Toilet-related Injuries and Deaths - Drop in Blood Pressure and Dangerous Valsalva Maneuvers

Drop in Blood Pressure and Dangerous Valsalva Maneuvers

Some instances of toilet-related deaths are attributed to the drop in blood pressure due to the parasympathetic nervous system during bowel movements. This effect may be magnified by existing circulatory issues. It is further possible that people succumb on the toilet to chronic constipation, because the Valsalva maneuver is often dangerously used to aid in the expulsion of feces from the rectum during a bowel movement. According to Sharon Mantik Lewis, Margaret McLean Heitkemper and Shannon Ruff Dirksen, the “Valsalva maneuver … occurs during straining to pass a hardened stool”. “If defecation is suppressed over long periods, problems can occur, such as constipation or stool impaction. Defecation can be facilitated by the Valsalva maneuver. This maneuver involves contraction of the chest muscles on a closed glottis with simultaneous contraction of the abdominal muscles.” This means that people can die while "straining at stool." In chapter 8 of their Abdominal Emergencies, David Cline and Latha Stead write that "autopsy studies continue to reveal missed bowel obstruction as an unexpected cause of death".