Heart Failure Patients Often Feel the Urge to Defecate in Later Stages

Many heart failure patients experience a persistent urge to defecate during the later stages of the condition. This symptom is closely linked to systemic circulatory failure, particularly as the disease progresses to involve the right side of the heart. In the early stages of heart failure, left-sided heart failure is more common, and patients often suffer from symptoms such as shortness of breath, orthopnea (difficulty breathing while lying flat), nighttime coughing, and the production of pink, frothy sputum.

Progression to Right-Sided Heart Failure

As the condition worsens, right-sided heart failure typically develops. This leads to fluid retention and swelling, especially in the lower extremities. Over time, fluid accumulation may progress to abdominal swelling and ascites (fluid buildup in the abdomen). This swelling results from congestion in both the arterial and venous blood flow to the gastrointestinal tract.

Impact on the Gastrointestinal System

The congestion in the gastrointestinal system places pressure on the autonomic nerves that control bowel function. This pressure can create a sensation of needing to evacuate the bowels, even if there is no actual bowel movement. Patients may experience frequent diarrhea or a persistent urge to defecate, along with other digestive disturbances such as nausea, acid reflux, and a reduced appetite.

Sign of Worsening Heart Failure

These gastrointestinal symptoms often signal a more severe stage of heart failure, particularly when right-sided heart failure is present alongside worsening global cardiac function. The presence of such symptoms should be considered a red flag indicating disease progression and the need for prompt medical evaluation.

Why It Matters for Patient Care

Recognizing these signs is crucial for timely intervention. Healthcare providers should consider the possibility of advanced heart failure when patients report frequent urges to defecate, especially when accompanied by other symptoms like bloating, fatigue, and weight gain. Early detection and treatment can help manage symptoms and improve quality of life.