Cardio-vascular events at defecation: Are they unavoidable?

Sikirov, B.A.

doi:10.1016/0306-9877(90)90128-2

Cited by 17 publications

(14 citation statements)

References 12 publications

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“…In contrast to Western countries, in Asian and African countries, their dietary habits and use of a squatting posture might contribute to the very low incidence of hemorrhoids, constipation and diverticulosis 9,20 . In addition, lower abdominal pressure on squatting defecation might reduce the risk of defecation syncope, 21 deep vein thrombosis, 22 and stroke 23 . Therefore, a new toiletry commode incorporating both Western and Eastern approaches is anticipated.…”

Section: Discussionmentioning

confidence: 99%

Influence of Body Position on Defecation in Humans

Sakakibara

Tsunoyama

Hosoi

et al. 2010

LUTS: Lower Urinary Tract Symptoms

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Section: Discussionmentioning

confidence: 99%

Influence of Body Position on Defecation in Humans

Sakakibara

Tsunoyama

Hosoi

et al. 2010

LUTS: Lower Urinary Tract Symptoms

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“…Several authors believe that the occurrence of CA on the toilet is the consequence of severe defecation/micturition syncope [15]. In patients with defecation/micturition syncope, a paradoxical decrease in blood pressure during straining occurs due to imbalance between sympathetic and parasympathetic autonomic function, which may in turn cause decreased cerebral blood flow and loss of consciousness [15][16][17][18]. Both increased extra-cardiac vascular events after suddenly elevated blood pressure and increased cardiac events after imbalance between sympathetic and parasympathetic nerves may be responsible for the disproportionally high frequency of CA while an individual is in the toilet.…”

Section: Discussionmentioning

confidence: 99%

Cardiac arrest in the toilet: clinical characteristics and resuscitation profiles

Inamasu

2012

Environ Health Prev Med

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Objectives The great majority of non-traumatic cardiac arrests (CA) occur at home. The toilet is a closed and private room where CA occurs frequently. However, due to the feelings of privacy that are associated with this room, the circumstances and causes of CA in the toilet have rarely been investigated. Methods A retrospective study was conducted to clarify clinical characteristics and resuscitation profiles of patients sustaining CA in the toilet. Results Among 907 CA patients treated during a 4-year period, 101 (11 %) sustained CA in the toilet. While the collapse was witnessed in only 10 % of these patients, return of spontaneous circulation (ROSC) was achieved in 41 %. However, the long-term survival rate was 1 %. Multivariate regression analysis revealed that a history of cardiac diseases was predictive of CA in the toilet (odds ratio 3.045; 95 % confidence interval 1.756-5.282) but that there was no correlation with advanced age. The frequency of CA in the toilet may be influenced moderately by seasonal/circadian variations. The 101 patients were classified into four subgroups according to mode of discovery of CA. The frequency of ROSC was highest in those who collapsed in the presence of caregivers and lowest in those whose collapse were discovered later by family members being worried that the patient stayed in the toilet ''too long.'' Imaging studies revealed life-threatening extra-cardiac lesions responsible for CA, such as subarachnoid hemorrhage and aortic dissection, in 23 % of the patient cohort. Conclusions The rarity of long-term survival among individuals sustaining CA in the toilet is mainly due to the delay in discovering the individual who collapsed. Although a history of cardiac diseases is a risk factor, predicting who may sustain CA in the toilet remains difficult due to etiological heterogeneity.

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“…6 There is a common agreement that VM has adverse effect on cardiovascular system and is one of the causative factors for defecation syncope and sudden death in elderly individuals. [7][8][9] The VM associated with the act of defecation/micturition may be considered as one of the triggering factor for cardiovascular incidence in compromised cardiovascular disease population. 10,11 Normal defecation consists of three components: Spontaneous phasic rectal contraction, relaxation of the anal canal, and straining (somatic component).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Response to Defecating Postures with and without Valsalva Maneuver in Healthy Individuals

Physiother

Jiandani

Mehta

2016

IJRSMS

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Aims: To assess the cardiovascular response to defecating postures of bridging and sitting lean forward with and without Valsalva maneuver in healthy individuals. Study design: Prospective interventional cross-over study in healthy population. Study material: Stop watch, Rubber tube, Nostril clip, Pillow, Mercury Sphygmomanometer, Cardioscope (Model no.: Iris 50, Maestros company). Materials and methods: A total of 100 healthy individuals participated in the study. They maintained sitting lean forward and in bridging position for 5 minutes with and without Valsalva maneuver. Valsalva maneuver was performed at 40 mm Hg pressure for 15 seconds. Blood pressure and heart rate were recorded. Mean arterial pressure and rate pressure product were derived. Data analysis: The data was analyzed using Statistical Package for the Social Sciences v 16. Shapiro–Wilk test was used to test normality, and nonparametric Mann-Whitney test was used with p < 0.05 as statistically significant. Results: Sitting in lean forward position showed statistical significant increase in heart rate (p < 0.05) compared to bridging position with Valsalva maneuver. There was a significant rise in blood pressure with bridging as compared to sitting lean forward with Valsalva. There was no statistically significant difference in heart rate and blood pressure between sitting lean forward position and bridging position without Valsalva maneuver. Conclusion: Sitting lean forward position and bridging position increase hemodynamic load compared to relaxed sitting posture. With Valsalva maneuver sitting lean forward posture causes greater rise in heart rate compared to bridging position.

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Cardio-vascular events at defecation: Are they unavoidable?

Cited by 17 publications

References 12 publications

Influence of Body Position on Defecation in Humans

Influence of Body Position on Defecation in Humans

Cardiac arrest in the toilet: clinical characteristics and resuscitation profiles

Cardiovascular Response to Defecating Postures with and without Valsalva Maneuver in Healthy Individuals

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