Vasovagal syncope of the untoward kind

December 11, 2009

One of the most embarrassing things to ever happen to me occurred when I was about 16 (surprise, surprise!) Although I didn’t have SIBO way back then I did have some intermittent IBS that came and went until years later when I started eating vegan. It was a party of some sort at my boyfriend’s house and I had eaten a lot of junk food and I started having stomach cramps. I went to the bathroom and that’s where the trouble really started. In addition to spasmy, crampy pain, I started to feel like I was going to throw up. I sat there on the toilet, having terrible diarrhea and getting more and more nauseous. I got hotter and sweatier and I started feeling like someone had dropped me into the bottom of a giant metal cup; all my hearing got tinny and thin. The next thing I know I was on the floor, and my boyfriend’s mom, head of Cardiology at a local hospital, was kneeling overtop of me. I had lost consciousness while on the toilet! She checked me out and I was fine. Cramps and nausea and everything else were gone. I cleaned myself up and that’s all I remember – I most likely lay down and went to sleep if I didn’t run back home out of embarrassment!

My sister took me to the doctor a few weeks later. (This would seem to be pretty par for the course for most folks, but actually going to the doctor when something weird happened to me would not be a theme in my life for the next decade or so.) He asked a few questions about what happened and although my boyfriend’s mom didn’t accompany us, she told us what to say. He did a few routine checks, found I had low blood pressure, and therefore pronounced me subject to vasovagal episodes, and bid us good day.

And it has happened to me ever since. Not a lot, but a couple of times a year most every year. And these past few years it has happened a few more times than that. In my life I’ve woken up on the bathroom floor more times than I’d like to remember (I used to think I had just lain down;) most usually on the bathmat, occasionally in the bathtub (with a bruised head to follow,) and once with my husband kneeling over me the same way my high school boyfriend’s mom did. “Oh I never told you I passed out?” I asked sheepishly…

To date in 2009 I’ve had 3 vasovagal episodes; 2 of them have occurred this week. Back in March I had the pleasure of passing out in front of a doctor; this meant I woke up to pure oxygen, which was quite pleasant! Both times this week when they occurred I managed to avoid full-blown syncope; the first episode was rather mild, but the second time was a bit traumatic. By now I’ve learned to just lie down on the floor when I feel it coming. But I was in the ladies’ room at work so I had to stay put on the toilet. And the prodome to losing consciousness just wouldn’t end. The nausea was terrible and I nearly completely lost my hearing. And something happened which I’ve never noticed before – I shook for about 15 seconds at one point, nearly falling off the toilet. I was worried that I was having a seizure but I was still awake. I asked my husband about the convulsing later, since he was actually present during the episode in the spring, and he said that I shook a bit before I collapsed then too.

I think the worst thing ever about my vasovagal episodes, besides the nausea, because I really can’t stand that part, is that they happen on the toilet. I don’t know what a blog about bowel disease would be without lots and lots of frank discussion of bowels. And years of blog posts, forum posts and doctor’s visits have definitely desensitized me to the topic. But before the SIBO, I wasn’t known as someone with a particular penchant for potty humor or conversation. I don’t really like to talk about going to the bathroom, I definitely don’t like to tell funny stories about the bathroom, and I have even shunned a good morning or goodbye kiss or two when just standing in the bathroom as I much prefer the sterility of the hallway. Yet here is where I like to pass out. Not fair.

It gets better. If you follow the link to the wiki entry on vasovagal episodes, you’ll see that what I have is actually even named after going to the bathroom – defecation syncope. That’s right. So, years of feeling awkward as a teenager/early twenty-something don’t get made up for here. Because I faint – how feminine of me, but I faint on the toilet. Awkward indeed! This is no gender-role-validating, subservient Victorian frail act, oh no, but rather something vile that I do behind a closed door. Turns out I would have to wait for several more years to come down with a condition with the word ‘intestinal’ in it before I would be made to feel girly by my own malaises*.

Of course, like many conditions from which I suffer, lots of ideas (but not all) about vasovagal syncopes center around the psychological aspect, and assume that triggers are triggering for emotional reasons, not necessarily physical ones, or at least that there is some emotion mixed in there somewhere. I do also pass out when I see my own blood. This keeps me from giving blood and when I get tattooed or have blood drawn for labs its essential that I don’t look at what’s happening to me. But just like defecation, I don’t have any particular emotional reaction to blood. This is probably hard for some people to understand, especially as they watch me go under, but I’m not squeamish. In fact, I used to be a big fan of gory movies. I don’t fear needles or bleeding. I don’t mind blood at all. Just like I don’t particularly like or dislike going to the bathroom anymore or any less than anyone else. But I cannot give blood or plasma and when I get a tattoo I have to make decisions about colors before we begin, and I have to trust the artist implicitly.

Here’s hoping to a relatively calm rest of the year…I’d like to end on no more than three!





  1. I learn something new every day. I’d never heard of defecation syncope, and so of course I read up on it. It seems to be one of the “reflex-mediated syncopal syndromes.” Other examples are micturition syncope (occurs during/after urination) and (I’m not making this up) swallowing syncope. That sounds worse. Passing out on the toilet is bad enough, but never knowing when you might swallow something and have it set off a faint? Not fun.

    The only thing that bothers me about your account is that people who have anaphylaxis can experience something quite similar. In anaphylaxis it’s like all hell breaks loose. You can have diarrhea and vomiting simultaneously (which leads to confusion in the bathroom — do I sit down or bend over or….) _and_ you can lose consciousness.

    What’s the difference? Well, anaphylaxis wouldn’t usually start in the bathroom (unless an attack were set off by those deadly little time-released “air fresheners” — the perfumes in those can set off some people), and most often, anaphylaxis begins with some kind of skin symptom — flushing, burning, hives, a rash, furious itching all over on in embarrassing places (like armpits and groin). Also, you can have other symptoms with anaphylaxis, like swelling (angioedema), asthma (lots of mucus or “air hunger”). In anaphylaxis, passing out is the grand finale, and without treatment, the person _could_ die.

    But still, those of us with mastocytosis or idiopathic anaphylaxis sure do understand what you mean about being afraid to faint on the throne. So, even if you have a rather rare condition, you’re not alone!

    • I’m so glad I could offer up new info – and oh yes swallowing syncope and micturition syncope do sound worse. I mean, not on the surface, of course, because what could sound worse than “defecation syncope,” but very scary indeed to think that such common triggers would possibly set off a faint. I have even discussed the matter with a friend who frequently faints at standing too quickly – we both agree there are worse triggers than what gets to both of us.

      …and Yikes, that scenario you describe is very scary. Personally I dont’ think I’m very sensitive to chemicals, smells, etc. but at the office the ladies are so fond of the heavy, choaking air fresheners, and I can only imagine how bad an anaphylactic reaction could be and how easily a place like the ladies room, when it smells so strongly of “mountain berries,” could set it off…

      Thanks for your comment – I hope you’re well. Looking for a new post from you soon I hope…

  2. I’ve got this same problem honey! It’s happened in the past with really bad menstrual cramps (which will include diarrhea) and sometimes vomiting if the pain is bad and then fainting…on the toilet. But I’ve also got low blood pressure and am sensitive to dehydration, but at 113 1bs, my whole system is pretty sensitive to any kind of shift in anything.

    I’m currently in chemotherapy for Breast Cancer (stage 1) and am getting my ass kicked during every treatment. I’ve had three so far and the last two have had me end up in the ER with overnight hospital stays because of exactly what you are describing (once at home at 3am and a bunch of hot paramedics looking at me splayed out on the bathroom floor) and the second time last week while Xmas shopping (and wearing purple wig – my hair is gone), I fainted on the throne with the whole diarrhea drama in a Korean BBQ restaurant at the mall. I’m sure those hot paramedics thought I was hooker on a drug bender with my purple wig and my jeans twisted around my ankles.

    Chemo makes me so weak that this complication doesn’t help the matter and it has taken me at least overnight with IV fluids to recover.
    I’m determined to NOT GO TO THE HOSPITAL for my next cycles of chemo. Hoping I can convince my doctors to give me IV fluids before this happens again.

    Sorry to ramble, but you are not alone! I was so happy to find your blog and you described it EXACTLY as it occurs with me. Good luck to you!

    • Vaxine! Thanks so much for your comment. Your story had me laughing out loud; what a sight! And you tell it with such humor. I see now I was so lucky to pass out in front of 6 or 7 middle-aged female nurses….but I was so chagrined at the time.

      Menustral cramps used to be bad enough that I would vomit and faint as well. These days it is usually only diarrhea and fevers that trigger me. I can only imagine that on top of a low BP and small frame you are fainting a lot more often with the chemo; I certainly hope your dumb doctors listen to you when you ask them for IV…although we all know how difficult getting a doctor to actually listen to you can be….Tell them they don’t want to see what went down at the BBQ…. 🙂

  3. […] What I can’t eat Vasovagal syncope of the untoward kind […]

  4. […] a few sentences he was naming them all for me. Salt cravings, weight gain, inability to get warm, low blood pressure, lots of colds, PMS and painful periods. He definitely listened to me when I talked but he did tell […]

  5. wow, well I think I am getting close to what I recently experienced….. ‘the first time was in the Food Lion ladies room. It started with cramps, but as i sat there upon the throne, my hands started tingling and I was feeling very very weak in addition to horrible abdominal pain. I knew I had to get my ars out of there fast cuz my boyfriend was out in the car and it could be hours before someone else came in. I was able to get my pants up but my fingers wouldn’t work and I couldn’t button my jeans. I staggered out of the grocery store….pale as a ghost, sweating and staggering; I basically collapsed outside of the entrance. My boyfriend carried me to the car and proceeded to drive me to the emergency room. I remember being furious as he took a super-long route and obeyed every traffic signal as though he couldn’t see I was dying on the seat next to him. When we finally got there and he finally realized I wasn’t able to get out and walk…(by this time I was having a hard time breathing, by hands/arms were completely numb, I had no bp and had sh_t myself……} He walked, yes, walked into the e.r. to “get a wheelchair’. With the last bit of strength I had I said “stretcher”. He came out with staff and a wheelchair….. the staff was fortunately quicker than he because they ran back in for a stretcher. I wasn’t unconscious as it was thought but I was simply too weak to respond. 2 IV’s were started and I was given epinephrine which did turn it around. I thought I was allergic to something. A year later, while again on throne, the sequence repeated itself only worsened as my hands (totally numb} looked like I had cerebral palsy. I had epi on hand and again, it turned around! One person present called ambulance and I was told it was “anxiety”! I almost laughed, but just muttered “whatever”. This time I was told at the e.r. that it was vaso-vagal syncope. I was also told to not do the epenephrine??!! He said yes, come to the e.r., but since was not an allergy, epi wouldn’t make a difference. So am now confused cause epi most definately saved me x 2. I was also told that it was a response to gastrointestinal pain…… this part made sense……tho nothing else does.

  6. Its very interesting to see that you are all ladies. i am a 56 yr old male diagnosed with vasovagal in 2007 after diahydrating and loosing all my electrolytes. I did a lot of exercise and rehydrated with water only. I was always warned against too much salt. I had no real episodes in my life only occasional feinting when taking injections. Suddenly on a hot stressful day in 2007 I’m rolling down onto the floor of my office with the screaming of my secretary ringing in my ears. In the IC for a few days and all cardiac results look good and after rehydration I am released but followed weeks of feeling drained and the feinting feeling again. 3 trips to the specialist and a tilt table test “killed” me for 21 seconds and a pacemaker was fitted. Who says its not life threatening? Since then my pacemaker is largely in active as i drink lots of isotonic drinks and take plenty of salt. But I still have very little energy in the mornings between 9 and 11 am and my bp falls to 95/50 with a pulse of 55. Hot weather and stress seem to be my main triggers but there is a relationship to my stomache as hot drinks first thing send me dizzy and I cant face breakfast at all now as that too would curl me up on the bed 30 mins later so I suppose my digestion process is the trigger. Sometimes the falling bp is so distressing it triggers a panic attack which makes me feel tons worse. I really feel like I am going to die. I have to admit my life is pretty miserable in the mornings these days and I’ve taken early retirement so I can actually say most mornings I’m back to bed at 9 or 10 am for a lie down until my bp comes up again. I am interested to chat with anyone with similar symtoms who could recommend some fix. I get little sympathy from my wife as she doesnt understand the problem and the doc too just says I have to manage it.

    • Ian,
      I’d love to know if you’ve ever noticed food triggers or tried to significantly change your diet.

      • Brooke my life has changred dramatically since i wrote that entry nearly 3 years ago. I left my couldnt-careless wife and new building project in bali as it was just a nightmare to me. Lost all my savings. I still live in Bali with a much tighter budget and simpler life. I found strong tea(which I loved) was affecting me so I stopped drinking tea. I think it is the tanin affects me. Coffee is fine for me so its not caffeine, i take 2 cups /day.. Also some red wines gave me fibrillation and I found out its sulphur dioxide preservative ( its got an E number) in some red wines but not in rose or white. I now eat simpler and smaller. Big heavy meals hit my stomache ad give me bad feelings in my heart then a burp clears it. so I eat little and often. Lots of water, and salt cos I sweat tons here. I do jogging but try to keep my heartbeat max below 120 bpm or it feels like palpitations will start. I look at YouTube healing mantras and binaural beats, self hypnosis for positive affirmations etc., to keep calm and open up a new aspect of my spirituality. Nice Karma makes me calmer ! I’ve been problem free for over a year with only a couple of small palpitation attacks. I feel all our issues are stress and lifestyle orientated. Hope this helps you and others. Good luck and take care.
        Ian Roberts

  7. This is the first time I’ve ever heard of anyone with the EXACT same symptoms as me! I’m glad to know I’m not TOTALLY ALONE in my misery. Thanks for the info about SIBO. I’ve never heard of it. Definitely something to learn more about.

    My doctor prescribed Bentyl, which helps a lot. If I’m sitting on the pot and start to feel crampy, I take a pill, lie on the couch for 30 minutes, and it all goes away. GREAT stuff. I hate taking meds, but it’s a lot better than my 5 year old finding me on the floor of the bathroom and calling hubby saying “Mommy fell down and won’t wake up.”

  8. I have this too – beginning all my testing with Neurology and Cardiology….but I know this is what I have. It is awful

  9. This sounds exactly like what has happened to me many times. I’ve only had shaking with it a couple of times. I shook like crazy but was conscious while it was happening. When I feel it coming on I take a pillow to the bathroom because I am tired of head bumps. Waking up is weird too… I feel my cheek on the floor and I don’t know I am on the floor and I have to figure it out. The ear ringing is odd too.

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