Suggest treatment for acid reflux, anxiety and occasional heart palpitations

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Posted on Wed, 10 Jun 2015 in Digestion and Bowels
Question: Hi doctor I have some acid reflux and anxiety. Lately for the past year I have had symptoms related to my heart such as palpitations and some etopic beats. I had all the heart tests done and everything came back normal and my cardiologists both insist the problem is not my heart and it is very healthy. The palpitations are originating from somewhere else. I noticed sometimes after eating I will get palpitations and then with any movement such as climbing the stairs my heart starts racing around 165 bpm. Like I said I also have anxiety which makes things worse. Can stomach related issues such as acid reflux cause these symptoms maybe via the vagus nerve?
doctor
Answered by Dr. Klerida Shehu 2 hours later
Brief Answer:
GERD/anxiety as major factors to your heart palpitations...

Detailed Answer:
Hi XXXX,

I have gone through your medical history carefully and can say as following:

1. You are reporting to have acid reflux and anxiety and palpitations problems, especially after eating. You have done all the heart tests which resulted normal. I am happy for that because this excludes cardiac problems.

2. Acid reflux/GERD is what is causing palpitations after eating. There are 2 major ways:
a. Anxiety does aggravate/trigger GERD; on the other hand, GERD is aggravating/triggering anxiety. It's like a vicious circle.

b. While you eat, the stomach is getting distended when having GERD. One part of stomach gas is going into esophagus, which is stimulating the vagal nerve. This stimulation is also associated with heart problems like palpitations. This is also know and Roemheld syndrome (gastric-cardia syndrome).

It is a benign syndrome.

To my opinion, an upper endoscopy is advised to evaluate your actual GERD situation.
While it is also important to follow a healthy diet to dominate GERD symptoms:
- eat often, small portions and chew up slowly
- avoid foods that would cause excessive gas: beans, etc.
- do not use straws when drinking
- avoid alcohol; coffee , carbonated drinks
- increase physical activity
- raise your head when sleeping
- do not lay down immediately after eating

3. You are also mentioning that you feel heart palpitations when climbing stairs too. This is because, during this activity, adrenaline hormones are being secreted. This hormone has a stimulating effect on the heart, which is felt like palpitations by you.

Hope it was of help!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Klerida Shehu 8 minutes later
Hi doctor thank you very much for your reply. I really appreciate it. I will see my family doctor about getting testing for this. Am I in any danger or us this not serious? Is it a common problem?
doctor
Answered by Dr. Klerida Shehu 7 minutes later
Brief Answer:
Not serious,no danger;upper endoscopy recommended

Detailed Answer:
Hi back XXXX,

1. Ok, follow up with your family doctor then.

2. This is not a serious problem and you are not in danger of anything. It is a fastidious situation, but not serious. It is happening sometimes, in certain patients (like you) to have this syndrome.

The most important thing is to dominate anxiety. This will resolve your problems.

All the best!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Klerida Shehu 1 hour later
Hi doctor thank you for your great explanations. I just got very worried because sometimes my heart rate will be fast and then I start to get anxious and it will go up to 170 bpm. My cardiologist saw this on holter monitor and insists my heart is very healthy
doctor
Answered by Dr. Klerida Shehu 1 hour later
Brief Answer:
Apart from general discomfort it wouldn't cause any problems to your health

Detailed Answer:
Hi back,
I understand your concerns.

You shouldn't worry as long as your cardiologist excludes any cardiac issue; these situations aren't harmful for you.

Your symptoms are related to Roemheld syndrome and anxiety that follows. In these cases HR may go even higher than 170 bpm (around 200 bpm). Apart from general discomfort it wouldn't cause any problems to your health.

Wish you health!
Dr. Klerida
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Klerida Shehu 12 hours later
Hi doctor thank you once again for your reply. I looked up Roemheld syndrome and went to a forum where many people suspect they have the same thing. They all had cardiac tests come back normal but have cardiac symptoms. One individual said his heart has stopped a few times. Is it possible or did he have another condition? Can the stomach cause the heart to stop?
doctor
Answered by Dr. Klerida Shehu 9 hours later
Brief Answer:
No, it's not true that stomach problems would cause heart to stop.

Detailed Answer:
Hi back XXXX,

That's an interesting question.

1. No, it's not true that stomach problems would cause heart to stop.

Each case has its own characteristics.

2. With regards to the case you are referring, a deep evaluation of blood, electrolytes, personal history of cardiovascular problems should be considered.

Hope it answered to your question
Dr.Klerida
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Klerida Shehu 14 hours later
Hi doctor thank you for taking the time to answering my questions. I have been very worried about this because i have always felt my symptoms are connected with my digestive tract but here in Canada my cardiologist doesnt aknowledge it. It drives my crazy because i feel like i have a irregular heart beat even when i wake up in the morning. He says my holter only showed some pacs which are benign and always in sinus rhythm. Its all confusing to me.
doctor
Answered by Dr. Klerida Shehu 3 hours later
Brief Answer:
Following advice.

Detailed Answer:
Hi back XXXX,

1. If the Holter monitoring showed only some pacs which resulted benign, then, nothing to worry about the heart problems.

2. The irregular heart beat you feel in the morning might be due to GERD and to stress hormones which are raised early in the morning and would provide the body with the energy it needs to carry the daily duties.

I still think there is nothing worrisome in here.

3. With regards to digestive problems, they can mimic symptoms, but after evaluation, no cardiac problem is found.

That's why you got a bit confusing. I advise to be more physically active and try to forget what you are experiencing. Psychological counseling can help.

Trying to control stress can also help improving your symptoms. Again, psychotherapy can be helpful.

Hope it was of help! Enjoy life!
Dr.Klerida
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
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Dr. Klerida Shehu

Gastroenterologist

Practicing since :2006

Answered : 2265 Questions

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