You have had a pretty thorough evaluation already, including a
catheterizationBladder catheterization, female
Bladder catheterization, male
Cardiac catheterization
Left heart catheterization
Left heart ventricular angiography
Urine culture - catheterized specimen 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
When i described the problem to my gastro doctor,he said he has never heard of such a problem.
" 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, “illness begins with the Vagus Nerve.” The Hiatal Hernia Syndrome (HHS) by pinching the Vagus Nerve causes Vagus Nerve Imbalance (VNI). This imbalance is usually a hyperexcitability, but a decreased energy state is also possible at some point in time. In a Hiatus Hernia, or Hiatal Hernia, the upper portion of the stomach protrudes through the opening (hiatus) in the diaphragm muscle. I urge the reader to go beyond any preconceived notions that this condition only causes GERD (acid reflux) and minor discomfort, and to read this article in its entirety before judging this work. My own recent research will be described for the first time, after reviewing one pioneering clinician's findings.
This article will reveal how this condition, Vagus Nerve Imbalance/Hiatal Hernia Syndrome, which I will abbreviate as VNI/HHS, can cause so many other maladies and symptoms, and how it can cause many other organs to malfunction. Then I will describe testing to uncover the VNI/HHS, and finally how to treat this insidious malady with various modalities. These methods include manipulations to rapidly correct (bring down) the stomach, as well as nutrition, diet and lifestyle changes. Health practitioners and/or patients can learn the crucial manipulations.
The physician, Theodore Baroody, D.C. after treating thousands of patients for many “other illnesses” calls the Hiatal Hernia Syndrome, “the Mother of All Illness.” 1 He states that nearly “every [non-infectious] condition (except trauma) is the direct result of some digestive dysfunction.” 2 He writes that the Hiatal Hernia Syndrome is “dangerous and brings about constant imbalances that lead to all maladies known to mankind.” 3 He has found that over 85% of all of his patients when tested have a Hiatal Hernia! He further postulates that about “85% of the overall populace” has the HHS! My own clientele, mostly sufferers of severe fatigue/fibromyalgia and extreme food, chemical, and electromagnetic sensitivities have the Hiatal Hernia Syndrome over 90% of the time. It's no coincidence. Baroody's findings are described in his brilliant opus, Hiatal Hernia Syndrome: Insidious Link to Major Illness. Simply put, if one considers finding the initiating cause of chronic, degenerative illness a key factor in medicine, this is one of the great works in the medical literature. I cannot blame the reader for any initial disbelief, as both Baroody and myself are often “mind boggled” to see again and again how seemingly unrelated illnesses or symptoms are often immediately relieved when “the stomach is brought down.” The difficulty in seeing all this clearly often arises because many factors can prevent the stomach from “staying down.” But Baroody's, and my own, improved techniques can help make this change last, and thus the improvement in these many, seemingly, unrelated conditions will be clear. Also, I might not have believed this myself if I hadn't, (unfortunately), lived through it; and, as a physicist, insisted on uncovering the most primary causes of my own problems.
As stated above, Hiatal Hernia refers to the stomach's protrusion through the opening, (hiatus), in the diaphragm muscle. Wellness can ultimately only return when the diaphragm's hole, (hiatus), has been repaired and the stomach can no longer jump up. This can take months of continuously doing everything just right. The key to an enlightened understanding of the VNI/HHS is that the amount of stomach protrusion is often irrelevant. In many people, serious illness begins unfolding even if the amount of protrusion, (the Hiatal Hernia), is “small,” as found, for example by X-ray. In many sufferers, any such protrusion causes major hyperexcitability of the Vagus Nerve! The extensive Vagus Nerve is so diverse and so interconnected to so many organs that it has been nicknamed the “wanderer.” The slightest upward displacement of the stomach through the diaphragm disorders the Vagus Nerve. Immediately the stomach no longer is able to produce the proper amount of hydrochloric acid. The entire digestive process is then adversely affected. The final result is often that the entire body will become too acid.
From an imbalanced Vagus Nerve, any other organ can begin to malfunction depending on genetic weakness and various other factors. Of course, the diaphragm itself will directly be affected and breathing normally no longer occurs. Other openings in the diaphragm itself now stretched or torn allow the major blood vessels to and from the heart to pass through it. Thus spasms in the abdominal aorta and inferior vena cava can occur. Indeed, Baroody found kinesiological (muscle) tests for two separate “stuck diaphragm” conditions related to abdominal aorta and inferior vena cava imbalances4. The heart itself can be crowded, and pressed on, by the stomach being “where it doesn't belong.” These last factors and the direct hyperexcitability of the Vagus Nerve's connection to the heart, leads to many Emergency Room visits and “pseudo-heart attack” symptoms of chest pain, difficulty breathing and left arm numbness. The reader, if experiencing these complaints, should seek emergency medical care, and not assume they are arising from the HHS. There is a remarkable similarity between Hiatal Hernia Syndrome and angina. Both can cause similar symptoms and both can occur after similar events such as overeating, exercise, and heavy lifting. My own hypothesis is that the Hiatal Hernia Syndrome, if uncorrected, may sometimes eventually become true angina.
Pregnant women, for the obvious reasons, need frequent Hiatal Hernia corrections. This can provide remarkable relief for many complaints. The Hiatal Hernia can readily result from the trauma of birth. This will be undetected unless a good kinesiologist is around to perform surrogate muscle-testing on the infant. Now the end of this article will reveal that there is a possible link between Hiatal Hernia Syndrome and life expectancy. I would propose a long-term study, from birth, to learn statistically what illnesses correlate with Hiatal Hernia as well as the Hiatal Hernia's possible use as a predictor of life expectancy.
The better Chiropractic physicians and kinesiologists will pull the stomach gently down on newborns possibly preventing a lifetime of illness! I can also imagine that the Hiatal Hernia Syndrome could arise before birth from weeks or months of being somewhat “scrunched” in the uterus. Physical trauma to the abdomen, at any time, can also cause a Hiatal Hernia. Even emotional stress is said to be able to cause or exacerbate this condition. There is a strong genetic component as many family members have the Hiatal Hernia Syndrome and often intestinal hernias and, in males, other hernias such as varicocele (or testicular hernia.) There is a strong allergy connection to VNI/HHS. There is a vicious cycle between allergies and the HHS, each one is capable of causing or exacerbating the other. In fact, I would like to note a possible, remarkable connection of a VNI/HHS symptom and a well-known allergy test! This is the Coca Pulse test, which denotes an increase in pulse rate some time after eating a food (allergen). But one of the most common VNI/HHS symptoms is an increase in pulse rate! So I hypothesize that most, (if not all), the food allergy sufferers, and their practitioners, who have used the Coca Pulse test for allergy detection (for decades now), were also dealing (unbeknownst) with Hiatal Hernias!
To get well, one often has to learn to give up one's favorite foods as these are usually allergy/addictions. Once a Hiatal Hernia exists, it may worsen with every passing day, with every stress, and with every meal eaten (especially if it's an allergic meal). Eventually this can result in very serious disease, unless uncovered and corrected and unless the appropriate diet and lifestyle changes are made.
The Hiatal Hernia Syndrome is the earliest cause of GERD (Gastroesophageal Reflux Disease) virtually 100% of the time, though the orthodox literature often only denotes “an occasional link.” But I believe, many people have Hiatal Hernia for some time before GERD develops. Even traditional physicians now make the following very helpful recommendations for GERD/HHS. Lose weight, chew food well, don't eat spicy foods, eat small meals, avoid alcohol, tobacco, (and I would add possibly other nightshades: tomato, potato), avoid fried or greasy foods and mints, elevate the top of the bed by 6-8 inches, avoid tight clothing at the waist, and don't eat less than 3 hours before going to sleep. Some sources recommend sleeping on the back or left side only. Avoid right side sleeping. Baroody notes that lifting, bending, sneezing, coughing, stress, and many other factors can immediately push the stomach up through the diaphragm. Other foods that can be problematic for this syndrome include dairy, wheat, vinegar, citrus and other fruits. Avoid food or drink that is too hot or too cold.
Diet constraints cannot be overemphasized. Eating only small meals is key. Getting complete food allergy testing, (via Kinesiology is recommended here), and possibly rotating foods to avoid new food allergies can be crucial. Avoiding greasy and spicy foods is also essential. I have found that roughage may have disastrous consequences for the Hiatal Hernia Syndrome sufferer. The cellulose fiber may immediately push the stomach back up, or worsen the condition itself! Likewise for nuts and seeds. So only soft foods, cooked foods or juices should be allowed at first. Indeed I have made the following hypothesis. A pure juice diet may have healing potential at least, in part, because the liquid diet will allow the VNI/HHS to heal! Likewise I have surmised that taking supplements may cause or exacerbate the Hiatal Hernia Syndrome. The hard tablets and capsules, (until they dissolve), may also push the stomach right back up through the diaphragm. I have had clients say, “all supplements make me sick.” Muscle testing on clients often reveals most clients are allergic to most of the supplements they take everyday; but never “all.” So perhaps the client is just reporting how the supplements push the stomach back up resulting in the myriad of symptoms of the VNI/HHS. Some people take dozens of supplements because they aren't well and don't know the cause often at the same time! (Up she goes.) Pulling capsules apart, and putting the contents in a liquid, may be absolutely necessary, or else avoid supplements until healing has occurred. Previously, as a general wellness modality, I recommended lengthy fasting. In theory, this might help heal this condition. (I have done several two-week, water fasts.) However, the work by E. Denis Wilson, M.D. on thyroid malfunction, (Wilson's Syndrome), indicates that fasting can disorder the thyroid system, as he calls it. Since his work shows that this may not show up on any blood tests because 80% of T4 to T3 conversion occurs inside cells and the thyroid and adrenals are already stressed from the VNI/HHS, I cannot recommend any lengthy fasting.
Avoiding caffeine and any other neurotoxins and/or excitotoxins such as MSG, (monosodium glutamate), or aspartame is also crucial. Perhaps the most nerve-damaging substance is mercury. Perhaps too the vagus nerve, due to its high metabolic rate, preferentially absorbs mercury, or other toxins, more than other nerve tissue? And this combination of VNI/HHS and mercury can be devastating. The Vagus Nerve, like the hernia itself, probably needs time to heal and for everything to be done right for a span of several months. Soda with the extra gas it contains should be avoided. Trapped gas makes this syndrome much worse. Indeed the sufferer may have episodes of feeling as if dying only to be relieved by belching or perhaps the gas passes down the other way unnoticeably. Likewise when the practitioner pulls the stomach down, much gurgling is often audible. One hundred years ago, medical schools taught Roemheld's, (or Gastro-Cardiac), Syndrome which described significant cardiac complaints arising from stomach problems. Unfortunately, this now seems to have disappeared from all but the homeopathic, medical literature.
The gastroenterolgist will do an endoscopic exam. The patient is put to sleep and a tube is inserted down the esophagus. Some gastroenterologists use a numbing, throat spray at the outset. Others have found this is often allergenic and unnecessary. The video camera that the endoscopic tube contains reveals the status of esophageal, gastric and duodenal tissues. Ulcerations, inflammations, and growths are looked for. The tube/device is also used to take biopsies. These tissues are then tested for cancer or pre-cancerous conditions and to look for bacteria, especially the ulcer-causing Helicobactor pylori. This examination also looks for the potentially, dangerous pre-cancerous, esophageal condition called Barrett's Esophagus, which can occur after long-term GERD.
It may not be possible to overcome the VNI/HHS unless the sufferer becomes thin. This can be difficult. Many forms of exercise will exacerbate the hernia. Finding some exercise regimen that doesn't worsen the hernia is crucial, as is taking it slow and steady. Getting thin alone may not bring the stomach down without manipulation; but losing weight may be necessary for it to stay down assuming everything else needed is being done. It may be very problematic to become thin as one complaint for the VNI/HHS is that eating when the stomach is up may immediately cause the sufferer to get hungrier (and not satiated) as s/he eats! Over-eating, (one of the worst things for this condition), often results. Hypoglycemia may be caused by this condition, Baroody asserts. But sometimes glucose testing, when these assumed hunger pains arise, reveals that no true low blood sugar exists.
I suspect many cases of “hypoglycemia” may either really be the VNI/HHS, and not hypoglycemia, or at least that the VNI/HHS is one of the exacerbating factors of hypoglycemia, (as well as are allergies, parasitosis, etc.) I was astounded once myself recently when I was feeling “out of it.” My glucose meter revealed a blood sugar of 60, which is low, and low for me. I had one of my students test me for Hiatal Hernia. My stomach was up, and I showed him how to pull it down. I felt that “assumed low blood sugar feeling” immediately go away. I was astounded to see the glucose meter then read 90! The VNI/HHS is also one of the great, hidden causes of obesity. However, when the Vagus Nerve is perhaps even more imbalanced, a loss of appetite may result. The sufferer is then in an even more dangerous condition, perhaps with significant, adrenal failure at that point.
Any practitioner who works with phobias, panic attacks, or anxiety needs to learn how to test and correct the VNI/HHS if s/he truly wants to help her/his patients. Or the sufferer must become his/her own expert. While I am fond of the “energy psychology” field and have made contributions to it, I state that various conditions cause these corrections to be far from “permanent” unless these underlying conditions are addressed. Perhaps chief among these conditions is VNI/HHS. Other “anti-permanent” factors include mercury and other toxins, and parasitosis and subsequent allergies. The acupuncture point tapping performed by energy psychologists will often be short-lived (often despite incorrect muscle-testing results), unless, and until, these other problems are corrected.
experience
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.
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.
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.
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.
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.
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
Please don't misinterpret me ,
I do beleive your problems are real and not in your imagination. . . I am not a beleiver in the "If tests are all negative, blame it on stress concept." I am merely suggesting that things are being exacerbated by stress---NOT caused by them, huge difference.
Stress does cause blood pressure and pulse to rise as well by the way. Also, a certain number of skipped beats are indeed normal in everyone. And stress does heighten pain perception . Your stomach pain, which is indeed real-- will be magnified if you panic when it occurs. You say this is greatly affecting quality of life , and it will to the degree that you let it.
You've had a pretty comphrehensive set of tests , and there are still additional ones to have-- which you should have. ( halter moniter , ph test for GERD etc ) Don't give up on finding the root problem . Not all problems are easy to diagnose, mistakes are made. No test is foolproof either.
Regarding your last comments. Beleive me, your symptoms are by no means rare , many people have the same. The tests you had are the proper ones for your history. Doctors do not give a lot of creedance to testimonials -- they primarily look at data. , not how you feel about your body . And doctors do beleive in illnesses that don't show up on tests. . There are numerous ones listed in both the Rome and Can dys criteria. Good luck to you
Best of luck,
Sally
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
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?
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
--------------------------------------------------------------------------------
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.
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.
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.
5 odd years of a darting pain that feels like it’s my heart,
comes and goes with month lapses in between episodes.
Here I am after discovering a strange feeling like being off balance when I’m sitting at my desk, I notice that my normally slow pulse 50-60 beats is doing a double beat every 2nd or 3rd beat.
EKG confirms the irregular beats.
I do high-end stress test; heart is great, CT scan all is normal.
I notice that if I sit, my pulse is wacky, when I stand
the beat is normal.
Cholesterol is high so I’m using Lipitor, and 1 month later
levels are normal.
Still abnormal beats so,
now I’m panic mode, and my stomach feels nervous, I’m having problems breathing, so I do
the lower GI and I have a hiatal hernia and reflux.
(Prior to this 10 tums at a time was the norm.)
OK so now I’m on Prevacid.
Still feel like ****, slowing down on the panic somewhat
but irregular heart beats still going on, if I sit for too long.
So now Im definitely seeing a connection between my gut and my heart.
I’m starting to loose weight, sleeping on the sofa seems to force me to lie on my left and back.
I’m supplementing frantically with Omega, wheatgrass, B, E all the **** in the world until I read this thread.
So the way I see it is that getting the stomach to lie in its normal position, should take care of most of these symptoms.
So how do we get the stomach in sync?
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.
aspirin is one of them,hormone replacement medication is another.