Heart Attacks
Dr. Berko Sikirov is an Israeli physician who has spent over 20 years studying the effects of excessive straining caused by the use of sitting toilets. His research on hemorrhoids and diverticulosis is discussed elsewhere on this webpage.
In 1990 he published an article entitled "Cardio-vascular events at defecation: are they unavoidable?" He begins by describing the problem:
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Probably every physician practicing emergency medicine has encountered tragic cases of sudden death in the lavatory. Patients with acute coronary events are especially vulnerable to excessive straining which accompanies defecation. Therefore, it is a routine practice in coronary care units to administer laxatives or stool softeners, hopefully to reduce straining ...
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The article goes on to explain how straining on the toilet can be avoided by adopting the natural squatting position. In the following summary, Dr. Sikirov uses the term "Valsalva Maneuver," which means pushing down with the diaphragm while holding one's breath.
According to the American Heritage Dictionary, this maneuver "increases pressure within the thoracic cavity and thereby impedes venous return of blood to the heart." Another term used below is "syncope" which means "fainting."
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Cardio-vascular events at defecation are to a considerable degree the consequence of an unnatural (for a human being) seated defecation posture on a common toilet bowl or bed pan. Excessive straining, expressed in intensively repeated Valsalva Maneuvers, is needed for emptying the bowels in the sitting position. The Valsalva Maneuver adversely affecting the cardio-vascular system is the causative factor of defecation syncope and death.
The cardio-vascular system of a healthy man withstands the intensive and repeated straining at defecation, while the compromised cardio-vascular system may fail, resulting in syncope or even death. The squatting defecation posture is associated with reduced amounts of straining and may prevent many of these tragic cases.
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Besides straining the heart, the Valsalva Maneuver also leads to pelvic organ prolapse, discussed in the Gynecological Disorders, Pregnancy, and Prostate Disorders sections.
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