Roemheld Syndrome

Don't know if anyone has experienced this with their GERD but Just thought I would share this with you, as I was convinced I had severe heart disease only to find out after much testing that I have Roemheld Syndrome. I am 62 yearsw old and this started when I was in my twenties - I would get heart palpitations or arrythmia (feeling like your heart is skipping a beat), especially after eating a big meal.  I would take an antacid for awhile and eventually the indigestion would subside and so would the arrythmia.  It also felt like everything I was eating was just "sitting" at the  top of my abdomen right under my diaghphram and until I belched about a 100 times, the irregular heartbeat would continue.  I haven't noticed the arrythmia now in about four years and about a month ago it returned with a vengeance ESPECIALLY after eating.  Being older now I was really afraid this was the real thing and I had slipped into actually heart disease (I'm a smoker).  But I still noticed that it was the worst after eating.  When I awoke in the morning the arrythmia was barefly noticeable and after taking my blood pressure med (Toprol) it would improve even more.  After doing some reading on the subject of arrythmia I started on a regimen of Potassium, CoQ10, Magnesium and Folic Acid (which seemed to help a little) but I was still worried what was really going on.  After much testing, I was diagnosed with Roemheld Syndrome....."characterized by presure in the epigastric and left hypochondriac region it is believed this leads to elevation of the diaphragm, and secondary displacement of the heart causing stimulation of the vagus nerve and a variety of cardiac symptoms, e.g. arrhythmia, sinus bradycardia.  This is complemented by gastro-coronary reflexes whereby the coronary arteries constrict with cardiovascular symptoms similar to chest-pain on the left side and sometimes in the left shoulder, dyspnea, sweating, upt o angina pectoris-like attacks and tachycardia even though there are no changes related in the EKG detected.  I am being treated now with an anticholinergic to treat the vagus nerve, an alpha blocker, simethicone, beano and Nexium and the Toprol.  It seems to be helping already but too early to really know for sure.  Just wanted to share in case anyone out there has similar symptoms.

< Edit> to bold several words.

Post Edited By Moderator (stkitt) : 6/26/2014 7:46:34 AM (GMT-6)

Hello RS sufferers...

when i get my RS attack, I drink Beer in order to burst the air bubble trapped in my stomach, or I jump up and down or take a walk or lie on my right side to relieve the pressure to the heart...

sometimes drinking a lot (Beer, Water, Baking soda water) will also burst the bubble and burping will then slowly releave the pressure...

you can also massage the vegas? nerve...

I find that when i drink a lot it doesn't happen but when i drink a few swallows it can trigger RS...

it's a scary thing when your heart starts to palpitate and won't quit...

so eat lightly...

be well...

Lore

I have. I think I've been suffering with this for about 10+ yrs. I began to get cold at night, and couldn't get warm. I started sleeping in a recliner after that. Back in 2002-3? I had all kinds of problems, but when I was eating a "healthy choice" meal one eve and nearly passed out. I went to the ER and told them that my heart was stopping but they thought I was faking or just crazy or having panic attacks. I continued to have all sorts of problems and saw many Drs and had all kinds of tests done. But they never found anything. What I have done for the past 8yrs has pretty well kept this condition under control? I stayed almost symptom free for 8-9yrs. I made sure to get all my vitamins, minerals, greens, etc. I would mix it all together and drink that in the morning. I would take a good probiotic, usu 35billion or so. And if I started having the digestive problems, I would take herbs to kill parasites. I haven't been doing my "regimen" lately and eating too much fiber and have been having problems again. I would up in the ER again last week and of course, they think you are crazy.

ref: roemhelds: check to make sure that you don't have a diverticulum on the stomach, as it can inflate with excess air in the belly and cause issues in addition to those which come with Roemehelds.

Based on my experience, it does not appear that western medicine, nor alternative physicians have an understanding of the Roemhelds paradigm and thus, am pursuing resources in Germany. It appears that physicians there have a much greater understanding of Roemheld's. If interested in the results of my research please respond and if you have resources please respond in kind.

I have weird muscle weakness (especially in my legs), diarrhea after many meals, hot flashes at times, cannot lay on my left side in bed, heart palps mostly fast, fatigue, and dizziness/lightheadedness during my episodes. I have been to ER several times thinking I was having heart issues. My event monitor never showed anything, echo, EKG's and stress test normal. Then my MD put me on Celexa and Xanax prn stating the maybe I was anxious or having panic attacks. I stopped taking those a while ago as they did not help. I had my gall bladder removed and my endoscopy and colonoscopy were normal. I am at my wits end with whatever is going on. My husband and doctor probably think I am crazy. Could this be the Roemheld Syndrome that you all are talking about? I am so tired of felling like I am going to die during these episodes! Forgot to mention that I am now on Omeprazole and Levsin.

Anybody actually get a "cure" for Roemheld yet?

I'm 53, 160lbs, 5'11''. Had symptoms like this since my 20's. Panic attacks, etc.

In 2007 had a major AFIB episode and was converted easily in hospital with Diltiazem and they thought it was a lone incident. I now realize that I had eaten a very big meal (with friends who love to cook and tell you eat! eat! and I did) with a few cups of tea and dessert. Never put the 2 together until recently.

Then I had a TIA (small stroke) in 2008 and an MRI revealed 4 previous silent TIA's so they assumed the AFIB was the cause and put me on Warfarin which has been ok until recently. Aug 30 of 2012 I had a minor heart attack (minor in that I had almost no muscle damage, it was barely detectable) and they put me on Digabitran (Pradax or Pradaxa in Canada) and that set off my stomach like crazy.

Within a few weeks I had to get off the Pradax but then the PVC's and AFIB really started kicking in, especially at night. I go to sleep at about 10:30 and usually wake up at about 3:30 in AFIB (which I can luckily usually stop with the ValSalva manouvre) but then it's like that for the rest of the night every 20 minutes to an hour. It drives me crazy.

I'm going for a virtual colonoscopy on Apr 4th and a gastroscopy on Apr 15th but I believe that I (and maybe many of you IMHO) have Helicobactor Pylori infections causing ulcers that cause the inflamation, that causes the gastric pressure that causes our symptoms.

Unfortunately this particular Gastroenterologist refuses to treat me unless he has a confirmed diagnosis of H. Pylori so I will have to survive another month like this and hope the biopsies come back positive.

I will keep you informed but if anyone has had similar issues and found success I'm all ears.

BTW, my best solution for managing the condition so far is: small meals MANY times a day, Pepto Bismol (or any Bi****h Sulfate product) multiple times a day to keep inflammation down and especially rightr before bed time. I'm also eating Manuka Honey, which may sound like a typical "internet hokus pokus cure" but the FDA has actually recognized the antibacterial properties of Manuka honey and considers it a valid treatment option for H. Pylori.

Anyway, that's my $0.02 for now.

Rick, Whitby, Ontario, Canada.

Wow, I was actually trying to find information on vasovagal syncopy syndrome, but found a possible answer to something I have been plagued with for quite some time. I have for years now had unexplained episodes of tachycardia, never diagnosed with SVT even though my HR would go into 160's and higher. I would go to sleep knowing it was coming, and discovered it would happen a lot to me after eating a large meal and going to bed with a full feeling. Or after drinking a stronger alcoholic drink. I would wake up not feeling right and then feel my heart racing. I also would barely fall asleep and then gasp for air and sit up. This can repeat every hour for several hours until I figure I am so exhausted that I end up falling asleep. My cardiologist tells me all is well with my heart, no SVT, but I should consider they may be panic attacks. What I am reading in your posts is interesting and kind of describes what I have been dealing with. So glad I joined.

Im glad I found this, my GERD nightmare actually started out with severe heart palpitations and several trips to A&E. After all the heart tests they said it was fine and then started treating me for 'anxiety'.

I would go to the doctors and say my heart was fast constantly, theyd measure it at 80bpm and say it was fine but I KNEW it wasn't my heartrate is 50-60 when resting, not 80 lying down! Noone believed me and I was brushed off as having anxiety (they told me so much they even convinced me that it was all in my head which gave me enormous mental health problems).

It was only when I was at my wits end and started taking some gaviscon for stomach pain that my heart magically slowed down after pretty much beating out of my chest for weeks. Since then I have been 100% certain that my stomach/esophagus and acid causes my heart palpitations but have only ever used the anti acids as a treatment.

They aren't gone completely but I dont get 'attacks' anymore, just the odd skipped beats

Original poster mentioned - anticholinergic to treat the vagus nerve

Does anyone know how the anticholinergic treats vegaus nerve. I googled and here is what it says

"Anticholinergic drugs are another group of bronchodilators that are different from the beta-agonists. While the beta-agonists affect the bronchioles (small airways), anticholinergics affect the muscles around the bronchi (large airways). When the lungs are irritated, these bands of muscle can tighten, making the bronchi narrower. Anticholinergics work by stopping the muscles from tightening."

Never heard of Roemheld Syndrome until finding this forum, I'm 51 and have a sliding hiatus hernia, been on omazaprol for couple months but stopped this treatment 3 weeks ago, had many of the symptoms here, tight bloaty feeling just below bottom rib left side which would make it feel like my heart was restricted (speeding up thumping etc) together with lethagy, slight nausia and anxiety, felt like there was a bubble down there that was pressing on everything.
For me this would only come on after sex (etc!), exercise or some other form of excitement ie watching football, could last anything from few hours to few days and it a pisser.
Noticed that when was on omazaprol this never happened but has returned since stopping 3 weeks back. Stopped omazaprol because acid reflux improved and didn't want to stay on this drug too long.
Makes sense all this biz about vagus nerve, for now going try to diet and stay off beer/wine see if helps, will repost later with outcome. Anyone else tried anything that works??

Hello out there..
Just signed up as I think I should share in what has been a nightmare for 6 years now. All the symptoms you guys are describing. Mine is slow than normal hear rate and eating actually helps... so not sure about this, but I do not feel heartburn or burp excesivelly. I am also the right weight for my height. But bouts of skipped beats so severe as to make me lightheaded and sick. Cannot stop them once they start. However: I have worked out that it has something to do with the way I sit (scrunched up stomach) for long periods, stress (tensing in the stomach area), leaning forward or streaching up. I do think the stomach and vagus are involved somehow, much to the doctors (and cardiologist's) disdain. So the biggest help has been adjusting position of my body, regardless if I'm working on a computer, driving, in social situations. And being super vigilant to what my body is telling me. If I am vacuming and I get one flutter, I literally drop the vacum and lie down and breathe for a while. Breathing exercises have helped a lot. If I ignore small early cues, then a huge episode will follow. Here is a corker though... I found years ago that a couple sips of alcohol of any type will make the skips go away. Sometimes for good, at bad times, only for a bit. I think it has to do with the vasodilating effect of alcohol as the ammount is way too small to be 'relaxing' as doctors suggested. So here it is. I hope it helps someone. I feel your pain, I too had heart checked several times and have developed anxiety and panic attacks as a result of this condition. I cannot believe that a condition that lowers the quality of life to this extent has been ignored by the doctors!! Maybe chats lie this will find solutions. Hurray for the internet! Good luck.

How nice it is to find this thread. It makes me feel like less of a freak and makes me realise I'm not alone with what I have been experiencing. I have had every single symptom that has been mentioned here. Granted it isn't every day thank the Lord. Really quite scary symptoms. The only comfort I have received is that I have had a cardiologist look at my heart.

It sucks to have to really watch I eat but then again, I'd rather that than having a completely sleepless night waking up gasping.

Once again, I'm thankful for healingwell for being able to reassure me, I'm not alone.

Since you are trying to self-diagnose in the absence of a cardiologist figuring out what is going on -

That's what I have had to do too. I get tachycardia when I eat one of my food triggers. I have specific food intolerances, all the foods happen to contain sulfites, but others could have other food triggers.

I see you have tried burping. I did that too at first, until I found out it was the same principle as Valsalva maneuver. After the tach one time caused a heart attack, from the coronary arteries constricting, I got help from my allergist because I knew it was related to certain foods. She had me keep a food journal (see the search box for more posts) and I identified my foods and what they contained.

The reason the stomach is affecting the heart is that they are connected by the vagus nerve. It's called cardioesophageal reflex. (see Google and also the archives - search box) The heart can affect the GI system too. It sometimes has given me diarrhea! And an infection in a bit of my colon has caused arrhythmias too!

I'm not saying this is your diagnosis, but it's worth considering if certain foods are the trouble or just the effect of eating.