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Reply to "How much straining is normal and can it cause strokes or heart attacks?"

Strokes from straining are mostly an issue for those with high blood pressure or cardiovascular disease or both. Your bigger issue is potential pouch prolapse with chronic straining.

Extreme straining is not normal. It is true that the small bowel lacks the musculature to empty the pouch like the rectum. It primarily empties by gravity and relaxing the external sphincters, which are under voluntary control. The internal sphincters relax under pressure of a full pouch (or rectum). Bearing down some is OK, but serious straining is not. It is possible you have pelvic floor dysfunction and are not relaxing your external sphincters properly. Pelvic floor physical therapy might help.

It could be due to nerve damage during surgery. This is more likely to happen when the full rectal cuff is removed. Those nerves are in the transition zone between the rectum and anal canal.

Jan

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