In this update to my article on the Hiatal Hernia/Vagus Nerve Disorder Syndrome, (1) I will emphasize two new, related matters. One is a common, but serious additional stomach/esophagus anomaly that may actually be causing some of the problems attributed to the hernia itself. The second matter is a possible causative factor to this whole syndrome that is relatively unknown--the Esophageal Longitudinal Muscle Contraction!
The Lower Esophageal Sphincter, or Schatzki's Ring
As detailed in my earlier article, the Hiatal Hernia Syndrome can (eventually) cause serious illness including respiratory and cardiac symptoms, and appears to be present in most sufferers of food and chemical allergies. (2) But some of these complaints may be caused by the so-called Schatzki's ring, and not the hernia itself. You can have either condition and not the other, or you may have both--as is common. Schatzki's ring is a disorder of the Lower Esophageal Sphincter (LES). The LES acts like a valve between the esophagus and the stomach. Schatzki's ring may be thought of as a hardened, thickened, multi-fold, scar-type tissue. If this ring is present, the LES does not function properly. It may be open when it should be closed--causing reflux (GERD); or it may be closed when it should be open. The latter condition can then lead to food being trapped above the ring. There may be constriction. Trapped food or spasms of the esophagus can then cause serious problems including breathing difficulty (asthma, etc.) and tachycardia and other arrhythmias. The LES (Shatzki's) Ring (as well as an Hiatal Hernia) shows up on X-ray (upper GI series) or during an endoscopy (EGD). Thus it is important to have either test if you have stomach complaints or food or even chemical or electromagnetic sensitivities. As stated in my previous article, once the Vagus nerve is under- or over-excited, the entire body is in great imbalance, and almost any organ can malfunction as many visceral organs are innervated by a branch of the Vagus (Para-sympathetic) Nerve. Also this can make the person sensitive to any environmental factor as well as possibly deplete or weaken the adrenal glands, thyroid or liver.
Some foods are more likely to get trapped (stuck) at the LES Ring, if present. These include breads and fibrous (tough) meats. Dry foods (like bread) can be a problem, but wheat, beef (or other) allergy may also be a factor. (Or this may be a purely mechanical problem, or contain elements of both allergy and mechanical anomalies.) "Steakhouse Syndrome" is the nickname Emergency Room personnel have given this syndrome when people come in with "high" anxiety, or respiratory or cardiac, or cardiac-like symptoms due to trapped food at the Lower Esophageal Sphincter. Steaks and bagels seem to be the worst, but any hard food or even drug or vitamin tablets or capsules can also get stuck! The person likely has some occasional swallowing difficulties. Foods may need to be pureed in advanced cases. Peristalsis is impaired in those with Schatzki's Ring. In the E.R., sometimes an emergency endoscopy and food or tablet removal has to be performed. Endoscopic stretching of the ring is also standardly recommended whenever Schatzki's Ring is found and when the person also has any swallowing difficulty or other complaints described above. This is facilitated by a choice of instruments inserted into the esophagus, including a balloon, telescoping device, or Bougie. Breaking (stretching) the ring is supposed to be a simple, relatively riskless procedure. Many people report great improvement in their health after this. The downside is that many of these people report that it only lasts six months to a year. Some people get it done every year.
Townsend Letter for Doctors and Patients, Jan, 2004 by Steven Rochlitz