Abnormalities of sympathetic and parasympathetic autonomic function in subjects with defaecation syncope

Abstract

Symptoms of syncope on defaecation are associated with autonomic failure. With appropriate therapeutic intervention our subjects all improved.

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

“…431,[433][434][435][436] Evidence for treatment is limited mainly to case reports, small case series, and small observational studies. 431,[433][434][435][436] Treatment of most types of situational syncope relies heavily on avoidance or elimination of a triggering event. This may not always be possible, so increased fluid and salt consumption and reduction or removal of hypotensive drugs and diuretics are encouraged where appropriate and safe.…”

“…[431][432][433][434][435][436][437] Appropriate investigations should be undertaken to determine an underlying etiology, including causes that may be reversible. 431,[433][434][435][436] Evidence for treatment is limited mainly to case reports, small case series, and small observational studies. 431,[433][434][435][436] Treatment of most types of situational syncope relies heavily on avoidance or elimination of a triggering event.…”

Clinical Characteristics of Defecation Syncope Compared With Micturition Syncope

“…3 Sympathetic and parasympathetic autonomic nerve dysfunction have been reported in patients with DS. 4 An irritable GIT could influence the autonomic nervous system and contribute to the occurrence of DS. GIT symptoms, specifically abdominal cramps and a strong urge to defecate with or without diarrhea, may be important predictors or triggers for DS.…”

Out‐of‐hospital cardiac arrests in the toilet in Japan: a population‐based descriptive study

“…This is particularly true in patients with diabetes mellitus or those with a history of heart disease . In addition, defecation and micturition cause syncope and altered/decreased respiratory function . In defecation/micturition syncope, hypotension caused by an imbalance between sympathetic and parasympathetic autonomic function leads to decreased cerebral blood flow or large changes in systemically stressed blood volume .…”