Recently, the OANP held it's monthly meeting with Dr. Steven Sandberg-Lewis, who covered the topics of hiatal hernia and ileocecal valve syndromes.  This CE presentation was inspired by Dr. SSL's new book on functional disorders of the gastrointestinal system.  Functional problems are often seen in natural medicine because they are a manifestation of the body's normal activities.  Although the GI may have problems caused by hypersensitive innervation, abnormal perstalsis or even central nervous system impairment, functional disorders are elusive due to normal blood tests, endoscopy and imaging studies.  This can easily lead to misdiagnosis and chronic systemic health problems.

Image courtesy Maligering's photostream

What exactly are ileocecal valve and hiatal hernia syndromes?  Here are a few definitions from Dr. Steven Sandberg-Lewis to get you started:

"Hiatal hernia syndrome occurs when upward pressure of the proximal stomach against the diaphragmatic hiatus leads to a host of symptoms - often incorrectly credited to various lower esophageal, respiratory, psychoemotional or cardiac etiologies. Common symptoms include reflux, anxiety attacks, limitation of full respiration, and globus phenomenon. The epigastric sensations may range from fullness and pressure to pain mimicking peptic ulcer, angina pectoris or myocardial infarction. Treatment involves visceral, fascial and spinal manipulation, simple exercises and breath training. Relief is immediate and usually long lasting or permanent.
    More details may be found in an article in the Townsend newsletter and in SS-L’s soon to be published textbook – Functional Gastroenterology – Assessing and Addressing the Causes of Functional Gastrointestinal Disorders (NCNM Press). Chapter 8 is dedicated to Hiatal Hernia Syndrome.
  

 Ileocecal valve syndrome is a functional disorder of the valve which controls the flow of chyme from the small to the large bowel. In the hypotonic or “open” version, patients may be prone to small intestinal bacterial overgrowth, since colonic flora is more likely to reflux into the ileum and diarrhea is the most common finding. In the hypertonic or “closed” version, constipation is the rule. Other common sx/signs that may be misdiagnosed as systemic, musculoskeletal  or neurological include a flu-like syndrome, right shoulder pain, carpal tunnel syndrome, nausea, non-cardiac chest pain, tinnitus, dizziness, headache, neck and back pain. Treatment involves visceral, fascial and spinal manipulation, dietary modifications and nutritional supplementation of chlorophyll, minerals, adrenal supportive measures or enzymes.
    More details on ICV syndrome are found in chapter 11 of his new textbook. Both syndromes are also covered in detail in SS-L’s elective NCNM course entitled “Gastroenterology Laboratory” and his weekend CE course “Functional Gastroenterology Level I.”

It's important to recognize the functional disorders of the human body before they manifest themselves into disease.  Many patients are overlooked and misdiagnosed with these syndromes causing needless long term suffering.  By investing our time into learning more about GI functional disorders we can make significant improvements in our patients' health.

Written by Dr. Steven Sandberg-Lewis

(Introduction by Leah Olsen)