Dennis’ medical history is a common scenario; marked worsening of autonomic nervous system function because of intense emotional trauma. Emotional trauma is a well-known phenomenon and, in its worse form, known as a takotsubo event, can sometimes be fatal (e.g., “dying of a broken heart”). Prior to Michael’s death, Dennis’ history was indicative of mild autonomic dysfunction from cumulative brain injury because of chronic neuroinflammation, most likely stemming from bacterial translocation (leaky gut) due to small intestine bacterial overgrowth (SIBO).
Whether it be from physical, emotional, or inflammatory insults, brain traumas commonly cause two different mechanical issues, which account for a variety of symptoms. The first is a decrease in blood pressure in the head and neck region. Low blood pressure makes it difficult for red blood cells to release oxygen into the tissues and thereby causes the tissues not to work correctly. If a muscle does get enough oxygen, it causes pain, and this is the cause of Dennis’ neck pain which is often referred to as coat hanger pain. Lack of oxygen released into the scalp muscle is increasingly believed to be the cause of most headaches, including migraine headaches. It also can lead to pain and tightness in the jaw muscles, mimicking the symptoms of TMJ. Lack of oxygen into the brain tissue is the cause of Dennis’ lightheadedness and worsening focus. Poor brain oxygen delivery can also cause altered balance, anxiety, increased hunger, increased thirst, abdominal pain, air hunger, foot tapping, and other fidgety behaviors.
The second mechanical effect of brain injury is that the forward motility action of the intestinal tract slows down. Each segment of the intestinal tract has unique symptoms suggesting its forward propulsion of intestinal contents has slowed. The esophagus will lead to the sticking of both liquids and solids, while decreased stomach motility can trigger nausea, post-meal vomiting, heartburn, and reflux. Slow motility of the small intestine can trigger IBS-like cramping, but many times, there are no direct symptoms, only the frequent occurrence or relapsing of SIBO. And slow motility of the colon leads to constipation.
If the nervous system is functioning properly, the injury that results in any of these symptoms will be fully repaired within a few weeks to months, and the symptoms would completely resolve except for if SIBO was triggered, this would need treatment with rifaximin or another antibiotic regimen to reverse. Unfortunately, Dennis’ symptoms for particular food intolerance is a common sign of leaky gut from SIBO, which commonly results in high levels of systemic and central nervous system (CNS) inflammation as well as priming of M1-microglia white blood cells within the CNS. Both persistent CNS inflammation and M1-microglia priming prevent brain traumas from recovering completely. There were signs of early autonomic damage in Dennis’ history, with the gradual worsening of his neck tightness and pain, which are manifestations of coat hanger pain.