Defecation Syncope: A Potential Holiday Hazard

This morning I was reading an interesting book called What's Your Poo Telling You? Written by Josh Richman and Anish Sheth, M.D., and illustrated by Peter Arkle, The book was published in 2007 and basically consists of different descriptions of the many types of bowel movements the average person experiences. I purchased it during a time when I was doing a lot of reading about bowel movements and wanted something comparatively "light" to read. As it turns out, many books about defecation are funny, perhaps because it's a subject that can be embarrassing for many people. And yet, every single living animal on the planet must expel waste in some way. For most of us, that means we poop.

Twenty pages into What's Your Poo Telling You?, I came across a funny description of a type of bowel movement the authors called "Poo-phoria". This bowel movement causes a person to experience euphoria and ecstasy as they pass a very large stool. The authors explain that "poo-phoria" usually leads to a feeling of exhilaration, intense relaxation, and even goose bumps. It's generally a very safe way to feel "high." though some people can get addicted to the experience.

The authors further state that the "high" feeling comes from stimulation of the vagus nerve, which is the tenth of twelve cranial nerves. As a very large bowel movement passes through the rectum, the vagus nerve fires. When the vagus nerve is stimulated, it usually causes a sudden drop in blood pressure and heart rate. Mild stimulation of the vagus nerve produces that "high" Richman and Sheth write about in their description of "Poo-phoria". However, if the vagus nerve is more intensely stimulated during a bowel movement, it can lead to what's known as defecation syncope.

Syncope is the medical term for fainting. Fainting is most often caused by overstimulation of the vagus nerve. A lot of different situations can cause a so-called vasovagal attack or episode. For instance, a person might have a vasovagal attack when he or she comes into contact with unpleasant stimuli such as intense pain, extreme hunger, sudden emotional shock, or perhaps the sight of blood.

The holidays can be a perfect opportunity to run into various stimuli that might lead to a vasovagal attack. For example, you might be so busy wrapping presents that you skip a meal, which leads to extreme hunger. One of your family members might reveal shocking news that takes you by surprise, making you feel woozy. Two of your siblings might have a fist fight over who gets the last Santa cookie and one of them might give the other a bloody nose, causing you to faint. Or... perhaps you'll eat a meal that is so rich and filling that you later find yourself on the toilet, experiencing a particularly intense case of "Poo-phoria". Next thing you know, you're waking up on the bathroom floor, a victim of defecation syncope.

This subject may seem like a laughing matter, but defecation syncope can be quite serious. While most fainting in and of itself is no cause for alarm, a sudden fall can lead to significant injury. According to an article written by Wishwa N. Kapoor for the National Institutes of Health, defecation syncope more often "occurs in elderly patients, often in the early morning hours" (Wishwa, 1990). The elderly may be more likely to be injured during a faint or the episode may be a sign of a more serious disorder. Moreover, defecation syncope does sometimes strike young people. I myself experienced defecation syncope once when I was a 20 year old college student. It was a scary and disorienting experience preceded by significant pain that left me wondering if I should see a doctor.

While I don't expect anyone to curtail their holiday eating just because of the minor threat of defecation syncope, I do want to inform my readers that the risk exists. The one time it happened to me, I wondered what had caused it. Now, thanks to a book called What's Your Poo Telling You?, which introduced me to the term and lead me to research it online, I know. And now, hopefully you know, too.

Happy holidays!

SOURCES:

Richman, J. and Sheth, A. (2007). What's Your Poo Telling You? San Francisco: Chronicle Books.

Kapoor, W. (1990). Syncope. Clinical Methods. Online. www.ncbi.nlm.nih.gov