GI and positional triggers

I have 2 primary triggers - GI symptoms and positional changes. I've done lots to address the GI, the most successful being HCL for the past 2 months. I'm seeing some improvement with my afib - hoping it is not coincidental.

The positional trigger is almost comical at times in how mechanical it is. Turning over in the night is what almost invariably starts it. Getting up usually stops it for the moment at least, but if I lay back down again too soon it will often start again.

I feel certain that the GI trigger is via the vagus nerve, but I wonder if the positional trigger is something more directly physical (organs bumping into or pressing against other organs). I'd love some analysis of the internal mechanical issues of positional triggers. Thanks, Ralph

Ralph - During the years of my afib challenge, I had similar postural triggers... bending over was commonly a trigger. I have written about my chiropractic treatment for what Dr. Jordon, D.C. called a displaced diaphragm... meaning the stomach was pushing up and encroaching on the diaphragm space and that in turn, then crowded the heart area and releasing pressure on the Vagus Nerve. His treatment was to pull down on the stomach...reaching just under the rib cage in a specific manner with fingertips with specific breathing maneuvers... hard to describe... but it worked for me so well that I was totally amazed. If you can locate a chiropractor who does that type of adjustment, it could be your answer as well. I'd call around and interview by phone. My experience is... there are chiros and then there are chiros... I saw many before I located this one who had the extraordinary knowledge and skill.

In addition to the postural triggers, I was also experiencing bouts of hiccoughs which indicated magnesium deficiency.

Years ago, I wrote the Calming My Heart post... and one segment discusses the chiropractic successes I enjoyed. I did comment then and still feel, that the stomach/diaphragm manipulation was successful both from a physical manipulation and freeing up or opening the energy channels or meridian flow... and also because I was heavily focused on optimizing magnesium and the other electrolytes.

You can read down through this, Ralph, to see the chiro treatment description.
Calming My Heart
[www.afibbers.org]
[Sorry that those annoying artifacts show up in the article... apparently a result when the BB transitioned from one system to another.... but wherever there was an apostrophe, that symbols is substituted instead.]

Oh, and another thing... There is an interesting report by Steve Rochlitz on the influence of Hiatal Hernia and Vagus Nerve Imbalances that is worth reading... It was posted here back 8 years or so ago... and influence my thinking about my postural triggers...When I golfed, bending over to put the tee in the ground was often an instant AF trigger... Do a google for Dr. Rochlitz and those words...there are many references that may be useful for your research for your postural triggers... If you can't locate the exact article, send me an email...I'm sure I have it on the computer somewhere.

If it's just that simplistic, you'll be as happy as I was once that triggering stopped.

Best to you,
Jackie

Thanks Jackie! I've never heard of a displaced diaphragm and I can't picture how that would work - is that the same as a hiatal hernia? I had an upperendoscopy in December 2011 primarily to see if there was a hiatal hernia and the doctor unequivocally said there wasn't, although I am aware of the theory of a stomach hernia going back and forth above and below the diaphragm.

I've been receiving deep stomach work the past 2 months from a massage practioner who practices Chi nei Tsang, and it has helped in various ways, but there is a piece missing still. I'm pretty set up with the supplements, mag level, etc.

Dr. Jordan isn't in California is he?

I've never heard this procedure referred to as a diaphragm adjustment. It is a stomach adjustment and is the same as that used for Hiatus Hernia.

Some Chiropractors use the term Hiatus Hernia Syndrome to differentiate between the stomach pressing against the diaphragm as opposed to going through the opening into the chest cavity.

It can be self applied and the link below describes how to do it.

[www,healingnaturallybybee.com]

Thank you Sam. I had never heard of HH Syndrome before, but it looks like it could be what is happening if there isn't an actual hernia. I saw some other adjustments on line that are similar to Bee's, and I'm going to work with it and report back.

Ralph - No, I'm here in Ohio. No, this isn't hiatal hernia... it's more to do with the diagraphm muscle itself..as I said, 'scrunched' up by stomach pressure... the pulling down on that muscle lets everything else relax...and there were some other chiropractic manipulations related to the whole procedure. as well. As mentioned, it was totally amazing and highly effective....and of course very welcomed by me since I had been experiencing afib daily or every other day and was concerned I was getting into the 'permanent' classification. Jackie

I may not have been clear enough in my last post about a 'diaphragm' adjustment. The point I was trying to make (and with 26 years experience as a Manipulative Therapist who studied all forms of manipulation, including Chiropractic, on this issue I do know what I'm talking about!) was that the adjustment in question is usually called a stomach adjustment and is the same as that used for Hiatus Hernia even when there is no Hernia but rather, as in Jackie's case, a problem caused by the stomach pressing on the diaphragm.

The self-adjustment in the link I provided pulls the stomach down and relieves the pressure on the diaphragm.

Hope I'm clearer this time!

Sam

Ralph,

You may be interested in the procedings of these two Conference Room sessions:

Session 28 - LAF, GERD and Diaphragm Displacement [www.afibbers.org]

Session 36 - Right Side vs. Left Side [www.afibbers.org]

Hans

Ralph –

Discussions about postural and positional triggers of arrhythmia must include the vagus nerve and the GI is definitely involved.

Numerous factors influence vagus nerve irritation. One consideration is to address your posture and sitting habits and the impact of sitting for hours at a time - as many do - working at a computer station…or your home desk or sitting scrunched on the couch with a laptop. Sitting continually, for long stretches, causes a myriad of problems aggravated by:
• Adiposity in the midsection.
• Weak Core muscles
• When heavy meals are eaten and the stomach is full or distended and then, followed by more sitting that scrunches the midsection
• Full stomach or one that becomes bloated with gas after eating and exerts pressure and displacement of surrounding organs and pushes upward on the diaphragm muscle.

When a nerve is pinched or trapped, it’s called ‘impingement.’ Impingement of the vagus is well-known and afibbers are typically very familiar with postural triggers of AF. Sometimes it’s bending over from the waist; other times lying down in a supine position allows for the positional shift of the stomach and diaphragm which pinches the vagus.

The check anatomy diagram at this link…showing organ placement and note how everything is neatly compressed into the abdominal cavity. It’s easy to see how the stomach could exert upwards pressure on the diaphragm which is the dividing muscle that between the chest cavity and the abdominal cavity In this illustration… only half the diaphragm is shown, but it covers both right and left sides in real life. Note that there are no abdominal fat accumulations fat added to the photo so you have to envision how fat accumulations affect the crowding of those organs… and then envision what poor posture, stomach gas, bloating and distension would exert pressure, push organs out of place and for this topic, cause the vagus nerve to be pinched and irritated. [www.webmd.com]

The Vagus nerve is the Tenth Cranial Nerve and is called “The Wanderer” because of its extensive length and pathways to various organs. Wikipedia offers a particularly elaborate description complete with dissection photos. [ [en.wikipedia.org] ] If you are prone to AF triggered by positional changes, it would be useful spend time looking at the medical diagrams of the path of the vagus and branches so you can envision what happens.

The vagus comes out of the brain, enters the body in the area of upper cervical spine area and is extremely vulnerable to subluxation or spinal misalignment. Starting in the area of the Atlas (bone) which is the first cervical vertebrae or C1, anything out of alignment there, affects everything downstream. [en.wikipedia.org])

The vagus nerve directly innervates the heart, larynx bronchi and lungs, esophagus, stomach, small intestine, abdominal blood vessels, liver, gall bladder, pancreas, colon is the link between the vagus and pelvic parasympathic, rectum, kidney, bladder and external genitalia. Branches from the main nerve, when impinged or distorted by various pressures, cause problems in other areas (referred), but track directly back to the vagus. Example… a mal-aligned Temporomandibular joint (TMJ) causes impingement on the branch of the vagus that goes to the ear..causing not only TMJ pain but also ear involvement..(maybe tinnitus). So, it is with the vagus and all the vagal branches.

Impingement or pinching of the vagus nerve anywhere weakens the body.

The Vagus is a parasympathetic nerve and impingement alters the function of the vagus in its entirety and can affect the heart, lungs, liver, gallbladder, spleen, pancreas, small and large intestines, thyroid and primitive brain-stem medulla. (Baroody)

As this all relates to a true Hiatal Hernia or can be symptoms of the HH syndrome when movement the stomach up into the diaphragm pinches or crowds the vagus nerve. Symptoms are likely to be the result of postural changes… such as lying down or middle-of-the-night shifting that cause symptoms such as afib and shortness of breath, gastric distress. The vagus goes down beside the stomach and when the stomach is malpositioned or abnormally distended, the vagus can be pinched.

Those who address the vagus involvement in their clinical practices are typically chiropractic physicians, and acupuncturists who treat nerve pathway obstructions. Their world revolves around the body’s energy flow through meridian pathways and spinal alignment to ensure that the muscles and organs served by the Autonomic Nervous System (ANS) are not blocked or impeded. Blocked energy flow or electrical signals affect affect every cell and every organ in the body and interrupts communication with other cells and organs… so it makes sense that if afibbers have impingement on the vagus, all of the other pathways can be adversely affected to one degree or another.

No one discusses the function of the vagus nerve more completely than Steve Rochlitz, PhD who has written prolifically about his clinical experiences treating patients with vagus nerve involvement. Whether this involves a true hiatal hernia or the Hiatal Hernia Syndrome complex, or the crowding or impingement on the vagus, Dr. Rochlitz who is Physicist, Nutritionist and Kinesiologist addresses every aspect in his prolific writings much of which is found online..

Quote Clips of interest from Dr. Rochlitz’s articles on Hiatal Hernia/Vagus Nerve Impingement Syndrome

….”The Vagus Nerve, like the hiatal 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 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.(The appropriate) examination also looks for the potentially, dangerous pre-cancerous, esophageal condition called Barrett's Esophagus, which can occur after long-term GERD."

"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."

Dr. Rochlitz also details "Schatzki's ring which is a disorder of the Lower Esophageal Sphincter (LES). He also discusses the influence of the Longitudinal Muscle Contraction (LMC) of the esophagus and how relates that connection to trigger points, which may be created directly, or indirectly, by mercury or other heavy metals or other toxins. The active trigger points then could cause the Esophageal LMC as trigger points are deeply entwined with muscle spasm.”

Any and all of which could contribute to postural or positional triggers for AF.

Jackie


These are a few links to reports by Dr. Rochlitz:

Hiatal Hernia/Vagus Nerve Disorder: a leading cause of allergies & chronic illness
Letters to the Editor - Letter to the Editor
Townsend Letter for Doctors and Patients, Jan, 2004 by Steven Rochlitz
[castlehighkingdom.proboards.com]
[www.wellatlast.com]