Can Stomach Issues Cause Heart Disease? Part 2: Roemheld Syndrome

Can Stomach Issues Cause Heart Disease? Part 2: Roemheld Syndrome

Roemheld syndrome is personal to me. I know the condition exists even with the little information out there provided to us.

Why do I believe in it so strongly? Because I suffered from it after my son Abel died and it was hell.

My son Abel had passed away a month before I felt the dreaded symptoms of Roemheld syndrome. My silent reflux had come back in spades from all the stress. All of a sudden no matter what I ate if I ate too much my heart rate would dip, then shoot up to 150+ bpm. My blood pressure would also go sky high. Why is this happening to me? I started to notice some patterns over time. When I drank water and when I burped, I felt better. When I took magnesium or had a bowel movement, I felt better. When I slowed my breathing and ate less, I also felt better. I did not know about Roemheld syndrome at the time, but I went on a restrictive low-FODMAP, low-acid diet. In a few months I lost weight and got my digestion under control, the symptoms disappeared.

Roemheld syndrome is well known in Germany, but not much of the known information is ascertained outside of the country. I hope I can use Fix Your Gut to spread awareness on this cruel, debilitating disease.

What Is Roemheld Syndrome and How Serious Is It?

Roemheld syndrome is also known as gastric-cardia syndrome and was discovered by Ludwig Roemheld in the 1930’s. Simply put it is a condition where poor digestive health leads to cardiac symptoms and issues. Ever felt a very low or very high heart rate during or after eating that was relieved by burping? You probably suffer from Roemheld syndrome.

Most of the following symptoms of Roemheld syndrome seem to occur after eating, especially a large meal. Some people have also reported their symptoms occur after strenuous activity, when excessive pressure is applied to their abdomen, or during sleep.

Here are the proposed symptoms of Roemheld syndrome:

  • Sinus bradycardia followed by sinus tachycardia
  • Hypotension followed by hypertension
  • Abnormal amount of premature ventricular contractions (PVC’s)
  • Arrhythmia (heart palpitations)
  • Chest pain (angina pectoris)
  • Anxiety
  • Syncope
  • GERD and / or silent reflux symptoms
  • Sleep disturbance
  • Fatigue
  • Weakness
  • Muscle cramps
  • Trouble breathing
  • Tinnitus
  • Hot flashes
  • Facial flushing
  • Vertigo
  • Visual snow
  • Atrial fibrillation
  • Coughing and throat clearing
  • Heart disease
  • Sudden cardiac death

The syndrome consists of both mechanical and neurological triggers. Mechanical triggers of the illness occur when pressure is placed on the fundus of the stomach or the esophagus. When the increased epigastric pressure occurs the diaphragm’s position is elevated and puts pressure on the heart and vagus nerve. Hiatal hernia’s are known to be a significant mechanical trigger of Roemheld syndrome.

The neurological conditions of the syndrome occur from increased vagus nerve pressure and misfiring. When the vagus nerve is compressed your heart rate and blood pressure decrease and in doing so the body’s autonomic nervous system is triggered creating a catecholamine dump into the bloodstream. The increased circulating catecholamines cause a massive increase in blood pressure and heart rate. Unless an underlying arrhythmia is triggered, the fluctuation from low to high cardiac pulses and pressure may be undetectable unless you are actively monitored during an attack and can be easily mistaken as anxiety. When an attack occurs, strong coronary reflexes happen, causing a lot of the cardiac symptoms associated with the syndrome and if the heart is stressed enough a heart attack may occur!

Over time the syndrome can lead to a weakening of the heart. It can cause arrhythmias to develop including atrial fibrillation and may cause heart disease and eventually heart failure.

Causes of Roemheld syndrome include:

  • Hiatal hernia
  • Abdominal hernia
  • Abdominal hernia repair (mesh)
  • Excessive gas in the abdomen (SIBO, lactose intolerance, fructose intolerance, food intolerance, uppergut infection)
  • Gas bloat syndrome (failure to burp)
  • Gastric bypass
  • Gallbladder issues
  • Being overweight

What Can Be Done To Help Recover From Roemheld Syndrome

Here are some tips to try to help reduce the issues from having Roemheld syndrome:

  • If your Roemheld syndrome is caused by a hiatal hernia, try to work on reducing it.
  • Reduce gas formation in the stomach and intestinal tract. Try to follow a low FODMAP diet throughout the week and a gluten free diet on weekends to see if that helps reduce gas buildup. Treat SIBO or an uppergut infection if you have it. Taking activated charcoal may reduce gas formation in the stomach and intestines. Taking digestive enzymes may help reduce gas formation. Make sure your stomach acid production is optimal.
  • Chew your food well and eat slowly. Do not over stuff yourself.
  • If you need to burp, make yourself by swallowing a little bit of water and try to burp. Most of the time making yourself burp relieves the symptoms of Roemheld syndrome.
  • Exercise regularly to strengthen your heart and supplement with magnesium and maintain proper intake of dietary omega 3 fatty acids to help reduce chances of developing serious heart arrhythmia.
  • Try to sleep on your back or side. Some people have fewer symptoms of Roemheld syndrome sleeping on their left or right side. Laying on the right or left side during an attack may provide instant relief. For most people laying on the right side seems to help more, even if that is counterproductive to sleeping recommendations individuals who have GERD.
  • Strengthen your diaphragm!

Limited Roemheld Syndrome Resources

Information is limited on Roemheld Syndrome so please if you find any relevant studies or books pertaining to the condition, leave a comment below. Thank you.

Book:

Websites:

Podcast:

Studies:

9 Comments
  1. Google Sanjay Gupta York Cardiology. Watch his videos, particularly the one on gastric-cardia. The guy is brilliant. Such a relief to find a doctor who does not scoff at this condition. It is clearly a VERY complex condition with a long list of triggers that vary person to person. Stress definitely is one or at least a contributor, but it is NOT a sole cause. Foods, drinks (caffeine, alcohol) are major contributors. You will need to carefully determine which you are more susceptible to. There is a lot of indirect research/info out there on food allergies and irritants which people with Roemheld clearly must be wary of. The important think is to rule out actual heart issues and then stop worrying about your heart and focus on the digestion, stress. Not much on it in the US, which is typical, since it is not a killer BUT Roemheld is REAL.

  2. I too have RS,that kicked in after my dad died.
    Stress is a huge part of this. But when you have the weight of the world crashing down on your shoulders what do you do?
    You slouch. Your breathing shallows out.
    With my Rs I also noticed what could be described as esophagus twitching. On slouching,the esophagous is compressed. The vagus nerve is compressed,the gas in the gut is compressed. And pushes.

    IMHO you cannot cure Rs without correct posture. Posture controls breathing.
    Now, read this.
    http://www.dpmartinjunghöfer.de/pdf/Breath%20Training%20for%20Roemheld%20Syndrome.pdf

  3. Two years ago I became very ill, with constant episodes of sudden dizziness, heart pounding, hot flushing, etc. I did ER visits several times and they had no explanation. It all went away and now it’s back with a vengeance. I’ve had miserable Gerd, and I feel sure I have a hiatal hernia causing all this by pressing on my heart and vagus nerve, but I just had an endoscopy and they didn’t see the hiatal hernia. I’ve read it’s very easy to miss it, if it’s a sliding hiatal hernia. I’m 57, and 30 pounds over weight – mostly in my belly. I can’t stress enough that these episodes feels life threatening, and my heart pounds and then suddenly struggles to continue beating. My blood work up showed low b-12 and d, so I started supplements. I am scared and wonder if weight loss would help. I had a bad cold this week with hard coughing and I swear I can feel something laying along my esophagus on the right side.

  4. Was referred to you from Bulletproof and came across this article. I’ve been Bulletproof for a few months with great benefits, but am burping quite a bit after morning coffee. I notice hot flashes after onions or fennel.
    Now, thinking it might be Roemheld brought on by sibo, I am trying to limit fodmaps, but the grass fed butter, BP coffee, BP vanilla, and xct oil are all low fodmap, and I still burp after it.

    I’m taking peppermint oil and probiotic, and it helps a little but not completely.
    Should I eliminate the oil?
    Go on a whey protein 3 day fast?

    Thanks!

  5. Hiya, I have just discovered the condition ‘Roemheld syndrome’ and am wondering if i have it..
    To cut a long story short, I have been feeling my heart stop followed by a sever dizzy spell followed
    by a few heavy heartbeats with a head rush then back to normal, this happens when swallowing (food feels stuck, just before stomach) or burping for want of a better word!
    I went to my Dr on more than 1 occasion and was always told to do more exercise
    and sent for a ECG that always comes back normal…
    I changed GP and when i mentioned these symptoms to my new Dr, she sent me for a 24 hour ecg monitor Thing! And after returning
    the device I received a call from my GP asking me to come and collect report and go strait to Hospital :0
    They discovered I get 3rd degree AV heart block lasting between 2 and 7.2 seconds!
    I received a pacemaker but while I was in hospital to have the procedure I was hooked to an ECG Monitor for a few
    days and could tell when the AV Heart block was about to happen… After I swallow food of burp… I mention this
    to the cardio dr who said: “I cant stop you from swallowing food, you need this pacemaker.
    Sorry for the long winded post but am wondering what you all think with re to my symptoms and ‘Roemheld syndrome’. I am due to see a gastro Dr for some further tests next week… I have already had a Endoscope (+6 biopsy’s) which all came back clear. On this visit i am to undergo a particular test that involves a tube being inserted into a nostril and down into my stomach which will then measure contraction of oesophagus? And a 24 hour acid monitor…. I am scared as nobody seems to believe me when I say that my Difficulty swallowing food AND 3rd degree AV Heart Block that I experience ARE INDEED LINKED. 100%
    any thoughts will be very much appreciated

    Thanks :)

    • I agree with you that you are probably suffering from Roemheld syndrome. I would look into uppergut overgrowth causing the issue like H. pylori, Citrobacter, or Proteus mirabilis. I would look into reducing uppergut overgrowth and maybe trying to test for it by getting a GI Effects test or http://biohealthlab.com/test-menu/parasites-and-pathogens/gi-pathogen-screens-401-401h/ for H pylori. I would talk to your doctor about taking magnesium and ubiquinol / PQQ for your heart and make sure your 25-hdroxy (vitamin D,) 1-25 hydroxy, and vitamin b12 levels are normal. Good luck!

  6. Hi John
    This sounds familiar to me. I think that I have experienced this on occasion, especially after going through two pregnancies in two years, which I know severely weakened my abdominal muscles (affecting the diaphragm)? When digestive health is optimal (zinc plays a big role in that for me), all is well. And, in fact, I can’t say that I’ve experienced this so much in the past couple of years. I have a slight abdominal bulge from the pregnancies that comes and goes (I had diastasis after both pregnancies. I’ve also noticed that it goes when my core is strong and my posture is correct), and I have had numerous people in healthcare positions tell me that it’s not a hernia. I don’t know, but i have seen it disappear and reappear with correlations to how I am feeling overall. My question is: would core strengthening exercises be helpful for this condition?
    Thanks so much.

  7. Hi John,

    This sounds like me to a T. I’v seen 3 cardooglists and done almost every heart test short of a catheterization with no explanation for my chest pain, palpitations, shortness of breath and other symptoms. I do have a lot of upper GI symptoms including burping and bloating and will be seeing a gastroenterologist soon to check for a possible hernia or infection.

    • Hi there i would like to share a remedy for roemheld syndrome see if it can help..coz it has helped me to..take some black mustard seeds and dry roast them in a pan and as they start popping up put some water immediately and then filter this water removing the mustard seeds and drink this water..atleast one glass..

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