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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 57077
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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I have a very unusual situation that I believe is being caused

Resolved Question:

I have a very unusual situation that I believe is being caused by an impinged / damaged vagus nerve. I have thoracic outlet syndrome on both sides (former wrestler) and have had a first rib dissection on the right 10 yrs ago that was extremely successful. So basically I know my vagus (along with vascular) are being impinged.

My question relates to an unusual symptom of immediate adominal distention (30-60 seconds to distend as far as skin allows) whenever I utilize my shoulder in say swimming or golf. I also experience the dissension nightly, typically about 2-3 hrs after I lay down. I do not get the effect if I sleep in a chair. This distension is accompanied by a rapid increase in heart rate (65 sitting to 130 in same 60 seconds). Lastly, stress / excitement (good or bad) is also a trigger.

I have no gastrointestinal issues whatsoever and have had EVERY test available. Have you ever seen a vagus nerve impingement create this type of effect? Could it theoretically create this effect given its control of the smooth stomach muscles and parasympathetic nerve system? Look forward to hearing thoughts.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 1 year ago.

Dr. Thomas, MD :

Hello from JA

Dr. Thomas, MD :

No

Dr. Thomas, MD :

Thoracic outlet would not cause vagal impingement.

Dr. Thomas, MD :

Vagal nerve stimulation would typically slow the heart

Dr. Thomas, MD :

The general abdominal distension is to non specific to attribute this to vagal stimulation

Dr. Thomas, MD :

are you there?

Dr. Thomas, MD :

can you enter chat?

Dr. Thomas, MD :

standing by

Customer: Yes - I am here. But if the vagus nerve runs thru the thoracic outlet, how could it not get impinged?
Customer: if not Vargal nerve damage, what could possibly cause such rapid distention? I also have pretty severe neck vertebrae compression if that is relevant.
Dr. Thomas, MD :

not likely

Dr. Thomas, MD :

The vagal nerve has many divisions and redunancy

Customer: I believe the heart rate increase is due to both compression on diaphragm and general distress that comes from inability to breathe easy
Dr. Thomas, MD :

This is not the area that would cause gastric disturbance

Dr. Thomas, MD :

We don't see this from thoracic outlet

Dr. Thomas, MD :

I am sure your MDs have not suggested this

Dr. Thomas, MD :

It is something else medically speaking

Customer: Interesting - so have you ever heard of such a thing? What could be cause? Again, I have been tested for carcinoid, adrenele rumors, all the related gastro desire sets - I am clear on all.
Dr. Thomas, MD :

IBS, irritable bowel syndrome; this can be affected by anything from anxiety to exertion.

Dr. Thomas, MD :

Just one possibility

Customer: Gastro Diseases / issues - sorry
Dr. Thomas, MD :

have you had scopes?

Customer: That would america sense but I have no symptoms whatsoever of IBS - no Gers, no vomiting, no pain, no stomach ache, no diarrhea, no constipation. Everything works perfectly
Dr. Thomas, MD :

IBS can be diarrhea, constipation, or distension, or all of them

Customer: All scopes - endo, colon, barium swallow X-rays, stomach biopsies - all perfectly normal.
Customer: It is a rapid production of gas. Eventually clears thru forced belching and eventual flatulance
Dr. Thomas, MD :

OK

Dr. Thomas, MD :

Not thoracic out let

Customer: Stomach does however stay swollen (inflamed?) for a few hours after episode
Dr. Thomas, MD :

Have you had an h pylori test

Dr. Thomas, MD :

hydrogen breath test?

Customer: No - have never heard of those. Was checked for all parasites, bacteria, etc if that is related to h pylori
Dr. Thomas, MD :

h pylori is the stomach bacteria, diagnosed with a urea breath test

Customer: Gotcha - so in summary, you would orient more towards a bacterial issue in the stomach itself? Odd, because it is not related at all to anything I eat. No correlation with certain type of food or eating at all. And comes on so suddenly. Strange
Customer: Very distressful
Dr. Thomas, MD :

I would check

Dr. Thomas, MD :

urea breath test for h pylori

Dr. Thomas, MD :

hydrogen breath test for small bowel overgrowth

Dr. Thomas, MD :

3 stool samples for giardia

Dr. Thomas, MD :

All produce gas

Dr. Thomas, MD :

The idea of nerve compressions is a chiropractic concept

Dr. Thomas, MD :

You might want to consider that evaluatoin

Dr. Thomas, MD :

evaluation

Customer: ok - will do. Last question and I will let you go. A damaged vagus nerve is related to anxiety - could the stomach distention just be an unusual symptom of anxiety?
Dr. Thomas, MD :

Yes

Dr. Thomas, MD :

Vagal effects are wide spread

Dr. Thomas, MD :

But the idea that neck compression would cause GI distension is a big stretch

Dr. Thomas, MD :

medically speaking

Customer: Interesting - good stuff. thank you. You were very helpful! I love modern technology :)
Dr. Thomas, MD :

If it were true, it should get better with structural treatment

Dr. Thomas, MD :

any time

Dr. Thomas, MD :

you are welcome

Dr. Thomas, MD :

find me by request

Dr. Thomas, MD :

Please let me know if you have further questions.


Please don’t forget a positive rating.

Customer: Will do - have a great night
Dr. Thomas, MD :

you too

Dr. Thomas, MD :

take care

Dr. Thomas, MD :

dt

Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 57077
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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