as they put it)and rapid pulse. As time has went on I have come to realize that these heart sensation occur more after eating and now I am having a very full feeling in my mid stomach area and a little nausea. I can even be just riding down the road and the vibration from the car will make my stomach move and immediately my heart will skip a beat. I almost feel like my food is not digesting properly and it is swelling my stomach which is pushing on the artery running by my stomach. I am so fustrated cause no one seems to believe that my stomach has anything to do with my heart but I know that this is happening.
I am not a hypocondriact, I know that this is happening and I am real concerned cause I feel it is getting worse. As a matter of fact I am really scared. There are no doctors in my area that have a specialty in this area. All test have revealed no answers.
PLEASE give me some suggestions as to what it could possibly be or research I can do on my own. I have searched the internet and I can not find anything that have digestive and heart related symptoms
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You have had a pretty thorough evaluation already, including a catheterization and endoscopies, CT scan, ultrasound etc.  

A couple of other tests to consider.  The first would be an event monitor.  This can monitor your heart rhythm so whenever you feel your heart skipping beats, it can document any arrythmias.  I would also consider an ultrasound to evaluate the heart structure.

Regarding pinning down a GI cause, you can consider a 24-hr pH study which can definitively evaluate for GERD.  A gastric emptying scan can also be considered to evaluate for gastroparesis.  Both of these conditions can cause some of the symptoms you describe.  

You may want to discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b
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Look at my question that posted on 6-4-04, titled "Is This Gerd?".  Maybe that will give you some insight...
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Thank You Imroswell. I was excited to learn that maybe there is someone out there that has had the same problems (although I do not wish this on anyone). I am going to read more on this Vegas nerve. Thanks again!
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What exactly is this and where can I find info about. I have looked on net and can not locate.
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the correct spelling is vagus nerve. However, much of what was posted in that thread is way off the mark.
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So where can we find out more about VAGAS nerves?
When i described the problem to my gastro doctor,he said he has never heard of such a problem.
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Please contact me @ ***@****. Imroswell you intrigued me when you stated that driving down the road would cause your heart to pause or get irregular. Thats one of the things I keep saying. Its like the jarring from the road will jar the stomach and in return my heart skips immediately. I am so desperate. No one can find out what is wrong and I know in my heart that my stomach and my heart deal are related. Like right now my mid section has a real full feeling (have not eaten this morning) and I can just walk across the room and the jarring from the walking is making my heart react. It seems to be getting worse. Use to I didn't have this full feeling for so long of a period, before it seemed to go away after 3 or 4 hours but now it is constant and I can take 2 bites of food and it is worse. PLEASE anybody out there with similiar symptoms contact me.
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one more time: it's vagus. Not vegas, or vagas. It's the name of the nerve, present in everyone, that goes mostly to heart, stomach, intestines. It's controlled by stimulation from the brain, and can be affected by certain drugs. Disorders of the vagus nerve are extremely rare; most problems attributed to vagus nerve action are not primary to the nerve, but result from stimulation, or lack thereof, due to other things. So it's the other things, not the nerve itself, that are the problem.
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Hi this surgeon seems more worried about the spelling of Vegas nerve than your problems . Let me tell you that they are not God The vegas nerve I have found through research aroung the glob Is a key factore In most illnesses Thats why they call it the mother of all ilness I have suffered from cardiac , neurological  problems for five years I had severe vomiting do to acid refluxe and when I developed a hiatle hernia, BANG Everything went way out of sink in my body , They did an EP study on mme for tackacardi or svt's almost died on the table the ep docter said it was comming from an outside source and to go see a gastro md . I have been on proton pump inhibitors for 4 years and without them , I would have all the problems that I had before I know this from experience I have pasted some studies that I think will help you understand that your not crazy and that there is a connection between your hernia and illness good luck guys Tony .            


" Could there be a factor either unknown, or not fully understood, by both mainstream and alternative medicine, that can initiate much chronic illness including allergies? Could there be a very dangerous condition in the body that can cause virtually every other organ of the body to malfunction? Could 85% of the population have this undetected condition? The answer is decidedly yes to each of these questions. At the end of this article, surprising, new evidence will be revealed that this factor may even be a predictor of life expectancy.

The biochemist Carey Reams, PhD, said,
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It is normal -- and everyone has an elevated heart rate after eating due to increased blood flow to the GI tract  . If you eat a large meal and the stomach gets overly distended, there are further irregularities . It's normal.  

It's also pretty normal to have beneign  PVCS and PACS ,  some people are just more aware.-- others don't even notice.  

  Yes the vagus innervates both the heart and stomach, but there are different branches. It's very complex.  You do not have  a vagus nerve disorder . There is NO problem with your vagus nerve ITSELF.  

You have a digestive disorder most probably.  . I'd like to add that many digestive disorders are exacerbated by stress --- and abnormal heartbeats are exacerbated by stress as well.  The more you worry about this,the problem will magnify . If the heart checks out fine, don't worry about it.  

Many people with digestive problems such as GERD etc. complain of heart irregularities , there are a number of theories rolling around regarding why this is,  along with  some small studies  , but nothing concrete yet.  ...Regardless,---- these irregularities are harmless, as long as the heart checks out fine , why worry or obsess?  Life is too short.  Just make sure you rule out the heart first as well as gastro disorders.   If you treat the gastro disorder , and calm down-- most probably your heart symptoms will disapate.

  That full feeling is called early satiety . You've ruled pretty much all causes of this out with the tests you've had, except  the ph and gastric emptying scan are 2 important tests to have in your case. .  If these are negative, nonulcer dyspepsia would be a probable diagnosis.



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The reason I spelled it is because people were saying they couldn't find it in searches. More importantly, the lengthy article replayed above is a perfect example of pseudo-science: it's simply a bunch of statements that sound authoritative but have absolutely no basis in any research using accepted scientific methods.
Simply putting something in print does not make it so. There are "articles" by people with all sorts of "degrees" from all sorts of "institutions" claiming virtually anything. Disease caused by magnetism, sunspots, the devil, all manner of "chemical imbalance," allergies to every substance know to man: you name it, it's in print. The ready availability of such nonsense on the internet makes it more imperitive than ever that people use judgement; and more likely than ever that they will be taken in.
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If you are looking something up and using the wrong spelling you won't get far. Most likely "vegas nerve" would tell you that it is something we experience while enjoying a gambling trip.
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And when you do find information .......  It will take you many months to understand everything pertaining to  the full function of the nerve  and the branches,--- the cranial nerves, ,superior and inferior vagal ganglia, subclavian artery, ,  nucleus solitarius, spinal trigeminal tract, etc. etc. etc.  

  You can't just read any article and blindly beleive it, you must study and understand it.
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Thanks, Surgeon, for your patience and clear thinking. I couldn't agree with you more about the need for caution when surfing the web for information. There are, unfortunately, a lot of scams and some just plain misguided folks posting cures/potions/etc that have no therapeutic value.

To our friends visiting this site: When using the Internet for research, you should restrict your research to very credible sources (example - if you see something on the Johns Hopkins Website, you can be pretty sure its credible info). Be careful about claims of miraculous cures from "alternative medicine". If you doubt a source, visit Quackwatch.com and run the name, product or procedure through their search engine. They do a good job of unmasking charletons. Above all, use good common sense. If a site promises cures that sound too good to be true, be alert to those claims.

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Okay this is a prime example of what I am going thru. Don't get me wrong I appreciate any comments so that I might can figure this out but when TJV says basically its nothing as long as my heart checked out don't worry but what no one is understanding is that this is affecting my daily life. I can not even focus have the time, either my head is so cloudy that I can't think or my stomach is aching or my heart is freaking out or all 3 at same time. Not in the past month have I had a normal day. Please understand I am not a person that runs to the doctor for every little thing. I am 43 yrs old and this last year is the FIRST time in my life I have had problems. I have always considered myself fairly active and now I can't even walk a block without this starting a reaction.
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And another thing when you say it is normal IT IS NOT NORMAL. Please understand that I have been to the ER 1 time with this and at that time I was actually having a mild case but I was wanting some documentation that it was happening and that it wasn't my imagination. They had told me that several people have skipped heratbeats (early beats) and that 6 a minute was not unusual. Keep in mind I said I was having a mild attack well I was having a min of 12 skipped beats a minute and my BP was 164 over 124 my pulse was over 100. When I would barely and I mean barely press my stomach I would have a BIG skip.
I am sorry but this is not normal! I have discovered that when Docs can't find out something instead of having the challange of discovery they just get lazy and put it off to stress. Sorry if I sound irritated but I am. I am so tired of no one caring enough about another Human Being to LISTEN.
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And speaking of listening. I want to say to ALL doctors out there that LISTENING to a patient is the main ingredient to finding out what is wrong. LISTEN it is their bodies and they know how they feel. Just because you have never experienced it or never read about it doesn't mean it doesn't exist.
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for what it's worth, i agree with the dr regarding an event monitor....this will help sort out any arrythmias you might be having....they can be scarey and nerve wracking....there are different types....you can get one for a month and when you get the sensation you can record it and send it into the company for a reading over the phone that same day......i know that your esophagus runs behind your heart and are close together and when you eat something or drink something cold, your heart can respond with an arrythmia which can or cannot be felt, especially in regards to someone who has a history of them......so if i were you i would ask your dr for a monitor so a recording of your palpitations can be recorded and hopefully will give you a diagnosis and peace of mind........good luck
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Please don't misinterpret me ,
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Thanks to all of you! I appreciate the input.
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Let me say that the symtoms (symptoms) are life threatening I had life threatening arithmia's and the best heart team in california said "IN THERE REPORT THAT THE PROBLEM IS COMMING FROM AN OUTSIDE SOURCE . I know from 5 years of hell, how to controll most of these symtoms (symptoms) studies or no studies " MY VEGAS NERVE HAS COME CLOSE TO KILLING ME FROM THE PRESSURE COMMING FROM THE HIATLE HERNIA " In the years to come these fools that think just because they went to college they have all the answers will not be commenting on this disorder VNI/HHS. And thanks for the email coleena I look forward to helping you out best wishes !!!
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I think the bottom line here is that no matter how much you need or want answers and a diagnosis, you aren't going to find them here.If all these Drs. you have been to and all the tests results haven't found it how in the world could anyone, Dr. or otherwise, in this setting, help you? You say the Drs. in your area aren't familiar with this then why not ask for a referral to one the university type hospitals where their specialty is dealing with and diagnosing the unusual? It would certainly be worth peace of mind to make a trip and get some useful answers. I know that the "vagus nerve" can cause all sorts of problems I have experienced some of them and when it became to much for my local Dr. I was sent for evaluation at one of those university hospitals.
Best of luck,
Sally
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Sally is right that some universities might be a better help , but getting on the internet can definitely help it connects us to each other and can and will lead to more illnesses being solved over time keep up the good work and good health .
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Dear Peter,
Thank you for your most recent contribution to our Forum. We have received many postings describing cardiav arrythmias related to reflux. It is apparent that the problem is more commmon than physicians realize. With regard to your specific questions
1) The vagus nerve regulates swallowing and heart rythm as well as transmits sensory information regarding the esophagus to the brain. INflammation of vagal fibers (as can be seen with esophagitis) may alter the neural tone that controls heart rythm. The specific mechanism would be highly speculative.

2)Bile in the stomach is a frequent finding during endoscopy. Bile can reflux into the esophagus. The role of bile in the genesis of the cardiac arrythmias is unknown.

3) Your liver problems are independent of the cardiac problem.

This information is presented for educational purposes. ASk specific questions to your personal physician.

HFHSM.D.-rf
*keywords: esophageal reflux, cardiac arrthymia
0.2

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My husband's complaints to several doctors, including the ones during his trips to the ER, couldn't and wouldn't believe his symptoms as he was explaining them to him, UNTIL, they actually documented it on and EKG.  I have to admit, it was very bizarre.  His recent gastric episodes, minus the cardiac symptoms, have again sent him to his gastro doc, who, remembered him, because his case was so unusual.  My recommendation to you, is that you go to a large academic center, and take with you all your pertinent medical records and start there.  I have no doubt this is affecting your daily quality of life.  We have been there.  There is an answer to your problems...
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  That post you posted on  the common acid irritating the vagal fibre theory in GERD  has absolutely nothing to do with your  hiatal hernia syndrome theory what so ever. So you're trading theories?

Was curious , you said quote  "I had life threatening arithmia's and the best heart team in california said "IN THERE REPORT THAT THE PROBLEM IS COMMING FROM AN OUTSIDE SOURCE ".

So what outside source do you suppose these cardiologists thought your problems were coming from?
  
And wasn't your heart deemed normal?

And  you said after 5 years you learned to control symptoms from this self professed life threatening VNI/HHS disorder. So what do you do to finally get your symptoms under control? What was the magic bullet?
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Until you have walked in my shoes keep your rude comments to yourself And I have not only lived this, hunderds of people around the world have. I hope that and I am certian that this  problem and life threatening condition in some will and can be managed  Good luck I will continue to help and try and find more info as I continue to do my own research !!!
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Dear Dr's.
I had an open Fundoplication in 88' and a thoracic fundoplication in 91'. Since the thoracic surgery I have had what first started as sinus Tach. After taking lopressor, prozac and Xanax my symptoms got better. In 94' I started having PVC's quite regularly and have them to this day on a daily basis. Two Gastroenterologists think this may be caused by scar tissue and adhesions from the surgeries. The PVC's seem to come whenever food or gas gets stuck in my esophagus. After making myself burp, the PVC's alleviate. It has always felt as if my stomach is somehow pulling down on my chest, like the two are connected internally from the adhesions. Do you think this is my problem and that I may benefit from laparascopic surgery to remove the adhesions. All cardiac tests are completely normal. Any insight would be greatly appreciated! Thank you for your time.

Sincerely, Erik

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Answer Posted By: HFHSM.D.-Gastro-RF on Tuesday, November 09, 1999

Dear Erik,
It is difficult to answer your question. We now see that cardiac arrythmias can be associated with esophageal reflux. Whether another surgery will prevent the cardiac arrythmias is difficult to predict. You should ask this question to the surgeon that you are considering for the operation.
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Posted by CCF CARDIO MD - DLB on July 15, 1999 at 13:21:10Dear Patricia

I agree with your cardiologist. I do not think that your hiatal hernia caused your PVCs. Despite what you might find posted on the internet, there is no proven connection between acid reflux or PVCs - both conditions are common and both are aggravated by stress. Thus both may coexist. The vagus nerve does supply the heart and help regulate the speed of the heart beat. Likewise, this nerve gives of branches that regulate stomach acidity. However, as appealing an explanation as it may seem, the two conditions are not linked.

I hope this has been useful. I wish you the best of luck. Feel free to write back.



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When you get a hiatal hernia , it allows a portion of the stomack to portrude through the hiatus If you look at how close the heart is to the hernia , there is what we call cardiac compression the heart is very sensative to anything that comes in contact with it or even close to it. So PVC'S can be caused by the hernia . And acide refluce that causes swelling and iritation in the esophagus , can cause cardiac symptoms . If i eat to late , I wake up with about 100 bpm about three hours later and all i hafto do , is drink small sips of water and the rate goes down to about 60 bpm . I have this ever since my hiatal hernia Well good luck and have a great weakend .
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I think that there has been some rude behavior in this forum related to the surgeon who is just trying to give everyone acurate information. For the record SVT and PVC's are not the same arrythmia. PVC's are premature ventricular contractions. SVT is supraventricular tachicardia. With SVT the heart rate is extremely rapid.(greater than 120bpm sometimes close to 200bpm) People suffering from SVT are acutely ill and do not generally convert to a normal rythnm without medical intervention. They often feel like their heart is fluttering not like a (skipped beat)They suffer from nausea/ vomiting and fainting. If untreated their blood pressure is low and they can suffer cardiogentic shock. which is not always the case with PVC's. PVC's become dangerous when they occur frequently, from different areas of irritabily in the heart, or in pairs. Many people have rare PVC's and donot even feel them. PVC's are not perfused and can not be felt in a pulse therefore they themselves do not cause tachycardia, when checking your pulse you would feel a skipped beat. The tachycardia r/t PVC's is called Ventricular tachycardia and does not generate a pulse. It is life threatinging. Many things affect heart conduction including stress, medications, electrolyte imbalances to name a few. Premature Atrial contractions are also responsible for the sensation of skipped beats, They can also cause tachy arrytrhmias. To really find out what is wrong a event monitor is a good idea. Irritation of the vagus nerve is often associated with slow heart rates (bradycardia) and fainting episodes. Which can be caused by extreme stress. I hope this helps.
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"PVC'S CAN AND DO START AN SVT RUN" I had svt's and pvc's and let me tell you this that when the pvc's started BANG there went my svt's But I had an ep study and the heart was perfect hmmm  the md said I would need to take toprol 50 mg's a day for the  rest of my life . Well as soon as I began proton pump inhibitors , everything subsided I am persuing a surgeon with my thoraxic / neuro team to correct the hiatal hernia and diaphramic hernia that has been the culprit of all these other symtoms (symptoms) good luck and have a great day > Ps I have been off the toprol for 5 years !!!
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Dear vegas1,
I hope that you did not take offense to my post. It was not intented that way. Supra means above and supraventricular means above the ventrical. So I can see what you are saying. If  PVC's cause enough irritablitiy I supose SVT could result, but they are still two different arrthmias. All arrthymias are caused by the electrical conduction of the heart not the structure. So a person with a normal heart structure can indeed have arrythmias. I was trying to give more clarity to the writer who was feeling skipped beats and/or a rapid pulse.
In the EPS lab the patient is given medicatons to stimulate the electrical conduction of the heart to try to reproduce the symptoms the patient is feeling so that they can figure out what arrthymia the patient is experincing. Somtimes they can even ablate the irritable focus and prevent the arrythmia from reoccuring.

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Thanks for the reply , I have just had so many problems that I kinda get on the offensive so anyway I have my svt's under controll as for the pvc's well depends on what and how mutch I eat like I A thoraxic surgical team is being assembled for a possible recunstruction / repair of the lower esophagus / diaphram that has major damage from vomiting well good luck anyway have a great day
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Well
5 odd years of a darting pain that feels like it
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Long-term use of certain kinds of pain killers can cause your symptoms.

Do you take either aspirin, Advil, Aleve, or Motrin?

I haven't read this entire thread so forgive me if this idea has been mentioned already.

-M.W.
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I do take BC powders, which are aspirin. As bad as I hate to admit I have taken 4 BCs a day, which is the same as 8 aspirin and have taken them for an extremely long time, probably 8 years. But I have slowed down to 1 BC a day which is the same as 2 aspirins. I actually quit for 2 weeks cause I was having a thyoid biopsy and the symtoms (symptoms) continued.
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Okay - I have no heartburn or any signs of hiatial hernia. My husband had this years ago and he had heartburn extremely bad and he thought he was having heartattack several times. My heart feels like it is skipping which doctor explained it is EARLY BEATS, what is this actually? I can feel in my pulse that my heart stops for a second. I have had people take my pulse and I can feel the sensation in my chest at the exact moment that they feel a so called skipped beat. My stomach JUST RECENTLY started having the bloating feeling (and its not an ulcer cause I had one years ago so I know what that feels like)right below my rib cage opening to right above my belly button. As a matter of fact like just sitting here now my stomach is all protruding (like fatness)at top and it feels like I am putting pressure on from just sitting. What is the medical term for the early beats?
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do you know certain medication weaken the LES??
aspirin is one of them,hormone replacement medication is another.
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Yoshi is right about things weakening the Lower Esophageal Sphincter (the "LES"). They also include chocolate, caffiene, alcohol, and mint (peppermint for example). A weakened LES exasperates GERD. Avoiding these foods, eating a low fat diet, losing weight (if one is obese), not eating or drinking anything three hours before going to bed, and sleeping with the head of the bed elevated about six inches, also help manage GERD.
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It is so strange to read your issues.  In 2004 I got really dizzy while on patrol (police officer) and then I almost blacked out.  After three months of searching, my cardiologist and gastro doctor gave me the thumbs up.  I returned to patrol and four days later felt a very weird, uncomfortable sensation in my abdomen.  From there I got numb in my arms and legs, my heart began to skip all around and I got really dizzy and weak.  3.5 years later they say I have autonomic insuffiency, and I am on anti-depressants.  Doing better, but only at about 70% of what I was and I can't patrol anymore.  I too have a full feeling all the time and believe I have incomplete digestion...  Help me out
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A related discussion, Hiatial Hernia was started.
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