Unexplained worsening gastroparesis and heart rate fluctuations
I am 38 years old and have been suffering from digestive problems since my 3rd pregnancy six years ago. Initially, I was diagnosed with GERD and an esophageal stricture (which was dilated during an endoscopy). I was also diagnosed with a slight hiatal hernia. I have been on some type of GERD med continuously for about five years and seemed to be stabilized on the meds up until about the last four months. For the last four months, it initially appeared that my GERD was worsening again. I switched to a stronger med and began supplementing more with Tums. None of this has stopped my symptoms from worsening. My predominant symptom is an immediate feeling of overfullness and nausea when I eat anything. This then often triggers dizzyness, pain in my chest and back, tightening in my esophagus. My doctor recently diagnosed this as gastroparesis but could not explain why it is happening. I am not a diabetic and do not have any other of the common causes, except for prior stomach surgery for pyloric stenosis 38 years ago as an infant.
I have simultaneously had an increase in episodes that were only very sporadic before where my pulse rate and heart rate suddenly quicken or suddenly slow down, in both cases resulting in feelings of dizzyness, chills, sweating and faintness. These symptoms were often caused by any pressure to my stomach area liking bending down quickly at the waist, etc. and did not happen often. If I lied down immediately, my heart rate would return to normal without any further treatment. Now it seems these episodes are triggered by very little. In fact I recently experienced this while lying flat with no pressure on my stomach.
My doctor previously associated the fluctuations in heart and pulse rate with pressure from the hiatal hernia. Now that I have presented with the gastroparesis, he believes that fluctuations in blood sugar may also be contributing to the near fainting episodes and fluctuations in heart and pulse rate. Blood work has not revealed any particularly high or low blood sugars but this would not tell me whether they are fluctuating throughout the day.
I noticed duing some research into these problems that the vagus nerve regulates both heart rate and also gastric functions. What is the likelihood that there is something wrong with this nerve and that it is responsible for both of these problems?
I am also wondering if another possible cause for the stomach problems is low stomach acid. Many of my digestive symptoms match this also but doctors don't seem eager to discuss this as a possibility despite the fact that my antacid medications seem to now have little or no effect and in some cases have made me feel worse.
I feel that diagnosing the proper cause to these conditions is essential because they are very disruptive to my life (I am missing work, can barely eat anything, am having trouble driving and am becoming afraid to go anywhere on my own because of the unexpected and unexplained near fainting episodes) and current medications seem to be only treating the symptoms. My doctor wants me to take reglan, but I am worried about long-term effects of the drug. Heart problems and stomach and intestinal obstructions have been recently ruled out. Another recent endoscopy found no easily observable problems either. Blood work has been good.
My only other previous diagnosis is thyroid nodules which are monitored annually by ultrasounds. I had fine needle aspiration biopsy about a year and a half ago and there was no cancer. I have never been diagnosed with any other thyroid related conditions.
I would appreciate any advice or help you could give me in figuring the cause of my problems or directing me to the proper specialists. Thanks.
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