Talk:Valsalva maneuver

Hernias and straining on the toilet

The article says that the Valsalva Maneuver is used for a bowel movement. This is only the case when using the sitting position (on a conventional toilet). Two-thirds of the world use squat toilets and avoid the deleterious effects of this maneuver -- both for defecation and for childbirth.

One example is hinted at in the article: "This maneuver is also sometimes used to discover an inguinal hernia in men." The daily use of this maneuver for excretion is the main reason why 700,000 hernia repair operations are performed each year in the U.S. See this link [1] to verify the number.

This link http://naturesplatform.com/health_benefits.html explains how sitting toilets force people to injure themselves thru the unnatural use of the Valsalva Maneuver, and how squatting would prevent much needless suffering.

~ Jonathan --65.146.211.39 16:58, 30 September 2005 (UTC)

Your link [2] only verifies the number of hernia operations done and does not prove what caused those hernias. Please submit some evidence that the Valsalva maneuver causes these hernias. Alex.tan 13:07, 2 October 2005 (UTC)

Yes, I know that it does not "prove" that the hernia is caused by straining on the toilet. But common sense would tell us that a maneuver that makes a hernia pop out (to be "discovered") is the most likely reason why it developed in the first place -- especially since this maneuver is (1) used multiple times for each daily bowel movement and (2) completely alien to natural bodily functioning. No other animal uses this maneuver.

In addition, all the conventional medical websites list straining on the toilet as a major cause of hernias and pelvic floor prolapse. The experience of those who have switched to squatting is that there is virtually no straining, or holding of breath. The posture naturally compresses the colon, eliminating the need to use the diaphragm for this purpose.

Many studies by Dr. B.A. Sikirov (see medline) have verified the greater ease of defecation in the squatting position. Here is his most recent study: [[3]]

I think it's a topic at least worth mentioning in the article.

~ Jonathan --65.151.216.207 17:48, 2 October 2005 (UTC)

As far as I know, constipation is a much bigger factor in causing hernias than whether you sit or squat on the toilet. Constipation, of course, can be caused by many factors other than just toileting position. Straining on the toilet does lead to hernias, but this is a result of constipation - there is no evidence that toileting position (sitting versus squatting) causes this. If you have any evidence to support this, I would like to read it. By the way, your quoted study by Dr. Sikirov is hardly a well constructed study and does not really prove anything. Alex.tan 16:02, 3 October 2005 (UTC)

I think you are confusing the order of causality. I'm a nurse and nurses deal a lot with constipation in their patients from a practical standpoint, and of course our education also provides both information and practical instructions of how to remedy and prevent it. So, from my understanding, when it reads somewhere that constipation causes hernias, I'd read into that the need of a constipated patient to employ forcefully and frequently the technique known as "straining on the toilet", i.e. even if there is no actual mention of this phrase or of "Valsalva's maneuver" they are still implied as the cause. However, you being a physician, you could perhaps supply me with some elaboration on what yuo have written to extend my general and vocational education? __meco (talk) 15:41, 30 May 2010 (UTC)

Getting back to the Valsalva Maneuver, you can easily prove to yourself that it is not required when squatting. Even if you don't buy all the implications for prevention and treatment of disease, the article needs to be corrected so it does not imply that the Valsalva Maneuver is involved in natural defecation. --Jonathan108 16:48, 4 October 2005 (UTC)

Function of the Diaphragm

This article incorrectly describes the function of the diaphragm. The diaphragm, like all muscles, can only contract in one direction. Muscles pull, they cannot push. That said, when the diaphragm contracts, it pulls down in the thoracic cavity causing inhalation of air into the lungs by creating a negative pressure (via cavity expansion). The diaphragm does NOT contract to cause exhalation of air.

68.63.28.61 06:19, 20 February 2006 (UTC)

Eye expelled through eye

Is there any documentation on the Valsalva meaneuver where the air is expelled through your tear-duct? This happens to me.

Yes : http://www.emedicine.com/OPH/topic592.htm Specifically, if the valve of Hasner and valve of Rosenmüller in the nasolacrimal duct are missing increased pressure in the nasal cavity (as with nose-blowing or the Valsalva maneuver) an cause retrograde passage of air or fluids through the nasolacrimal duct onto the eye.

In an episode of _Ripley's Believe it or Not_ Jim Cichon was documented as the world record holder for squirting milk from his tear duct.

This article has been referenced by a Slate magazine article. I think there is a template that can be added to the top of this page to say that but am quite new so can't find it. Any ideas? --Wikipediatastic 10:57, 17 March 2006 (UTC)

The article is here: http://www.slate.com/id/2137959/?nav=fo

When viewed just now, the image in this article showed just the Wiki sample default image. Also, a few sentences below that is the sentence "Blood pressure (systolic and diastolic) and pulse rate during a normal response to Valsalva’s manoever." which is missing a key word... the longer description described increases and decreases, and my non-medical self can't figure out which should go in the sentence. Ricky 00:15, 7 October 2006 (UTC)

Ah, looks like a new user did major edits yesterday. Could somebody who knows something about the topic look at this? It seems bad to me, but not knowing anything about the topic, and being a newish Wikipedian myself, I don't feel bold enough. Ricky 00:25, 7 October 2006 (UTC)

Abuse of this Mechanism?

I remember when I was in school we once did this "trick," where you stood against a wall and held your breath, then someone applied pressure to your chest and would then suddenly stop pressing. Which made you fade. Does that work in the same way as the Valsalva maneuver?83.118.38.37 00:02, 3 November 2006 (UTC)

Pretty much! InvictaHOG 19:22, 6 November 2006 (UTC)

I am just curious. Does fade mean the same thing as faint here? I am unfamiliar with this usage. -- trlkly 10:32, 29 July 2007 (UTC)

See Fainting game. Can cause brain damage and even kill you... --TiagoTiago (talk) 04:36, 6 November 2011 (UTC)

only good in descent?

I'm removing the following unsourced text:

It is important to note that the maneuver is only helpful during a descent, either in the air or water. During an ascent, the increasing pressure in the middle ear relative to the decreasing ambient pressure will generally escape through the Eustachian tubes without assistance. In any case, attempting to force additional air into an already over-pressurized middle ear is almost certainly a bad idea, and potentially dangerous.

I'm not sure this is true. Even if the middle ear is overpressurized, it makes sense to me that the V maneuver, by opening the Eustachian tubes, might ultimately allow air to flow out of the middle ear after an initial further increase in pressure. My own experience and some Googling seems to support this. (Most websites refer to the V maneuver as a way to equalize pressure in general, and don't say it's only for cases where pressure is too low.) --Allen 04:12, 19 May 2007 (UTC)

Removed Psychiatic applications

I removed the following because it seemed completely nonsensical

== Psychiatric applications ==

Factitious disorders: multiple cases of factitious pheochromocytoma by way of conscious altering of autonomic function with Valsalva maneuver.

-- trlkly 10:48, 29 July 2007 (UTC)

Exhaling Against Closed Lips Not The Only Method

When performing the Valsalva maneuver, neither I nor other fliers I know do it against closed lips. Everyone I know does it by closing off the back of the mouth with the tongue. This is less fatiguing if you have to do it many times, gives more direct pressure, and also doesn't look goofy. Shawn D. (talk) 16:32, 18 November 2007 (UTC)

Other Warnings for Self-Treatment via Valsalva Manuever

Chrishibbard7 (talk) 18:39, 6 January 2009 (UTC) There are caveats to self-treatment via Valsalva maneuver: it does increase blood leakage between the two upper chambers of the heart for anyone with a PFO, currently estimated as 10-30% of healthy humans alive today. I was told to use this method during a PFO test to increase surgically aerated blood between chambers in order to determine the size of the inter-chamber opening. I was warned by the tech performing the test not to purposely execute this maneuver again and also warned not to 'strain too hard' during BM for the same reason.

Also, moving the jaw forward and down or simply downward in order to open eaustacian tubes to relieve ear pressure can contribute to TMJ syndrome (pain in the TurboMandibular Joints).

No references

While this article is well-composed, it has no sources or references.Wuapinmon (talk) 22:46, 10 February 2008 (UTC)

Who cares?

Opening those tubes

Am I the only person who needs not yawn or swallow, but can simply conciously open those tubes? to 'click one's ears' ... I've been able to since I was little. —Preceding unsigned comment added by 75.73.70.113 (talk) 02:38, 5 April 2009 (UTC)

When defecating

I see no mention in the article of this applied in relation to defecation, i.e. to assist or trigger bowel movement. Reading the topmost post on this page I gather that the article in a previous state has discussed this. So why doesn't it anymore? __meco (talk) 15:25, 30 May 2010 (UTC)

It is mentioned briefly in the Valsalva retinopathy section, but the early sentence "It is also often used to aid in the expulsion of feces from the rectum during a bowel movement" was removed as "redundant" by this edit in February 2006. It was unsourced, so liable to be removed. I would suggest finding a reliable source that describes this application and use it to expand the article. --RexxS (talk) 18:10, 30 May 2010 (UTC)

According to Barry B. White, the main causes of Valsalva Maneuver are: 1. Straining at stool due to constipation. 2. Straining to urinate. 3. Straining to raise up in bed or to get in or out of bed... See Barry B. White, Therapy in Acute Coronary Care (1971), p.65. According to Sharon Mantik Lewis, Margaret McLean Heitkemper and Shannon Ruff Dirksen, “Valsalva maneuver … occurs during straining to pass a hardened stool.” “If defecation is suppressed over long periods, problems can occur, such as constipation or stool impaction. Defecation can be facilitated by the Valsalva maneuver. This maneuver involves contraction of the chest muscles on a closed glottis with simultaneous contraction of the abdominal muscles.” See Sharon Mantik Lewis, Margaret McLean Heitkemper, Shannon Ruff Dirksen, eds., Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 6th edition, Volume 2 (2004), p.951. Gladys Nite and Frank Neal Willis write that it has been pointed out “that the danger of a Valsalva maneuver is increased by constipation.” See Gladys Nite and Frank Neal Willis, The Coronary Patient: Hospital Care and Rehabilitation (1964), p.164. Onefortyone (talk) 00:49, 3 June 2010 (UTC)