Abdomino Phrenic Dyssynergia Symptoms, Causes, Test, Treatment

Abdomino-phrenic dyssynergia is a condition in which the gastrointestinal system does not function normally. The digestive system of the patient in this condition functions opposite to the normal. It involves contracting of diaphragm muscles and relaxing of abdominal muscles. Thus, the coordination between these two muscles is disturbed.

This dysfunction causes constipation, abdominal distention, and bloating in patients. Bloating in the abdomen affects 10% to 25% of healthy adults. The motility and movement of the gastrointestinal system are affected or slowed in this condition. 

As a result, the peristaltic action of the intestines and stomach-churning are affected. An abdomino-phrenic dyssynergia is caused by a brain-gut reflex and this condition is manifested by the bloating and distension of the abdomen. The patient does not have to show both symptoms at the same time. They both can occur independently. 

Abdomino-phrenic Dyssynergy develops when the brain, through the phrenic nerve, is unable to regulate the appropriate motion of the diaphragm in response to the fullness of the belly (abdominal muscles), resulting in stomach pain and bloating. In this condition, the volume of food is unable to travel through the gastrointestinal tract on time, resulting in reduced transit time.

Abdomino-phrenic Dyssynergia Symptoms

The most common symptom of this abdomino-phrenic dyssynergia is bloating. This symptom is highly common in people with various functional gastrointestinal disorders (FGIDs) and irritable bowel syndrome (IBS), as well as in patients with organic diseases.

Bloating can range from minor discomfort to severe discomfort. The patients are mostly bothered by this symptom. Bloating can irritate the patients and can be proved fatal to their life.

The other symptoms include the following complaints of the patients suffering from this disease:

1. A distended stomach that does not improve with diet or exercise adjustments.
2. Excessive gas in the stomach.
3. Bloated and unpleasant feeling in the stomach.
4. Pain in Abdomen.
5. Constipation.

Abdomino-phrenic Dyssynergia Causes

Dyssynergia of the abdomen and the phrenic nerve occurs when the diaphragm and the abdominal cavity are not synchronized. 

The digestion of the food, in this case, becomes difficult for the patient because the abdominal cavity and the diaphragm do not function properly. Thus, severe abdominal pain and constipation are the results of this dysfunctional coordination of the diaphragm and the abdominal cavity.

Some of the other causes of APD are as follows:

1. Small intestinal bacterial overgrowth.
2. Dietary intolerances.
3. Abdominal air build-up.
4. Visceral hypersensitivity.

Abdomino-phrenic Dyssynergia Test

APD is mostly diagnosed through:

1. Simple, affordable, and non-invasive breath tests are conducted to check whether the patient has developed any symptoms of APD.
2. An in-depth look at the spine, pelvis, abdominal and pelvic muscles, and viscera (organs) of the abdomen and pelvis.
3. A pelvic floor muscle test that may involve surface EMG (Electromyographic ) biofeedback and a comprehensive orthopaedic lower quarter evaluation.
4. The gastrointestinal functions can be evaluated through a wireless motility capsule or scintigraphy to check whether the patient is constipated or not. 
5. CT or MRI enterography for individuals with constipation.
6. Serologies for celiac disease to evaluate if wheat and gluten malabsorption are present.

A pelvic floor physiotherapist who is skilled in this area can evaluate the abdominal and pelvic muscles for function. An internal assessment of the pelvic floor muscles may be performed to check for muscle tone, weakness, or tightness, as well as synchronization of movements.

Abdomino-phrenic Dyssynergia Treatment

The treatment options are given by the therapists, after identifying the areas of rehabilitation. The treatments that are mostly prescribed by the medical professionals include biofeedback with esophageal probes, central neuromodulators, and rebreathing procedures. Central neuromodulators are a common strategy for reducing visceral hypersensitivity and improving brain regulation of the experience, which results in patients experiencing less bloating and discomfort after treatment. Bloating can be alleviated or at least decreased to a lower degree if the underlying cause of brain-gut imbalance is addressed.

The other treatment options for Abdomino-phrenic dyssynergia are as follows:

1. Therapists use manual therapy to help diaphragm structures move better.
2. Spinal and pelvic girdle manual treatment.
3. Exercises to improve the function and coordination of the diaphragm and abdominal wall, which help in breathing.
4. Massage of the intestines and abdomen.
5. Breathing and mindfulness exercises.
6. Biofeedback.
7. Changes in diet, exercise, and posture.
8. Proper toileting habits and tactics to avoid muscular tightening throughout the day as well as stressing.
9. Global muscle relaxation techniques.
10. Incorporating manual therapies and particular breathing exercises into a daily routine can help in achieving a more balanced movement of the diaphragms.
11. Using a manual method known as visceral manipulation, patients can assist their digestive organs to regain their normal motility and motion.
12. Techniques for taping.
13. Using the nerve flossing technique.