VAGUS NERVE and STOMACH or HEART LURCHES (spasms)

[petestrand]

I'm a sixtish male with a history of mitral prolapse/systolic functional murmur, PVCs and PACs. I take very low dose Atenolol. I was told that I have mild acid reflux, but decided to restrict diet rather than take a prescription for that.

I often get what I call "lurches" that seem to be centered in the area of my diaphraghm. These lurches (spasms?) seem to correspond to the old phrase "my heart leaped into my throat." When they were first noticed about 25-30 years ago they were closely correlated with eating spicy food, but were quite infrequent.  Over the years they have varied in frequency of occurence, from a good many days with none, to several a day, to several an hour, to one every few minutes. (Generally, more often as I aged.) About 18 years ago I had them more or less continuously for about 4 hours. A Holter monitor test about that time indicated PVCs and PACs, but no treatment other than the minimum dose Atenolol, and I have never had activity/exercise restrictions.

I have long been convinced that most, if not almost all, of the lurches are STOMACH SPASMS. Doctors have seemed very sceptical of that, insisting they were irregular heart beats. This week I had left arm pain that occurred while having fairly frequent lurches. In the emergency room, bloodwork and EKGs were normal. The doctor (an internist) indicated that the left arm pain might have come from a nerve problem in my neck, and when discussing my "stomach spasms as cause" theory said that the vagus nerve could possibly transfer stomach spasms to the heart.

What is the possibility that my theory is at least somewhat accurate? I would worry a lot less about stomach lurches than if the lurches were from a heart problem!! I have asked several doctors if I could try having my heart monitored aftr eating known "too spicy" foods such as mustard or hot sauce, but got no agreement.

Could the stomach/vagus nerve be a significant source of the lurches? If so, could the lurches  be mistaken for irregular heartbeats? Or, would they almost always/always trigger irregular heartbeats? If the irregular beats are triggered by stomach/vagus, does that mean less cause for anxiety than if they  originate solely in the heart itself? I'd greatly appreciate any information/suggestions/referrals to other info sources, etc. Thanks.  Pete

[Kevin Pho, MD]

If there is continuing concern that the spasms are coming from the upper digestive tract (i.e. stomach and esophagus), there is testing for that.  

You can consider a 24-hr pH probe with esophageal manometry.  This can evaluate the upper digestive tract, and when any such spasms hit, it will be recorded.  The pH part of the probe will evaluate for GERD.  

This test can be arranged by a GI specialist and can be discussed with him/her.  

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.
http://www.straightfromthedoc.com

[belita857]

A related discussion, Vagus nerve was started.

[kvogel5]

I absolutely love this forum.  I too have the bloating, gas, heartburn, PVC's.  I've been prescribed Nexium, Omeprazole, Prevacid, etc.  They haven't really helped.  I feel like I just need something to keep the digestion and bowels moving normally.  All the Dr.'s I have talked to about this look at me like I'm crazy.  They all eventually suggest that I have an anxiety problem and should look into medication for it.  I KNOW it is a digestive problem.  

When I'm having an "episode", usually soon after I eat, I feel very lightheaded and I have the constant need to belch.  I also have an occasional palpitation, accompanied by the feeling that I can't catch my breath - but it all seems to get better if I can make myself belch.  The breathless feeling and the palpitations used to seriously freak me out - to the point where I would panic and call 911 - because it feels like you are having a heart attack!  Now that I know it's not a heart issue, I remain calm and just try to belch, usually by bouncing around and trying to push the air out.  Antacids help as well - although I don't want to get in the habit of taking something that is neutralizing the stomach acid that I desperately need to aid digestion!  

I just scheduled my first appointment with a gastroenterologist (have never seen one before), but after all these posts I've been reading, it sounds like that may be a waste of time and money!  I've been printing out a lot of these posts and want to show them to the Dr., so they know this is going on and that I'm not crazy!  

I'm so glad to know that there are others with this problem that I can talk to!  Why do NO doctors recognize a link between the digestion issues and the breathless/irregular heartbeat/lightheaded thing?  I am going to look into the vagus nerve theory - very interesting.  Thank you everyone for all the advice and for sharing your experiences!

[Queen Spasm]

I thought I was all better after my last post.  My esophageal spasms were down to one a week and I had no reflux!  But then, the pain in my stomach started.  A stabbing kind of pain, right underneath the breastbone and radiating under both rib cages.  My gastro doc says it's the reflux -- that I'm just feeling different symptoms now.  My endoscopy showed no esophageal erosion, which was good, but it also didn't give me any answers.  I'm back on Prilosec now and I don't really feel like it's doing anything.  I'm supposed to see my doc next month to tell him how the Prilosec is working.  When I see him, I'll ask him about the Vagus Nerve thing.  

For those of you who have experience heart palpitations and panic attacks with this GERD nonsense, I have too. My arm goes numb...the whole nine yards.  All I want to do is feel good again.  Someone told me to try apple cider vinegar (a tablespoon after each meal).  It's supposed to cure acid reflux.  We'll see...I'll try just about anything!  (And, I'll keep you all posted as to my success or failure with it.)

[wowmetoo]

Wow, I accidentally came across this cause of a paramedic friends story about the Vegal nerve. So I googled it and this post came up.

I've had the same exact symptoms many of you have detailed.  Heart racing, skipping, stomach pumping, leaping, arm tingles pain, sweating, etc.  I went through the battery of blood tests and heart tests too with noting found. I had some panic attacks several years ago so I assumed these symptoms were all part of anxiety problems and never paid much attention to it.  The reason I was able to disregard these symptoms was something actually works for me to stop them.

Years ago my Uncle suffered irregular heart beats and he told me his doctor said to "bear down" like he was taking a large bowel movement to steady his heart, apparently due to the Vegal nerve stimulation.  This works for me too.  (At the least the heart symptoms stop.)  

In my case it is a diet/stress thing.  There are certain spicy foods that I'll pay for eating, especially if I'm physically active or stressed out.  Also, I have a mild case of gluten intolerance or celiac disorder.  I went gluten free for several months as a test and it really made a huge difference for all symptoms.  However, I enjoy bread, deserts etc.(all contain glutens) and spicy foods so I'm back on them in limited doses and have these symptoms return from time to time.

I'm not suggesting it is a cure and make sure you get all the tests but if there is nothing else wrong, here's what works for me. When I get the onset I "bear down" on the Vegal nerve, sometimes take an antacid then go do something that occupies both my mind and my body!  It seems getting busy as well as bearing down makes the symptoms stop farily quickly.

Hope this helps someone!

Best Wishes Friends!

Thanks for reading,
Rob

[spearoelo]

I have come across this site after looking for help on the web. I have been having extra heart beats for several years. They actually feel like missed heat beats. Recently they have become worse and after one really bad session,when I thought my heart wouldn't start beating again, I saw my consultant and wore a monitor for a week. Needless to say although they did pick up some there were no really bad ones. However for the past few days they have started again and have changed slightly. As well as the missed beats my heart seems to thud and flutter and beats in my throat. Today it it was bad for about 20 mins and although it is doing it now less frequently I feel very uncomfortable. I have read on this site that some people think it is related to reflux and the vagus nerve. Now I have been on Prevacid for 6 years as I do suffer from GERD and have a hiatus hernia and have often thought there was a connection between irregular heart beat and eating, as mine sometimes came on after a heavy meal but am worried that this is not the case with me as my reflux is being treated. Does anyone here being treated for reflux still have the irregular heart beats. I would add that I watch my diet and dont have anything with caffeine in. I am sorry to go on for so long but am sitting here terrified as the feeling of my heart beating irregularly in my throat is so unpleasant. I am a 56 year old female.
Also I have a blood pressure machine and when I am having these episodes I use it as it shows the beating of the heart and I can actually see that it is missing beats. My one worry on this though is that all the family use it and it always works properly, but when I use it when I am having the symptoms it keeps showing errors and won't take a reading. Does anyone know why this is? Thank you.

[Foreverosier]

I have had all the same problems/symptoms as all of you and the same meds nothing has worked. SIX years now and counting! I even have suffered stroke/neurological symptoms from it. But one thing I know that it IS the Vagus Nerve that is causing all of this. My Cousin is a Nurse Practitioner and trys to help me learn. Now the great problem into solveing this is, why do Gastro docs know this and choose to ignore it, ignore us? Vagus Nerve controls alot of things, read up on this please. Vagus nerve causes stomach/intestinal spasums  which in turn throws that fun acid up into the throat and Wah-Lah, GERD! Vegus Nerve controls the heart, epilepsy, it causes malfunctions in the brain and can tell the brain to release adrenalin into your system mimicing STRESS (heart lurches), to name a few......Now what causes the Vagus Nerve to malfunction and cause such pain? It's a "HECKIFIKNOW" thing. I know... one of us needs to go to Med school then come back and cure us all. I have litterly been to over 200 doctors and not one can help. WHY- WHY-WHY-!?! Well as soon as one of you find a doctor that has 100% understanding of our plight, please post it so we all can go and get help. I know there is a new treatment for Epileptics called the "Vagus Nerve Stimulator" which helps to control siezures in epileptics. It is a little box like a pacemaker that turns on and off the Vagus nerve. I wonder if it would help us???? Again any one know a good Doc?   I do agree with the person who said to see a Chiropractor. It does help.  TA-TA!            Val in Cal.

[Elizabeth 4]

After 2 years of utter frustration, I was heartened by the posts I just found from Pete, Wally and Bluebottle.  Those symptom descriptions are the closest I've found to my experience, and I'm desperate for answers.  I have a history of GI problems and was thrown into the IBS "bucket" many years ago, though it never seemed to be a very good match for my symptoms.  My first "lurches", or jolts as I call them, were probably 8 or 9 years ago, but they seemed to be rare and isolated events.  Two years ago I had an acute onset of diarrhea, jolts, tachycardia, dizziness, GI pain, and weakness.  The acute phase lasted 8 weeks, during which I lost 25 pounds (20% of my body weight).  I've had many tests (colonoscopy, endoscopy, 24hr urine for catecholamines, EKG, holter monitor, CT scans, screens for thyroid, glucose, blah blah blah).  While stress certainly doesn't help, I don't believe it

[astros18]

Well, I don't think I sound like a conspiracy theorists, but obviously we look at things differently. I don't think anyone can deny that the state of our health in this country and the Western world in general has declined dramatically since the advent of processed and refined foods along with the thousands of prescription drugs that have so many side effects(that are listed on the label) and do damage to the liver. Since immunizations became required, there are thousands of children with autism and other learning disabilities. And the list goes on and on. I know on a personal level about pain and gastrointestinal issues. I was bedridden with them. I tried every prescription drug under the sun trying to get better. I never did until I had a car accident and went to a chiropractor who explained to me how the body works. It was for me a "light bulb" moment. I began to research everything I could get my hands on concerning natural means of healing and lo and behold, it worked. Whether you personally believe in it is of no consequence to me, but if I can touch one persons life and change it for the better, then that's what I will continue to do. If you think the pharmaceutical companies want to cure your disease, then the jokes on you. They have NO interest in curing anything. If they did, then it would have been done by now. We spend too much time studying the sick instead of looking at people who aren't sick and seeing what they do and eat and how they live. Prescription drugs for the most part do mask symptoms. That's why at the end of the commercial for the purple pill, it states that a serious stomach condition may still exist. Doesn't sound too good to me.

[astros18]

Acid reflux is not a disease. It is called one so that the pharmaceutical companies can make money off of people who want a quick fix for their health problems. Long term use of your PPi's can cause more problems than it supposedly fixes. I don't dismiss all allopathic medicine, but I have a huge problem with Gerd all of a sudden being a disease. The key is to find out what is causing the reflux and go from there, not masking symptoms.

[ckg]

hey wally,

nexium, from my practice, is a far better agent than both AcipHex or Prevacid -- as it is a derivitive of Prilosec.  From the studies that i've read -- it's a cleaner, longer acting version of Prilosec -- so more patients receive symptom relief faster and better with Nexium than with all others.

if you'd like more comparitive data, i'd check out the american college of gastroenterology website for all of the data on the different medications.  they should have a journal search or something of the sort.  I know that Dr. Donald Castell & Dr. Philip Miner have published a lot of studies on the different PPI therapies, I'd check them out if you'd like more info too.

Nexium is the agent that I prescribe most often -- when -- the awful insurance companies will pay for it.

[Wally1470]

I posted similar symptoms a couple of weeks ago.  I can actually see the beating in my stomach area.  I had an ekg while in symptoms and it showed an extra beat but blood pressure was good etc..  Are your symptoms relieved or made worse by lying down?  Mine are relieved by getting into a prone position or by exercise such as walking.  I NEVER get symptoms while exercising (Over 60 minutes of cardio) and actually feel excellent for hours/days after.  I was given Prevacid which eventually made my stomach feel "lousy" and then Acifex which did the same.  Did you ever try sipping water, it helps me since sometimes my mouth gets dry during symptoms?  I will look into your supposition...it is interesting since sometimes I will get symptoms by sitting with my left arm on an arm rest above my shoulder or my crouching over a computer with tightness in my upper stomach muscles.  Good luck, I will let you know my research.

[ckg]

Have you tried to take reflux medication to see if the "lurches" subside?

I've often seen patients who are unable to control their acid reflux with diet alone.  Usually starting them on a PPI therapy would subdue any/all symptoms they've seen.

PPI therapy is the most efficacious therapy out right now - because it turns off the activated proton-pumps in the stomach that produce the acid - as well as work on all 3 of the enzymes released during acid production (medication such as Zantac or Pepcid only work on 1).

hope this helps ...

-ckg

[ckg]

Hey Wally,

Have you ever tried Nexium?

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[r2studios]

Hi guys. I have been experiencing similar symtoms such as missed beats for many years and saw 2 cardiologists in that time. The symtoms were so distressing that it affected my physicoligical well being until I became to scared to leave my house (aggoraphobic). Last feb I had a take out and within 5 hours woke up to find my heart was fluttering continually and thought I was going to die. My wife called an ambulance and when I got there I was quickly diagnosed with 'atrial fibrilation'! At that time I told the doctors there that this is what I had been experiencing in the past but only for a few seconds at a time and not the 7 hours this attack turned out to last. I was sent home within a day with no diagnosis as there was no physical problems with my heart and a mystery. Firstly I believe that prior to this I was having vagal problems. I visited a dietician and when I mentioned the attack the first thing he asked was 'did you eat take out that day?' I said I had pizza hut in the afternoon and chineese in the eve as it was my wifes birthday. He told me to find the ingredients of both meals as he suspected I had eaten a large amount of MSG or monosodium glutamate. So I checked and sure enough both had E621 which is MSG! He put me on a strict diet of low glutamate (no cheese no poultry or beef and NO MSG) sure enough a year has gone by and no major attack yet. I still get the short flutters like before but some times not for days. I tend to get them if I eat chicken and tomatoes which was what I used to eat a lot of. I am also on a very low dose of tambocor but only half a tab a day when usual is 2 or 3. I hope you guys may find this usefull as I am not the first to be hit by the MSG bullet!

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[Mozartcowgirl]

i would love more information.. please!! contact me through my myspace.. which you can find me.. under the same name.. Mozartcowgirl. THANKYOU SO MUCH