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Roemheld Syndrome


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  • 8 years later...

Reviving this very old post as this is something I wonder about. I have a lot of minor GI issues and often they affect my POTS and heartbeat.  

Dr Sanjay Gupta talks about it in one of his videos under the name gastro-cardiac syndrome. 

How important has stabilising your go symptoms been on improving things like adrenaline rushes, tachycardia spells and general POTS? 

I found this helpful

https://www.fixyourgut.com/roemheld-syndrome-stomach-heart-issues-relief/

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@Chuske - dysautonomia affects the GI tract as well as many other body systems, not only cardio-vascular. In my case in the beginning of my illness, when I was completely unstable, I had severe GI problems. I had GERD, gastroparesis, IBSD ( Irritable bowel syndrome with diarrhea ) and ended up with precancerous esophagitis ( Barrett's ) and duodenitis. This was due to the high norepinephrine levels causing these GI problems, as soon as we found the right med combination for me everything improved, GI and CV symptoms.  

The GI tract is controlled by the ANS and when we eat the parasympathetic branch kicks in to aide in digestion. By doing so it diverts the circulation of blood to the organs required for digestion and away from other body parts. ( That is why often we get lazy and sleepy after a big meal ). --- When we go into the Fight-or-Flight response the opposite occurs, and the ANS directs blood flow towards the vital organs: heart, lungs and brain. This will draw the blood away from the digestive tract. 

Normally these reactions occur in balance, meaning that they happen at the appropriate times and are activated by the appropriate triggers. In dysautonomia however they happen in chaos, not in response to the appropriate triggers but often in attempt to compensate for the dysfunction. This will cause both heart and GI symptoms and it can put our bodies under extreme stress, therefore causing the ANS to kick in stronger. I my case this caused high HR, palpitations, BP fluctuations, excessive vasoconstriction, high stomach acid and increased peristalsis ( bowel contractions ), acid production in response to some triggers and low BP and gastroparesis at other times. 

The article you provided explains this in reverse: the GI symptoms can cause cardio-vascular problems. This is also true - but in dysautonomia BOTH are caused by the dysfunctional ANS. 

 

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@Pistol I totally agree that ANS is the root cause of both, I guess my point is bloated stomach or hiatal hernia etc or whatever GI prob if it causes pressure on the vagus nerve or the heart then that can also cause heart etc symptoms directly?  

Last night I was woken with a racing heart at midnight.  But even though my stomach was fine before I slept it seemed bloaty and a bit refluxy when I woke.

I hoping soon to have 7 day holter to look at these night-time tachy spells as they could be POTS directly, heart directly (svts), stress or my stomach or a sleep issue. Luckily if I go private can do that by post with Dr Sanjay Gupta.

I think when I'm stronger I need to push my GP to send me for GI workup.  At the mo that isn't practical when can't get downstairs.

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34 minutes ago, Chuske said:

Last night I was woken with a racing heart at midnight.  But even though my stomach was fine before I slept it seemed bloaty and a bit refluxy when I woke.

@Chuske - this used to happen to me all the time when I was unstable. For me it was b/c in my case the adrenaline would not drop during sleep, as it does in healthy people, and the digestive system never "slept" due to the high adrenaline. Bloating and Reflux were very uncomfortable during the night - and the day as well!!!

 

37 minutes ago, Chuske said:

I think when I'm stronger I need to push my GP to send me for GI workup.

Yes - I totally agree. In my case the EGD revealed a lot of problems due to the acid and gastroparesis and I needed about a year of heavy GI meds ( I took about 6 different meds at that time for GI issues ) and a complete change of both diet and eating habits. Generally low acid foods. higher protein, lower carbs and 6 snacks rather than 3 meals helped me a lot. 

Other tests they did were a barium swallowing study to determine if there were any anatomical reasons for the reflux and a gastric emptying study - to see if the food leaves your stomach normally or dumps too fast or stays too long. They also took biopsies during the EGD to test for H. Pylori and Gluten sensitivity. Food allergies or sensitivities can also play a major role in digestive troubles. 

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@WickedMindz - yes, I have NCS as well as HPOTS. Eating a heavy meal ( think Thanksgiving or Christmas ) will divert the blood to the GI tract to aide in digestion, and away from the brain. This causes feeling tired and lazy in normal people but it can easily cause us to develop worsened symptoms, even fainting ( which I used to do generously ). That is why smaller but more frequent meals are recommended. eating more protein and less carbs has helped me with that as well. 

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  • 3 weeks later...
On 5/28/2020 at 8:06 PM, Pistol said:

@WickedMindz - yes, I have NCS as well as HPOTS. Eating a heavy meal ( think Thanksgiving or Christmas ) will divert the blood to the GI tract to aide in digestion, and away from the brain. This causes feeling tired and lazy in normal people but it can easily cause us to develop worsened symptoms, even fainting ( which I used to do generously ). That is why smaller but more frequent meals are recommended. eating more protein and less carbs has helped me with that as well. 

Thanks for the information Pistol you’re always so helpful on here. 

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