AFIBBERS FORUM

Previous links:
<[www.afibbers.org]> -Part 1 DGL
<[www.afibbers.org]> -Part 2 GERD, Digestive Issues & Health
<[www.afibbers.org]>- Part 3 GERD & Digestive Ailments – Includes Resource References


Part 4 continues the examination of why the average American has gut dysfunction.

Three areas will be examined.
1. Food Stream (Part 3)
2. Stress
3. Physical/functional aspects of diaphragm and LES

This is such a huge topic with so many influencing factors. The following just skims the surface, but it doesn’t take much imagination to connect the dots to associate stress to digestive ailments or expand on that to see how gut disturbances can influence atrial fibrillation.

Dr. Brady says that the majority of people visiting his office for treatment have some form of digestive complaint.

We know Type A’s are typically stressed out individuals and are high achievers. We also know the typical afibber can relate to being Type A - Those who are over-stressed, overbooked, living on the edge of life in the fast lane and who become ‘stuck’ in the sympathetic nervous system (SNS).

Prolonged activation of the stress response creates many chronic degenerative symptoms that accelerate aging. (Lipski)

Jackie


2. The Impact of Stress on the Digestive System

Following is a very brief review – excerpts mostly from Dr. Robert Blaich’s book, “Your Inner Pharmacy” and comments from others referenced in Part 3.

Regarding basic adrenal functions and related to the saber-tooth-tiger effect…

Many baby boomers are ex-adrenaline junkies – people who lived in the fast lane for too many years. As they age, they are starting to have many similar problems. When the “tiger” attacks the body or when any form of immediate stress occurs, in the fight-or-flight response, the sympathetic nervous system (SNS) fires, releasing adrenal hormones to create survival mechanisms including: elevated blood pressure and blood sugar, increased heart rate, dilated pupils, opened up airways (bronchodilation). Normal digestion and even intestinal peristalsis is stopped to allow the body to focus on survival. And the parasympathetic nervous system (PNS), which regulates day-to-day activities like slowing the heart rate and stimulating digestion, is inhibited.

An estimated 90% of all visits to all types of doctors are for stress-related illnesses and these are all caused by some variation of this imbalance of the nervous system and adrenal function.(Blaich)

Dr. Hans Seyle, a pioneer in the field of stress research, referred to three stages through which the adrenal glands progress when frequently and repeatedly activated by stress. These stages, called General Adaptation Syndrome include: the initial response, (Alarm Stage) and is the classic fight-or-flight response that brings on the adrenaline rush.

Seyle observed that animals continuously and repeatedly stressed went into the (next) Resistance Stage. If under prolonged stress, the Resistance Stage may last years or even decades during which several changes occur in the body. One is enlargement of the outer layer of the adrenal glands (cortex) where hormones are produced that control general balance – blood sugar levels, inflammation and even secondary sex characteristics.(Blaich)

During the Resistance Stage of repeated stress, Dr. Seyle’s lab animals developed intestinal and stomach ulcers and weakened immune systems.(Blaich) In humans, this translates to the enormous increase in digestive problems including heartburn, GERD, IBS, chronic illness and fatigue we see today.(Lipski)

Then at some point, the body can no longer maintain the increased production of these hormones to meet continued, ongoing stress and the adrenals reach the Exhaustion Stage(adrenal burnout), wherein the body can no longer regulate its own vital functions.(Blaich)

Chronic disease develops gradually as a result of dysfunction. One doesn’t just “get” GERD, diabetes, heart disease or cancer… they are each preceded by years of dysfunction of the body involving gradual deterioration of normal function over time. (Blaich)

It’s easy to understand how it would be common to develop digestive problems during the resistance stage since continued activation of the SNS by ongoing bouts of stress puts the body into survival mode. Normal digestive processes are inhibited while the body tries to service the current crisis. As the crisis continues on and on, the normal production of digestive enzymes continues to be “shut off” or greatly reduced. The consequence then, of eating heavier foods like proteins that require more enzymes (and the enzymes aren’t there) is the resulting discomfort of bloating, gas and heartburn.(Blaich)

Unfortunately, rather than looking at the cause of these common digestive disorders, we are programmed to take an antacid or medication for ‘immediate’ relief of symptoms. This is often temporary and rarely corrects the imbalance in the nervous system that is limiting normal digestion in the first place.(Blaich)

There is correlation in studies with Irritable Bowel Syndrome and Post Traumatic Stress Disorder from the neurological and hormonal picture seen in PTSD. Often cortisol is abnormal (often even low) and it’s not just burned out adrenals but they are getting a secondary adaptation overdrive of catecholamine. So they are in a fight-or-flight stage all the time – neurologically -- and it affects the Enteric Nervous System as well. We know serotonin is a major player in the ENS. These patients often have too much catecholamine and too little serotonin,.particularly serotonergic activity in the ENS. It can be difficult to balance out those problems. (Brady)

We know that cortisol and stress hormones act very negatively on the intestine particularly the immune surveillance by directly decreasing secretary IgA thereby allowing greater antigen penetration through the gut wall and creating the common problem of pan-allergy to foods.

The more antigenic and toxic exposure through the intestinal tract, the higher the burden on the body-- not only the immune system, but the liver in hepatic detoxification. (Brady)

Julia Ross (The Mood Cure, The Diet Cure) says that “No matter how much stress we endure, we have just two little glands to fight it for us…the adrenal glands.” In periods of prolonged stress, we go into adrenal overdrive and the adrenals can get stuck in the ‘on’ position. The chemicals released by the adrenals in the fight-or-flight stage are adrenaline and cortisol. Adrenaline is needed for the short blasts – if we are threatened by a mugger or an angry boss and cortisol bolsters us in the long-lasting stresses – like flu or a divorce.

In this state of adrenal alarm, other systems try to compensate. The thyroid may turn down its hormonal activity in an attempt to reverse adrenal overdrive and make us tired and heavy as metabolism eventually slows. DHEA and other adrenal hormones can also alter functions as adrenals become depleted. We don’t relax and rest to allow for repair and rebound. So we get sick more often or have trouble sleeping. By the time, the second stage arrives, we are running low on cortisol as well and feel tired sick and stressed too often. In the third stage, we are quite low most of the day in cortisol, DHEA, thyroid and other hormones like testosterone, estrogen and progesterone and we are almost always tired and can’t cope even with minor stress well at all.

SYMPTOMS OF ADRENAL EXHAUSTION:

+ Sensitivity to exhaust fumes, smoke, smog, petrochemicals
+ Inability to tolerate much exercise or feel worse after exercising
+ Depression or rapid mood swings
+ Dark circles under the eyes
+ Dizziness upon standing
+ Lack of metal alertness
+ Tendency to catch cols easily with weather changes
+ Headaches, particularly migraines, along with insomnia
+ Breathing difficulties
+ Edema (water retention)
+ Trouble falling asleep or staying asleep
+ Feeling of not being refreshed after sleeping
+ Feeling tired all the time
+ Feeling of being mentally and emotionally overstressed
+ Low blood sugar symptoms
+ Need for caffeine (coffee, tea, others) to get going in the morning
+ Low tolerance of loud noises and/or strong odors
+ Tendency to startle easily, panic
+ Food or respiratory allergies
+ Recurrent, chronic infections, such as yeast infections
+ Lightheadedness
+ Low tolerance for alcohol, caffeine and other drugs
+ Fainting
+ Tendency to get a second wind (high energy) late at night
+ Low blood pressure
+ Haven’t felt your best in a long time
+ Eyes sensitive to bright light
+ Feelings of being weak or shaky
+ Constant fatigue and muscular weakness
+ Sweating or wetness of hands and feet caused by nervousness or mood swings
+ Ability, at times, to relieve paranoia and depression by eating
+ Frequent heart palpitations
+ Chronic heartburn
+ Vague indigestion o abdominal pain
+ Alternating constipation and diarrhea
+ Infrequent urination
+ Cravings for sweets or alcohol
+ Lack of thirst
+ Clenching or grinding of teeth especially at night
+ Chronic pain in lower neck and upper back
+ Inability to concentrate and/or confusion usually along with clumsiness, ADD and ADHD
+ Chronic breathing disorder, particularly asthma
+ An excessively low cholesterol level (below 150 mg/dl)
+ Bouts of severe infection.

Source: (pp. 46-49 The Diet Cure)
[www.moodcure.com]
[www.moodcure.com]

[Can you recognize some of your own symptoms here?]

Dr. Rogers notes that in the fight-or-flight stage, most of the blood in the body is shunted to muscles and the heart and among results, the secretion of digestive juices slows to a halt since blood is pulled from the digestive tract.

On the other hand, she says the parasympathetic nervous system energizes the glands, promotes healing, repair and aids digestion. So you must relax after a stressful day before eating so you can reap the benefits of the PNS.

Stress reduction and a peaceful meal time without stress obviously become very important. A concerted effort must be made to make mealtime unstressful to ensure proper digestion and an effort must be made to take time to eat peacefully, quietly and properly. Tall order in todays rushed workplace with busy schedules, traveling, limited food selections and choices.

Dr. Rogers offers suggestions:

1. Eat your meals in a stress free-tranquil environment. Make sure mealtime is peaceful as digestion begins in the head. Eliminate TV, unpleasant discussions, violent videos etc.

2. Chew each mouthful at least 10 to 50 times. [In a previous post, I relayed the advice that we should chew food until it becomes a watery slurry without adding any liquid to make it that watery consistency.]

If your dentition is preventing you from chewing adequately, take steps to correct that problem. She says a common problem with stomach acid starts because people are in such a hurry they don’t chew adequately. The saliva produced in the mouth is the first (and very important step) toward breaking down food so it can be properly digested.

3. Some people observe food combining that successfully eliminates gas and bloating as well as weight loss. Simple premise… Cut back on eating many dissimilar foods at one sitting. If starches and proteins are eaten with fruits, they require longer digestion times. Fruit doesn’t need much digestion time, and while it waits for the other foods to break down, gas and bloating is created as the fermentation begins quickly with fruit. She adds that food combining can be intensely limiting and there is little scientific evidence that it is totally effective.

Gas and bloating comes from fermentation action between gut bacteria, gut yeasts. When gases distend the gut wall, they cause painful bloating, cramps, uncomfortable fullness and indigestion. They can also turn toxic to tissues and nerves and cause an inflammatory reaction that impairs the normal peristaltic wave action initiated by gut nerves to propel food along which adds constipation to bloating and cramps.
She says – pure food is the key to good digestion which leaves out junk foods, additives or foods ground, crushed, mashed or otherwise mutilated by some machine.

Addressing the stress issue is critical. (Rogers)

She says, “Never underestimate how intimately the gut is tied to the brain. In fact, the brain and emotions are as much a stimulant to the gut as any food, bug, ulcer or cancer. And the opposite is also true: The gut can stimulate other parts of the body. Be that as it may, never forget that you have absolute control over how threatening you perceive anything to be and how extensively you are going to allow it to affect your GI tract function.”

In 1996, Michael Gershon, MD, wrote The Second Brain- (Your Gut Has A Mind of Its Own) The Scientific Basis of Gut Instinct and a Groundbreaking New Understanding of Nervous Disorders of the Stomach and Intestines. (Harper Publishing) It’s a well done book that explains how the Enteric Nervous System functions and influences overall health – and especially gut disturbances.

He says: “95% of all serotonin in the body is in the gut where it triggers digestion. Nerve cells in the gut also use serotonin to signal back to the brain. This information can train us not to eat certain foods by communicating pain, gas and other terrible feelings.”

[Think about it … not producing stomach acid… eating foods with chemicals, additives, bad fats, sometimes allergenic foods… and no digestive enzymes to help deal with it.]

It’s not difficult to visualize a connection between stress and poor digestion, absorption, and assimilation.

So from there, we can also visualize a cascade of detrimental functional sequences that begin with food choices, the impact of stress on how what is consumed will be handled by the body and what systems depend on this handling. Key to this is the immune function that is largely the function of the small intestine and this will be covered in the probiotics section in a forthcoming segment.


3. The Diaphragm - Stress, LES & Hiatal Hernia

The nervous system normally controls stomach acid production and the
parasympathetics stimulate stomach acid production through the vagus nerve, the 10th cranial nerve from the brain that enervates the stomach, diaphragm and heart with signals. Malfunctions or distortions can mean the wrong messages get to the stomach and produce too much or too little stomach acid. (Blaich)

In his chiropractic treatment, Dr. Blaich always evaluates the balance and function of the parasympathetic nervous system and since the vagus passes through the skull and down along the vertebrae of the upper neck, he makes sure the bones are properly aligned and don’t impinge on the nerve. Often, he finds that once the normal function of the vagus is restored, stomach acid production returns to normal.

On a physical/functional level, the diaphragm is highly important and influential in digestive health. Dr. Blaich says he considers it second only to the heart as the most important muscle in the body. It not only increases oxygen levels in the brain and body, it also pumps the acupuncture energy that flows through the meridian system.

It is the barrier that normally keeps acid in the stomach by the function of the diaphragm, the muscle that separates the chest and abdominal cavities. It contains the esophageal sphincter – the barrier ‘valve’ between the stomach and esophagus (often called the Lower Esophageal Sphincter or LES). The tone of the diaphragm muscle and the LES maintains the barrier and keeps stomach acid out of the esophagus. Therefore, if there is a problem of acid reflux, it makes sense to consider the muscles may not be functioning properly.(Blaich)

Medical textbooks note that hiatal hernia symptoms such as acid reflux result from muscle laxity or weakness around the esophageal sphincter. Often, people respond to correcting the dysfunction of the diaphragm muscle by a visceral manipulation that pulls down the stomach that is otherwise being pushed up through the opening into the esophagus. Correcting a dysfunctioning muscle makes sense. It’s non-invasive, holistic and can impact a patient’s life in broader ways than just solving the mechanical problem. What doesn’t make sense is the standard first-line of treatment that millions receive for this problem, which is to take medications to reduce acid production. It makes no sense to assume that everyone with heartburn and reflux has excess acid production. On the contrary, many of these people don’t have too much acid. The problem is that the acid is in the wrong place – up in the esophagus where it doesn’t belong. So rather than a chemical problem of producing too much acid, it is likely to be a mechanical problem with a muscle that can be corrected.(Blaich)

We often talk about not sitting scrunched at the computer for or slouched in a chair for long period of time as it can be a trigger for afib. Dr. Blaich observes that as we age, our shoulders and upper back become increasingly hunched over… called thoracic kyphosis. When hunched over, you can’t take a deep breath and your stomach is compressed up into your diaphragm putting extra pressure on the LES and “challenging its ability to keep the contents in your stomach and out of your esophagus.” He says if you eat a large meal while hunched over, your full and expanded stomach which is compressed by your position, has nowhere to go but up into your diaphragm. If the diaphragm and LES are weak, the upward pressure of the stomach can force a portion of the stomach or its contents into the esophagus, causing gastric reflux and even a hiatal hernia.

So from a functional point of view, it’s easy to understand how poor posture, a full stomach and a weak diaphragm muscle can create gastric reflux. These are all correctable by motivation, discipline and manipulation along with stretching and breathing exercises to activate the diaphragm.

He says he sees more and more diaphragm-related problem in younger people as a sedentary lifestyle become more habitual. The diaphragm, like any other muscle, needs exercise to be healthy.

Stress can adversely affect the diaphragm. When stressed, you naturally tighten up, breath less deeply and often feel tightness in the chest. He reminds people to breathe deeply during stressful times or when working intensely in a stationary position (ie, hunched/scrunched at the computer).

Emotional traumas and stresses have a tightening effect on the diaphragm. The LES is controlled by the autonomic nervous system and the sympathetic nerves tighten the sphincters while the parasympathetic nerves relax them. When you are exhausted from constant stress, the body may not be able to maintain the normal tone of the sphincters which can predispose to gastric reflux. He treats with nutritional support to rebuild exhausted parts and functions of the body as well as mechanical adjustments.(Blaich)


This concludes this segment on the examination of a few more influencing factors that impact digestive dysfunction. It’s an extremely cursory report because of space constraints. The list of stress symptoms serves as a stark reminder of how all encompassing the insults can be to total-body, optimal functioning. We are a web of interconnecting biochemical reactions all working to function as one whole symphony. When even one player is off key, the result is less than perfect harmony.

It is small wonder that gut symptoms can be a significant sign of underlying imbalances and abnormalities.


Following segments will focus on more influences and will include:
Leaky Gut Syndrome, Pathogens, Candida and Parasites…all part of digestive dysfunction. The Immune System and Probiotics will follow and concluding will be Testing and Treatments – both pharmaceutical and natural remedies.

Stay tuned.

Jackie

Thanks Jackie! You have done a fantastic job putting all of this together for us. I have been saving each part and plan to put it in a binder as I want my son to read all of it as he has an ulcer and acid reflux. I have finally convinced him that he has to eat better so he and his wife made a new year resolution and have been doing real good with it. However, he eats so fast and I know he doesn't chew his food well, so this part will be very important.

Thanks again, did anyone ever tell you that your name should have been "Jewel"...because that is what you are a bright shining jewel! Sharon

Nothing wrong with eating quickly, and not chewing food, provided you eat only raw fatty meat. Consider that all carnivorous animals eat like that, so do people and it's the lowest stress way of eating.

If you were to choose to pass this on to your son, I'd love to know his response.

William

Wonderful report, Jackie....as Sharon commented am going to print out and keep.
I have been diagnosed with a lung condition, now, bronchiectasis, and am interested in the connection to longstanding GERD. If I had known what GERD
can do to your body I would have treated much more rigorously early on
and especially changed my diet.

A friend has had a voice problem for over a year. It started with a cold, but didn't improve despite speech therapy.
It was thought she might have had a TIA, as she had already had one of these, and that the vagus nerve might have suffered some damage.

Recently she was in hospital for more tests and while she doesn't understand/know what the diagnosis was [apart from it's not cancer] the doctors have prescribed omeprazole "for my voice problem".

Her voice is improving.

How I wish I could just put my faith in the medics and allow them to look after me!!!!!!

Joyce

William, I will pass it on to my son and if he remarks on it, I will be glad to share. Sharon

Interesting article on bacteria I read while waiting to give blood last night.

[www.newsweek.com]

A couple of interesting notes - on sugar digestion & also H pylori

- George

"Microbes play an important role in digestion, especially of polysaccharides, starch molecules found in foods such as potatoes or rice that may be hundreds or thousands of atoms long. The stomach and intestines secrete 99 different enzymes for breaking these down into usable 6-carbon sugars, but the humble gut-dwelling Bacterioides theta produces almost 250, substantially increasing the energy we can extract from a given meal.

Of course, "energy" is another way of saying "calories." Jeffrey Gordon of Washington University raised a colony of mice in sterile conditions, with no gut microbes at all, and although they ate 30 percent more food than normal mice they had less than half the body fat. When they were later inoculated with normal bacteria, they quickly gained back up to normal weight. "We are finding that the nutritional value of food is pretty individualized," Gordon says. "And a big part of what determines it is our microbial composition.""

...

"The task is complicated, in part because some bacteria seem to be both good and bad. The best-known is Helicobacter pylori, a microbe that has evolved to live in the acid environment of the stomach. It survives by burrowing into the stomach's mucous lining and secreting enzymes that reduce acidity. Nobel laureates Barry Marshall and Robin Warren showed it could cause gastric ulcers and stomach cancer. But then further studies discovered that infection with H. pylori was protective against esophageal reflux and cancer of the esophagus, and may also reduce the incidence of asthma. H. pylori, which is spread in drinking water and direct contact among family members, was virtually universal a few generations ago but is now on the verge of extinction in the developed world. The result is fewer ulcers and stomach cancer, but more cancer of the esophagus—which is increasing faster than any other form of cancer in America—more asthma, and … what else? We don't know. "H. pylori has colonized our guts since before humans migrated out of Africa," says Blaser. "You can't get rid of it and not expect consequences."

Blaser questions whether eliminating H. pylori is a good idea. Someday, conceivably, we might intentionally inoculate children with a bioengineered version of H. pylori that keeps its benefits without running the risk of stomach cancer."