More real 丨 Defecation too hard may cause sudden death? There really is such a thing

True points:

The incidence of cardiovascular disease in modern people is higher, and patients are prone to constipation due to bed rest, weakened gastrointestinal peristalsis, reduced diet, etc., and forceful defecation may indeed lead to aggravation of cardiovascular disease and even sudden death. Therefore, an important health advice for doctors and nurses to patients is to pay attention to whether the bowel movement is smooth and avoid excessive force.

Verifier: Zhang Haicheng 丨 Chief Physician of the Department of Cardiology, Peking University People's Hospital

Recently, the idea that forceful defecation on the Internet may cause sudden death has aroused the attention of many netizens. Are the consequences of defecating too hard that they are so serious? Constipation, which is very common in the elderly, is actually a "silent killer"? Dr. Zhang Haicheng, Director of the Department of Cardiology, was invited to answer this question.

First, forceful defecation may raise blood pressure, speed up the heart rate, and cause myocardial ischemia, and cardiovascular patients should indeed be careful

Why can't cardiovascular patients defecate too hard? First, forceful bowel movements may raise blood pressure. In general, although constipation does not cause hypertension, if hypertensive patients are accompanied by constipation, it is easy to aggravate the instability of blood pressure. When defecating forcefully, the patient's heart beat is accelerated, the contractility of the heart is strengthened, and the volume of blood excreted from the heart increases, which will cause a sudden increase in blood pressure.

Some studies have found that the pressure of the cerebral arteries can increase by more than 20 mm Hg when defecating forcefully, if the patient's blood pressure is not well controlled, and suddenly the blood pressure rises again, it may cause cerebral hemorrhage (especially in patients with cerebral aneurysms, who usually have no symptoms and do not know that they have an aneurysm), and even sudden death. In addition, for patients with aortic dissection, coronary heart disease, myocardial infarction, cardiac insufficiency, etc., a sudden increase in blood pressure may also lead to worsening of the disease and even sudden death.

Second, forceful defecation may speed up the heart rate. When defecating forcefully, the patient will be irritable, activate the sympathetic nervous system, and at the same time due to increased abdominal pressure, a large amount of blood returns to the heart, so that the heart burden is suddenly excessive, the heart rate is accelerated, causing or aggravating arrhythmias; patients with cardiac insufficiency may have an acute attack of heart failure. If it is a patient with coronary heart disease or myocardial infarction, it can also induce angina, and even acute myocardial infarction or heart rupture.

Again, straining the bowel movement may trigger myocardial ischemia. Due to the increase in blood pressure and rapid heartbeat caused by forced defecation, the heart's demand for blood and oxygen supply is significantly increased, and the shortening of the diastolic period reduces the coronary artery blood supply capacity, which may lead to an imbalance between supply and demand, causing angina or myocardial infarction, which in turn leads to sudden death.

Second, patients with cardiovascular diseases are prone to constipation, and it is even more necessary to avoid forceful defecation

Some patients also asked, since the cardiovascular disease, it is easier to constipate, what is going on? Patients with cardiovascular diseases are prone to constipation for the following reasons:

First, gastrointestinal function is weakened. Cardiovascular disease is mostly elderly patients, the elderly original gastrointestinal function is weaker, coupled with reduced activity, emotional anxiety, etc., gastrointestinal function is further weakened, resulting in long-term difficulty in defecation.

Second, dietary factors are affected. When the elderly eat less or partially, it leads to a decrease in the amount of vitamins ingested and a significant reduction in fiber (especially in the elderly with poor teeth). In addition, gastrointestinal ischemia or congestion can also lead to loss of appetite.

Third, it is associated with hypokalemia. Many patients with cardiovascular diseases due to high blood pressure, cardiac insufficiency and other long-term use of diuretics, coupled with insufficient potassium in the diet, will lead to low blood potassium in the body, which is also an important factor leading to intestinal decline, and low blood potassium may lead to intestinal paralysis, and even cause fatal arrhythmias.

Fourth, some drugs cause constipation. The use of duronin, morphine, 654-2, or atropine drugs in elderly patients with cardiovascular disease can lead to hypersympathy, increased secretion of digestive juices, and decreased gastrointestinal peristalsis.

Third, to prevent forced defecation, you can do this

In reality, there are many cases of sudden death caused by forced defecation. Therefore, an important health education for doctors and nurses for patients is to pay attention to whether the bowel movements are smooth and avoid excessive force. Patients should pay attention to the following points if they want to have smooth bowel movements:

1. Establish good bowel habits: use physiological rules to establish defecation reflexes, and defecate regularly every day. For example, after getting up every morning, do a little exercise indoors, drink a cup of cold boiled water or warm boiled water on an empty stomach, even if there is no intention of defecation in the morning, you should squat for a while to form a conditioned reflex and develop the habit of regular stool.

In addition, it is recommended to use a toilet with warm water to automatically flush the anus, and the local massage of the anus with warm water under a certain pressure can help relieve constipation and solve the problem of excessive dryness of the initial part of the stool.

2. Scientific diet: drink more water appropriately, eat more vegetables, fruits, yogurt, milk and other foods that help laxative. In patients with severe heart failure, the amount of water to drink should be carried out according to the guidance of a doctor.

3. Moderate supplementation of dietary fiber: dietary fiber can promote intestinal peristalsis, reduce the residence time of food in the intestine, and also increase the volume of feces, absorb water from the intestinal cavity to soften the stool, and play a role in preventing constipation. Konjac, wheat bran, cereal, whole wheat flour and brown rice, oats whole grains, legumes, vegetables and fruits contain more dietary fiber.

4. Moderate exercise: Moderate exercise can enhance intestinal peristalsis and muscle tone, and promote bowel movements. Patients who have been bedridden for a long time should also allow themselves to have an appropriate amount of passive exercise through massage and other methods.

5. Provide a comfortable bowel environment: A comfortable bowel environment can reduce discomfort and tension before defecation. Comfortable bowel positions, bedridden patients as soon as possible to get used to the bed basin, can help elderly cardiovascular patients constipation relief.

6. Medication-assisted if necessary: For patients with refractory constipation, medications to relieve constipation can be taken under the guidance of a doctor.

In short, the incidence of cardiovascular disease is now higher, and patients are prone to constipation due to bed rest, weakened gastrointestinal motility, reduced diet, etc., and the superposition of the two will indeed lead to aggravation of cardiovascular disease and even sudden death. Patients with cardiovascular disease should not only pay attention to the strength of defecation, but also actively prevent and treat constipation, so as not to aggravate the disease.

This article was edited by connerliu

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