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Gastroenterology (Expert Forum)
arrythmia § burping
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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arrythmia § burping
by flutterz, Jan 06, 2004 12:00AM
This is in reply to an earlier thread, and I would like to raise the topic again.
"I often have what feels like flutters also, but after carefully observing realized they ussually are followed by a belch."
You may be 'relieved' to know that I have this exact same problem! Every few weeks to months I get incidents of arrythmia that are coincedent with the feeling of small gas bubbles rising in my throat. When I burp these little bubbles out the arrythmia stops immediately. Sometimes to be followed by the same cycle a minute or so later. It can happen for just a few minutes or off and on for a day or two. I've found that taking antacids usually calms it significantly or lacking that sometimes just drinking a cola helps. (the big burps seem to chase the litte ones away) So I've come to the conclusion that it has something to do with reflux, like tickling a nerve in the throat somewhere that then affects the the heart's rythm.
Generally it doesn't affect me in a serious way, although I have had 3 or 4 cases when the sputtering was so intense that I had to sit or lay down until it (the burps) passed. I also understand what you mean about the panic effect since it can come on suddenly and is a very disturbing sensation.
By the way I have talked to two GI doctors about this and I'm not sure either believed me. Both scratched their heads and wanted to refer me to a cardiologist, and I can understand that, but I have declined. I have no history of heart disease in my family, am in pretty good shape, and am also currently dealing with mild adult onset Crohn's so I already have my fill of exams and probings. It was in fact a visit to my GP about this arrythmia 10 years ago that led to the discovery that I was anemic and eventually the Crohn's. The bouts of arrythmia have actually decreased over this period because I am now more discretionary about what I put in my GI tract. No more hard to digest or spicy foods, etc. I attribute this to less reflux and hence fewer flutters.
I'm glad to know I'm not the only one in the world with this strange problem.
To the doctors: Does this condition have a name so that I can impress my regular GI doc who seems to think I've lost my marbles?
Thanks,
flutterz (male, 35)
"I often have what feels like flutters also, but after carefully observing realized they ussually are followed by a belch."
You may be 'relieved' to know that I have this exact same problem! Every few weeks to months I get incidents of arrythmia that are coincedent with the feeling of small gas bubbles rising in my throat. When I burp these little bubbles out the arrythmia stops immediately. Sometimes to be followed by the same cycle a minute or so later. It can happen for just a few minutes or off and on for a day or two. I've found that taking antacids usually calms it significantly or lacking that sometimes just drinking a cola helps. (the big burps seem to chase the litte ones away) So I've come to the conclusion that it has something to do with reflux, like tickling a nerve in the throat somewhere that then affects the the heart's rythm.
Generally it doesn't affect me in a serious way, although I have had 3 or 4 cases when the sputtering was so intense that I had to sit or lay down until it (the burps) passed. I also understand what you mean about the panic effect since it can come on suddenly and is a very disturbing sensation.
By the way I have talked to two GI doctors about this and I'm not sure either believed me. Both scratched their heads and wanted to refer me to a cardiologist, and I can understand that, but I have declined. I have no history of heart disease in my family, am in pretty good shape, and am also currently dealing with mild adult onset Crohn's so I already have my fill of exams and probings. It was in fact a visit to my GP about this arrythmia 10 years ago that led to the discovery that I was anemic and eventually the Crohn's. The bouts of arrythmia have actually decreased over this period because I am now more discretionary about what I put in my GI tract. No more hard to digest or spicy foods, etc. I attribute this to less reflux and hence fewer flutters.
I'm glad to know I'm not the only one in the world with this strange problem.
To the doctors: Does this condition have a name so that I can impress my regular GI doc who seems to think I've lost my marbles?
Thanks,
flutterz (male, 35)
Doctor's Answer
by Kevin Pho, MD, Jan 07, 2004 12:00AM
, Jan 07, 2004 12:00AM
I am not aware of a single condition that unifies the symptoms of flutters and reflux. It is possible that the reflux may lead to palpitations or flutters. It is also possible that they have no relation.
To further investigate the palpitations, I would suggest an event monitor. This is a portable device that is worn. When the palpitations occur, a button is pressed and the heart rhythm at that time is recorded and later read by a cardiologist. If there are any irregular rhythms, it would most likely be caught using this device.
Regarding investigating the reflux, an upper GI series can investigate this as well as a 24-hr pH study. Optimal treatment with a proton pump inhibitor should be considered if GERD is present.
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.
Thanks,
Kevin, M.D.
To further investigate the palpitations, I would suggest an event monitor. This is a portable device that is worn. When the palpitations occur, a button is pressed and the heart rhythm at that time is recorded and later read by a cardiologist. If there are any irregular rhythms, it would most likely be caught using this device.
Regarding investigating the reflux, an upper GI series can investigate this as well as a 24-hr pH study. Optimal treatment with a proton pump inhibitor should be considered if GERD is present.
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.
Thanks,
Kevin, M.D.
http://www.mercola.com/2003/sep/13/inflammatory_bowel_disease.htm
Medscape article
GERD Linked to Lone Paroxysmal Atrial Fibrillation
Laurie Barclay, MD
Dec. 12, 2003 — Gastroesophageal reflux disease (GERD) may be a causal factor for lone paroxysmal atrial fibrillation (PAF), according to the results of a pilot study published in the November issue of the Southern Medical Journal. The investigators suggest that GERD should be investigated as a potential pathogenetic mechanism of lone PAF."Clinical observations and a case report in the literature suggest that
GERD may induce atrial fibrillation and that therapy of GERD decreases the frequency of attacks of PAF," write Manuela Weigl, MD, and colleagues from the Krankenanstalt Rudolfstiftung in Vienna, Austria. "Since proton pump inhibitors (PPIs) have fewer side effects and are less expensive than antiarrhythmic drugs or electrotherapy, therapy of GERD in patients with PAF might be an attractive alternative to the conventional and often not completely successful therapy of PAF."
Record review of 89 patients with reflux esophagitis revealed that 18 had lone PAF, including six women. Age range was 39 to 69 years.After PPI therapy, 14 (78%) of 18 patients experienced a decrease or the disappearance of at least one PAF-related symptom, and all had sinus rhythm on follow-up electrocardiogram. None of the patients required an increase in dose or addition of antiarrhythmic drugs, and five patients were able to discontinue their antiarrhythmic drugs.In two of the four patients who did not show improvement in PAF symptoms after PPI therapy was started, GERD-related symptoms persisted.Study limitations include small number of patients, the retrospective design, the lack of a control group, and possible placebo effect
"In lone PAF, GERD should be investigated as a potential pathogenetic mechanism," the authors write. "PPI therapy reduces not only GERD-related but also PAF-related symptoms."
South Med J. 2003;96:1128-1132
Reviewed by Gary D. Vogin, MD
PAJ, that's a very interesting article on fungus and Crohn's. Interesting because I have always believed I contracted it and am even willing to go out on a limb and speculate on possibly how. I've always wondered about this. About a year before it was suspected that I had Crohn's I did something very dumb while under the influence of too many drinks at a bar. I only marginally remember it and the gaps were filled in later by some friends. But to keep it short on a bet I wrestled a dirty bar rag out of the mouth of the proprietor's dog with my bare teeth. It was all great fun at the time. But over the next few days I developed some very nasty GI problems with intense stomach cramps. I was prescribed some antibiotics among other things and it cleared up for the most part after a few days. But my system was never quite 'normal' after that episode and then about a year later, voila. Crohn's diagnosis.
Maybe it was just pure coincedence. I always thought it was far fetched given the information on the disease I've read. But articles like this always make me wonder.
I just turned 34 years old and consider myself to be in good general health. I work out regularly and eat well. I took an IG4 allergy test which is a delayed sensitivity allergy reaction test and found that I am allergic to wheat. If I eat bread, pasta, etc. I have a difficult time digesting, and my heart rhythm changes, creating APC's or PVC's (flutters) until my digestive system settles down. This worsens greatly with the addition of stress. So here is my equation for heart flutters. Please respond to this post if you are suffering from a similar problem.
WRONG FOODS + STRESS = POOR DIGESTION, CREATING "FLUTTERS"
I have been convinced for a long time that gas or reflux of undigested food is creating pressure on nerves that effect the hearts rhythm. I appreciate all of your posts and will be happy to answer any questions if I can. And...Thanks for the ear.
-Dr. Dean
Couple of articles from Washington University.
http://aisweb.wustl.edu/alumni/atwu.nsf/crohns
http://mednews.wustl.edu/medadmin/PAnews.nsf/0/5F8C6B997674B6C886256C68006F4873
I came accross this by accident while seaching for arrythmia topics.
I have had Ventricular pvc's for over a year that i know of I take metoprolol 75mg 3x day, and after lots of tests i was fitted with a AICD , its only gone off 4 times the day after it was fitted due to a faulty lead :-(
Anyway regarding the burping, I get arrythmia several times a day and if I burp it gets better or goes away??
I get arrythmia a lot after food, and if i am sitting? sounds strange i know, I dont recall getting it walking? stress has brought a couple of dizzy spells on (VT)maybe the sitting position sqaushes some nerves??
Any ideas
Andy