Why Strokes Often happen in the bathroom

Stroke is a medical condition where poor blood flow to the brain leads to cell death. There are two main types: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. This results in impaired brain function, and signs include difficulty moving or feeling on one side of the body, speech problems, dizziness, or loss of vision.

Strokes are not inherently common in washrooms, but they can occur anywhere at any time. Factors like vascular health, blood pressure, genetics, lifestyle, and underlying medical conditions contribute to stroke risk. Some associate strokes with washrooms due to incidents during bathing or concerns about triggers like cold showers.
Research indicates a rise in bathing-related accidents, with cardiovascular diseases being the primary cause, followed by cerebrovascular and respiratory diseases. Heart attacks during defecation may result from straining, adversely affecting the cardiovascular system and potentially leading to syncope or death.

The sitting posture during defecation on a sitting toilet increases the risk compared to a squatting toilet, as it requires more strain, elevating intra-abdominal pressure. Straining can raise blood pressure, potentially pushing someone prone to a stroke over the edge.
Venous back up during straining may raise intracranial pressure, increasing the risk of a blood vessel rupture, a potential cause of stroke. Cardiac arrest in the bathroom is also noted, especially in the morning when blood pressure is highest.

Tips for stroke prevention in the bathroom:

● Take blood pressure medication in the morning.

● Shower an hour or later after taking medication, starting from feet and working up to head with lukewarm water.

● Consume fiber or fruits to avoid constipation and straining.

● Avoid wetting the head and hair first during bathing to prevent abrupt changes in blood pressure.

● Be cautious about sudden cold water exposure, as it can increase blood pressure.

● Sequence bathing by wetting legs first, gradually moving up to the head.

● Be mindful of falls and injuries in the bathroom, particularly for the elderly.

● Consider the bathroom as a potential place where the urge to use it may coincide with a rise in blood pressure, leading to increased straining and associated stroke risk.

Ultimately, reducing stroke risk involves maintaining a healthy lifestyle, managing underlying health conditions, and seeking medical care as needed. High blood pressure, smoking, diabetes, high cholesterol, physical inactivity, family history of stroke, and other cardiovascular conditions are primary risk factors to address.

Dr Showkat Shah, Medical Superintendent Khyber Medical Institute and critical care specialist