Sit, Squat, or in Between? How Body Position Affects Elimination

Nov 19, 2019

If you sit to poop, you don’t know squat about pooping. Squatting makes pooping easier and faster in the following four ways:

  • In the squatting position, gravity does most of the work. The weight of the torso presses against the thighs and naturally compresses the colon. Gentle pressure from the diaphragm supplements the force of gravity.
  • Squatting relaxes the puborectalis muscle, allowing the anorectal angle to straighten and the bowel to empty completely.
  • Squatting lifts the sigmoid colon to unlock the “kink” at the entrance to the rectum. This kink also helps prevent incontinence, by taking some of the pressure off the puborectalis muscle.
  • The colon is equipped with an inlet valve (the ileocecal valve) and an outlet valve (the puborectalis muscle). Squatting simultaneously closes the inlet valve, to keep waste from pushing back up into the small intestine, and opens the outlet valve, to allow wastes to pass freely out of the body. The sitting position defeats the purpose of both valves, making elimination difficult and incomplete, and increasing the risk of waste backing up into the small intestine where it should not be.

For more about the potential hazards of sitting to poop, please see “5 Problems With Sitting On Your Toilet.”

The Squatty Potty line of toilet stools enables you to simulate the squatting position using a standard sit-down toilet. In a way, it gives you the best of both worlds — the benefits of squatting with the comfort of sitting. But what’s really best: sit, full squat, or somewhere in between? The research is somewhat limited, but the evidence suggests that the optimal elimination posture is a relaxed position as close as possible to a natural squat.

Studies Show Squatting to Poop Is Best

One source of evidence that supports the benefits of squatting is from a Japanese study, “The Influence of Body Position on Defecation in Humans” published in the journal Lower Urinary Tract Symptoms (LUTS). For the purposes of this study, three positions were tested:

  • Sitting
  • Sitting with the hip flexed at 60 degrees with respect to the rest of the body (sitting with feet raised)
  • Squatting with the hip flexing at 22.5 degrees with respect to the rest of the body

For each position, researchers measured abdominal pressures, subtracted rectal pressures and anal sphincter pressures, and examined fluoroscopic images to compare the amount of strain required for elimination (i.e., defecation). Based on the results, the researchers concluded that “the greater the hip flexion achieved by squatting, the straighter the rectoanal canal will be, and accordingly, less strain will be required for defecation.”

In other words, the closer you are to a full squat, the easier it will be to poop.

In another study, “Comparison of Straining During Defecation in Three Positions: Results and Implications for Human Health” published in the Journal of Digestive Diseases and Sciences, Dr. Dov Sikirov had healthy volunteers ranging in age from 17 to 66 years old with normal bowel function use a digital timer to record the time needed for sensation of satisfactory elimination in three different positions:

  • Sitting on a standard-sized toilet seat (41–42 cm high)
  • Sitting on a lower toilet seat (31–32 cm high)
  • Squatting

Six consecutive bowel movements were recorded in each position. The average time for satisfactory elimination during squatting was 51 seconds, compared to the average times for the lower and higher toilet seats: 114 and 130 seconds respectively. Participants were also asked to note their subjective impression of the intensity of effort. Based on the results, Dr. Sikirov concluded that “the sensation of satisfactory bowel emptying in sitting defecation posture necessitates excessive expulsive effort compared to the squatting posture.”

A third study, “Role of defecation postures on the outcome of chronic anal fissure” involved patients with signs and symptoms of anal fissures — tears in the thin, moist tissue that lines the anus, typically from passing hard or large stools. Patients were evaluated before and after changing their defecation postures — sitting, squatting, or a modified sit/squat position. What these researchers concluded is that the modified posture — sitting with feet elevated — was best, better than both sitting and squatting, for reducing and almost totally eliminating chronic anal fissure.

Achieving a Fuller Squat

For convenience and comfort, we recommend that you sit down, pull the Squatty Potty out to a comfortable distance, place your feet on the foot rests, and let nature (and your body) take it from there. However, if you are interested in trying a fuller squat, your Squatty Potty stool is very accommodating. Here are a few suggestions for achieving a fuller squat:

  • Depending on your height, consider using a taller Squatty Potty — the 9-inch as opposed to the 7-inch. Some people are so tall, and their toilets so short, they practically can do it without the stool, but unless you’re seven feet tall or taller, you’ll probably need a stool.
  • Pull the Squatty Potty out from the toilet just far enough for your heels to be at the back of the stool without bumping into the toilet. You want to be as far back as comfortably possible, so your poop goes in the toilet and doesn’t “roll around the rim” as they say during this, the season of March Madness in college basketball.
  • Lower yourself to just above or just touching the toilet seat, and scoot back just far enough to make sure any tinkle goes in the toilet.
  • Get comfortable. It may help to rest your forearms on your thighs or knees. Remember: The optimal elimination position is one in which you are relaxed.

Of course, the proof is in the pudding, so to speak, so if you’ve tried all three positions, please post a comment to let us know what works best for you: sitting, partial squat, or full squat. And if you have any tips to share, they’re always welcome!