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Defecation SyncopeA Symptom With Multiple Etiologies
Wishwa N. Kapoor, MD;
Jacqueline Peterson, PA;
Michael Karpf, MD
Arch Intern Med. 1986;146(12):2377-2379.
Abstract
• To our knowledge, there is no previous clinical description in the literature of patients with defecation syncope. We evaluated 20 patients with this disorder who were a subgroup of a larger, prospective study of syncope, 13 women and seven men, with a mean age of 59 years. Eleven patients had had one episode and nine had experienced multiple episodes. Fourteen patients were recumbent before the urge to defecate, nine of these asleep. The diagnostic evaluation disclosed that two patients had gastrointestinal tract problems, three had cardiac diseases, and one had transient ischemic attacks. Three additional patients had marked orthostatic hypotension. No identifiable cause for defecation syncope was found in 11 patients, but new medical problems were noted in four of those patients. In follow-up at two years, syncope had recurred in ten patients, but the majority of recurrences were unassociated with defecation. Seven patients died during the follow-up period
Author Affiliations
From the Division of General Medicine, Department of Medicine, University of Pittsburgh.
Footnotes
Accepted for publication April 7,1986.
Reprint requests to Room 100 Lothrop Hall, 190 Lothrop St, Pittsburgh, PA 15261 (Dr Kapoor).
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