Squatty Potty Blog
Paleo Poopers: How to Deal with Caveman Constipation
You switched to a paleo diet — lots of veggies, a moderate amount of meat and eggs, a small amount of fruit for dessert, and perhaps some dairy. Good for you. You’re probably healthier than ever before. And now that you’ve gotten off the roller coaster of energy spikes and dips from consuming too much sugar and starch, you’re probably feeling better than ever. Trouble is, now you’re constipated. If this diet is healthier, why isn’t it making you poop healthier, too? And, more importantly, what can you do about it? What’s Causing My Constipation? Whenever you drastically change the way you eat, your body needs time to transition how it functions. With the paleo meal plan and lifestyle, the transition may be even more challenging, for several reasons: You’re switching your fuel source from sugar (and other simple carbs, such as bread and pasta) to fat. You’re probably eating less fiber, especially if you’re loading up on meat and not so much on vegetables or if you’ve switched to a low-carb paleo diet, avoiding certain fruits and vegetables, such as sweet potatoes. You’re probably consuming fewer calories, so you have less waste — less poop. What Can I Do About It? Fortunately, you can usually cure caveman constipation without giving up your paleo ways. The first step is to understand the composition of healthy poop: 75% water 7.5% undigested fiber and solidified components of digestive juices 7.5% bacteria 2.5% to 5% fat 2.5% to 5% inorganic matter .5% to .75% protein To alleviate your constipation, you need to give your body, and the microbes that reside in your lower digestive tract, the nutrients they need to produce the ingredients for healthy poops: Drink sufficient amounts of fluids. Water is best, but other fluids count, too. Diuretics, such as beverages containing caffeine and alcohol, may be counterproductive. Eat more plants than animals. If you’re loading up on meat, eggs, and dairy and ignoring veggies, fruits, beans, nuts, and seeds, try eating less of the former (animal-based products) and more of the latter (plant-based products). Plant-based foods contain the two types of fiber your body needs: Soluble fiber: Soluble fiber absorbs water and turns into gelatinous mush. It slows the absorption of sugar into your system, bulks up your poop, helps to eliminate toxic waste and maintain a healthy pH (acidity) in the intestines, and nourishes the beneficial microbes in your gut. (For more about feeding the friendly microbes, see our previous post, “Restoring Intestinal Flora Leads to a Healthy Gut and Happy Poop.”) Insoluble fiber: Insoluble fiber is found in vegetables, fruit and potato skins, seeds, and nuts. It retains a lot of water and helps to keep waste moving through the colon and to control and balance pH, but it’s largely un-fermentable, meaning it’s not the greatest food source for your friendly microbes. Take a probiotic. A probiotic consists of live bacteria that can restore or add to your friendly intestinal microbes. You can take a probiotic daily, but more importantly, take a probiotic for several weeks after taking an antibiotic. Probiotics are present in in some foods, including live-cultured yogurt, kefir, sauerkraut, kimchi, pickles, miso, and tempeh, and they’re available as supplements. Take a prebiotic daily. A prebiotic is soluble fiber that nourishes the microbes already in your digestive tract, in addition to delivering all the other benefits of soluble fiber. Prebiotics are contained in many foods, including beans, vegetables (especially Brussels sprouts, turnips, sweet potatoes, squash, and asparagus), fruits (especially apricots, grapefruit, oranges, and mangoes), nuts, and seeds. You can also buy prebiotics as supplements, typically psyllium. Make sure you’re getting enough potassium and magnesium. If you switched to a low-carb paleo diet, you may be avoiding some of the best sources of potassium, including bananas and sweet potatoes. Taking a good multi-vitamin that contains potassium and magnesium, both of which support motility (the contraction of muscles that mix and propel contents in the gastrointestinal tract), may help. However, avoid taking massive amounts of potassium or magnesium, because doing so can lead to imbalances that cause other health problems. Be patient. Give your body some time to adjust to the paleo diet and to any changes you make, including upping your fiber intake and taking a probiotic. A paleo diet is healthier than the Standard American Diet (SAD), but your body needs time to adjust. If you’re currently following a paleo diet or you tried it and decided it wasn’t for you, please share your experience and insights. Did it make you constipated? If so, what did you try to alleviate the constipation? What was most or least helpful? If you tried the paleo diet and then returned to a more “normal” diet, why did you switch back? encouragement, and information. Let us know how you approached this condition — what helped and what didn’t. Help shorten the journey from illness to wellness for others! – – – – – – – – Disclaimer: This blog post on the paleo diet provides general information and discussion about medical issues and health-related subject matter. The words and other content provided in this post, and in any linked materials, are not intended and should not be construed as medical advice. If you or any other person has a medical concern, consult with an appropriately licensed physician or other health care professional immediately and do not rely on the information presented in this post. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog post or in any linked materials. If you think you may have a medical emergency, call your doctor or 911 immediately.
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10 Tips for More Predictable Poops
Irregularity got you down? Do your poops seem to experience chronic flight delays? Do they get hung up in the morning’s rush hour traffic? Do they come out soupy one day and like adobe bricks the next? Well, we can help with that. Here we offer ten suggestions to achieving healthier, more predictable poops. It’s all about consistency — both in timing and texture. Follow these 10 suggestions, and you’ll be well on your way to poops that move down the tracks as smoothly as Japanese maglev trains. Start by Keeping Your Eyes on the Goal When we say “regular,” what does that mean, exactly? What’s normal? What’s healthy? Fortunately, doctors have been examining bowel movements and stool for millennia to diagnose illness. What have they concluded? Generally speaking, “normal” means pooping one to three times daily, and, according to traditional Chinese medicine (TCM), healthy stools are medium brown floaters with little or no sheen. Researchers at the Bristol Royal Infirmary — part of a dynamic and thriving group of hospitals in the heart of Bristol, England — have developed a more systematic gauge for judging the consistency of stools called the Bristol Stool Form or BSF scale, shown below. According to the BSF, stool types 1-3 are too hard, types 4 and 5 are just right, and types 6 and 7 are too soft. Unfortunately, the BSF doesn’t include anything about color, scent, or density (whether it floats or sinks), but it’s a pretty good gauge of whether you’re consuming enough water and fiber and whether you have some sort of intestinal infections or imbalances. So, if you’re pooping one to three times daily, and you’re squeezing out snakes or soft blobs, you’re in good shape. No need to change anything. On the other hand, if you’re pooping too often or less frequently than once a day, and if you’re laying bricks or squirting Hershey syrup, the following suggestions can remedy the situation. Use Common Sense: Listen to Your Body… and Your Doctor The suggestions we offer here are just that: suggestions. We are not your doctor, and we aren’t privy to details about your body, diet, lifestyle, and frequency or consistency of your poops. Tune in to what your body tells you. If you up your fiber intake, for example, and start experiencing loose stools, the added fiber may be doing more harm than good. Try different methods, choose what works, and ignore the rest. And always consult with your doctor over any serious or persistent problems. Consume Enough Fiber Hard poops typically indicate three problems. You’re not getting enough: Fiber (prebiotics) Water Probiotics Let’s start with fiber. According to the National Academies Institute of Medicine Dietary Reference Intake (DRI) for macronutrients, the average woman should be eating 21-26 grams, and the average man should be consuming 30-38 grams daily, depending on their age. Most people consume only about 15 grams of total fiber daily. You can boost your fiber intake by eating more high-fiber foods, including vegetables, fruits, nuts, legumes (beans), and whole grains. All of these sources of fiber contain water, so if you’re getting your fiber through food, you’re also boosting your water intake. Whether you need to take a fiber supplement is something to discuss with your doctor. Too much fiber can cause problems, as well, especially if you’re not consuming enough water. Drink Enough Water The standard advice on water consumption is to drink eight 8-ounce glasses of water daily; that’s 64 ounces, a half-gallon. According to the DRI, you need even more than that; women should be consuming about 2.7 liters (about three quarts) of water daily, and men should be drinking about 3.7 liters (just shy of a gallon). That’s a lot of water! Warning: Many people misinterpret that recommendation by failing to account for the water in foods and beverages. Water in juice, milk, coffee, tea, soda, and so on, also count toward your daily water consumption, as does the water contained in solid foods, including vegetables, fruits, nuts, whole grains, meat, cheese, and yogurt. Yes, drinking water is better for you than drinking soda, but if you’re struggling to drink a gallon of water daily, and you’re peeing all the time, you’re probably overdoing it. Supplement with Pre- and Probiotics Dry stools are often an indication of an imbalance of intestinal flora or gut bacteria and yeasts. These microorganisms in your intestines help to digest your food. They also retain the water that softens stool. An overgrowth of harmful bacteria, viruses, and fungi can interfere with digestion and cause a host of health problems that impact bowel movements or make the stool too hard or too soft. Prebiotics (dietary fiber) and probiotics (beneficial live bacteria and yeast cultures) can help restore a healthy balance. For details, see our recent blog post, “Restoring Intestinal Flora Leads to a Healthy Gut and Happy Poop.” Embrace the Foods That Bind If your stools are runny, consider a temporary shift to the BRAT diet: Bananas Rice Applesauce (not apples) Toast Other foods that can be helpful in alleviating temporary bouts of diarrhea are white bread, peeled potatoes, white pasta, rice, and peanut butter, but any bland, low-fiber foods can help to alleviate diarrhea. Avoid high-fiber foods, such as prunes, berries, cabbage, broccoli, beans, lentils, fatty meats, and greasy foods. Also avoid caffeine, alcohol, sugary drinks, and carbonated beverages. Although the BRAT diet is still recommended by some doctors, it’s only a temporary fix, and it is being phased out. Now, the Academy of Pediatrics recommends that children with mild diarrhea continue to eat a normal diet supplemented with commercially available electrolyte solutions to replace the water and salts lost during diarrhea. If diarrhea is severe or persistent or accompanied by a fever of over 102 degrees Fahrenheit, seek medical attention. Diarrhea can lead to dehydration, which poses a serious health risk. Embrace These Stool-Loosening Foods It’s common knowledge that certain foods, such as prunes, can help you poop, but prunes haven’t cornered the market. Here’s a list of 14 foods to help grease the ol’ poop chute: Beans Kiwi Sweet potatoes Corn and popcorn (poopcorn?) Nuts and seeds Whole grain breads and cereals Prunes, plums, pears, apples Berries Flaxseed Broccoli, green beans, spinach Dried fruit Coffee Yogurt Aloe vera juice And don’t forget the water! Put Your Body in Motion One sure fire way to cure constipation is to take a long jog to somewhere miles away from any toilet. As soon as you’re a safe distance from any convenient dropping point, you will have an uncontrolled urge to do your business. We don’t have any medical studies to support this phenomenon, only plenty of anecdotal evidence. It’s called the “runner trots.” But seriously, according to a study published in the Canadian Journal of Gastroenterology, regular physical activity, not necessarily an exercise regimen, can help with chronic constipation (CC), especially in older people who are less active. As for younger patients, the study concludes that exercise appears “to have little improvement in bowel function unless they engage in vigorous exercise.” The study goes on to state that “Exercise can still be recommended to patients because it improves quality of life and has other health benefits unrelated to CC.” Relax Stress is tough on your entire nervous system, part of which, the enteric nervous system (ENS), is devoted to controlling your digestive tract. For many people, stress contributes to constipation. For others, it gives them the collywobbles (stomach ache) and diarrhea. In an article posted on Harvard Healthbeat entitled “The gut-brain connection,” Editor in Chief Anthony L. Komaroff points out that “the gastrointestinal tract is sensitive to emotion. Anger, anxiety, sadness, elation — all of these feelings (and others) can trigger symptoms in the gut.” In fact, results of a study conducted at the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital (MGH), both Harvard affiliates, show that a nine-week training program that included elicitation of the relaxation response had a “significant impact on clinical symptoms of the gastrointestinal disorders irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) and on the expression of genes related to inflammation and the body’s response to stress.” (See “Genomic and Clinical Effects Associated with a Relaxation Response Mind-Body Intervention in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disease” published in PLOS One.) If you’re feeling stressed out and experiencing bowel irregularities, you may want to look into starting a relaxation regimen centered on yoga, mindfulness, tai-chi, or some other deep relaxation technique. Review Your Medications Experiencing chronic constipation or diarrhea? The root cause may be sitting in your medicine cabinet. Many medications can negatively impact digestion, including the little purple pill and its cousins, which are commonly prescribed for acid reflux (heartburn). If you’re having trouble pooping, we urge you to consult with your doctor, who can review your medications (both prescription and over the counter), and help you determine whether one or more of them may be the culprit(s). When You Gotta Go, Go! A busy schedule isn’t the most conducive for regularity. As a result, many people resist the urge to poop when at work or in public. If you’re part of this group, you need to figure out a way to answer the call of nature when it arrives. The fact is, holding it is bad for you. When you resist the urge to poop, your stool is held in your colon, where moisture is extracted from it, and it hardens, causing, you guessed it — constipation. Hold it too long, and your poop can become impacted, your colon can become distended, and its ability to contract impaired. The moral of the story — when you gotta go, go! Squat to Poop Your body is equipped with three muscles to help you choose when to take a seat on the porcelain throne… and when not to: The puborectalis muscle loops around the rectum like a sling, pulling the rectum forward to create a more acute angle between the rectum and the anal canal. When you stand, the muscle crimps the rectum to keep the poop in. When you sit, the muscle relaxes to a certain degree, but it only relaxes fully in the squat position. The internal sphincter is a smooth muscle controlled by enteric neurons — nothing you have any conscious control over. The external sphincter is a skeletal muscle that you can consciously control, as in when you decide to deliver the package. Whether you sit or squat, you consciously relax the puborectalis and external sphincter muscles, but only the squat position fully relaxes the puborectalis muscle to provide a straighter corridor through which your poop can travel. Lesson here? Squat to poop. And we can definitely help with that. Squatty Potty gives you the choice of simulating the squatting position or going full squat over your conventional toilet. The result: A quicker, fuller elimination of poop with little or no conscious effort on your part. Now we’re well aware that discussing poop in public is taboo, but we do it all the time anyway, and we encourage you to do the same… if you feel so inclined. Please share your poop problem and what you have done successfully, or not so successfully, to address the problem. It might just help someone else. – – – – – – – – Disclaimer: This blog post on predictable bowel movements provides general information and discussion about medical issues and health-related subject matter. The words and other content provided in this post, and in any linked materials, are not intended and should not be construed as medical advice. If you or any other person has a medical concern, consult with an appropriately licensed physician or other health care professional immediately and do not rely on the information presented in this post. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog post or in any linked materials. If you think you may have a medical emergency, call your doctor or 911 immediately.
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Encopresis 101 — Understanding Your Child’s Condition
Is your child regularly soiling his underwear even after being successfully potty-trained? If so, your family is probably suffering from one of the most embarrassing and tenacious conditions to afflict children — encopresis (en-kuh-pree-sis) — involuntary defecation — a condition that, left untreated, can follow your child into adulthood. If you’re a parent of a child with encopresis, you don’t have to imagine the psychological impact of encopresis on you and your child. You can’t send your child to school without dreading the possibility of your child passing stool in class or on the playground. You find excuses for your child not to go to friends’ houses for sleepovers. You dread answering the phone when your child is away from home, expecting it to be a call about your son or daughter having “an accident.” You see the frustration, anguish, and shame on your child’s face, as the harder they try to control their bowel movements the more they fail. To make the situation worse, encopresis is a condition nobody likes to disclose or discuss, so families often become increasingly isolated. If you do venture to discuss your situation, you become the cause — other parents unfamiliar with encopresis will assume that you did something wrong when potty training your child. You’re likely to get plenty of unwelcome parenting advice on how to reward your child when he uses the potty and how to enforce consequences when he soils himself — as if soiling oneself isn’t consequence enough! Even some doctors fail to fully understand the problem or provide parents the valuable understanding, insight, and guidance they need to meet the challenge. We’re here to help. Here we bring you up to speed on encopresis — symptoms, causes, and cures. Symptoms of Encopresis The most obvious symptom of encopresis is the soiling of oneself. Other symptoms, according to the Mayo Clinic, include the following: Leakage of stool or liquid stool on underwear, which can be mistaken for diarrhea Constipation with dry, hard stool Passage of large stool that clogs or almost clogs the toilet Avoidance of bowel movements Long periods of time between bowel movements Lack of appetite Abdominal pain Problems with daytime wetting or bedwetting (enuresis) Repeated bladder infections, typically in girls As we point out in a previous post, “10 Tips for More Predictable Poops,” normal pooping involves going one to three times daily and having semi-soft stools that are light brown in appearance. There’s actually a Bristol Stool Chart presented in that post to help you determine whether the consistency of your child’s stool is in the normal range. If your child isn’t having a normal bowel movement at least once a day, or is experiencing one or more of the symptoms described above, consult your child’s doctor for advice. What Causes Encopresis? The primary cause of encopresis is chronic constipation, and the longer a child remains constipated, the worse the condition becomes. At a certain point, the stool can become so impacted in the bowels that it will not move, and the mass continues to grow, stretching (distending) the bowel muscles to the point at which they can no longer contract effectively to push the mass out. The bowels and rectum, which are already lacking in the nerve department lose any “feeling” they have, so the child doesn’t even sense when she “has to go number two.” Softer stool descending through the bowels flows around the existing mass and leaks out, through no fault of the child, soiling the child and her clothes. Yes, it’s disgusting, and your child knows it, but she can do nothing to control it. But what caused the chronic constipation in the first place? Well, that depends. In some cases, a medical illness may cause or contribute to encopresis; hypothyroidism, Hirschsprung’s disease, diabetes, cystic fibrosis, spina bifida, and other illnesses have been linked to problems with colon function. In most cases, however, the cause of the chronic constipation is related to: Diet Sedentary lifestyle Medication Emotional/behavioral issues A combination of the four Diet It’s no secret that most kids these days eat more junk food than in generations past. Our hectic lifestyle leads us to eating more convenient, processed foods and less whole foods, and feeding these same processed foods to our children. Like adults, children should be eating more as nature intended — primarily a whole foods diet consisting mostly of vegetables, nuts, and fruits; some whole grains; and protein from quality sources. A focus on whole foods naturally reduces consumption of sugary foods and drinks (and diet products), simple carbohydrates, and processed foods, such as chips, cupcakes, mac & cheese, and fruit rollups. It’s all about establishing a consistently healthy, well-balanced diet. A diet that is overly restrictive can cause nutritional imbalances, but even too much of a good thing, such as cow’s milk and cheese, can contribute to constipation. Sedentary Lifestyle Many children lead active lives, but too many are overly sedentary, spending more time on their smart phones, watching TV, and playing video games than they do riding their bikes, jumping rope, exploring the great outdoors, and engaging in physical activities with friends. Healthy bodies require movement to keep muscles toned and blood flowing and to ensure proper digestion. If kids with encopresis simply matched every hour of sitting with a half hour of physical activity, they would be well on their way to avoiding constipation and achieving optimal health. Medications When you start researching encopresis, you find a lot of information about lack of fiber in the diet, dehydration, and behavioral issues, but you see very little in the literature about medications contributing to the problem. And the few medications cited may not be the biggest culprits. Several articles call attention to over-the-counter cold medications, antacids, anticonvulsants, chemotherapy, and narcotic pain medications as contributing to constipation, but none of the research we encountered pointed out what may be the biggest contributor of all — antibiotics. Parents know better. Many parents of children with encopresis report that their children were put on repeated trials of antibiotics to treat persistent ear infections and other infections prior to developing encopresis. Given the fact that antibiotics kill intestinal bacteria at the same time they kill the targeted infectious agents, and the fact that beneficial intestinal bacteria are an essential ingredient to healthy bowel function, we wonder what role antibiotics might play in triggering encopresis in children. We would like to see such a study conducted. If you know of such a study, please post a comment to share with our readers. Emotional/Behavioral Issues As we point out in a previous post, “Don’t Get Your Colon in a Knot: The Anxiety-Pooping Connection,” healthy bowel movements are often a case of mind over matter. The same is true for children. Thoughts and emotions may impact their ability to poop. Here are a few emotional/behavioral issues that may contribute to constipation: Stress in the family, at school, or among friends A change in bathroom routine, such as when a child starts or returns to school after a break The busy boy or girl syndrome, in which the child is too busy to take time to use the restroom Constipation and encopresis can result in additional emotional and psychological fallout, especially if the child doesn’t understand the condition and is blamed or blames herself for it. This is a highly stigmatizing condition. What Can Be Done to Cure Encopresis? Fortunately, encopresis can be cured in most cases, but it’s not unusual for full recovery to take a year or longer, especially if the bowel has been distended for some time. Bowel tone and function must be restored through changes in diet and lifestyle and through medical intervention. The first step is to see a gastroenterologist who can order x-rays and other tests to rule out or treat any medical conditions that may be at the root of the problem. Both the American College of Gastroenterology and WebMD have online physician directories that can help you get started. Regardless of the cause, the gastroenterologist is likely to recommend/prescribe: Increased fiber consumption Reduction or avoidance of constipating foods, such as cheese, or milk (if your child has an intolerance to milk) Increased water consumption A pre- and probiotic to restore intestinal flora (see our previous post “Restoring Intestinal Flora Leads to a Healthy Gut and Happy Poop“) Laxatives (perhaps heavy doses over an extended time) and enemas to keep the bowels clear Counseling to help with any stress that may have contributed to the encopresis or any emotional or behavior issues resulting from it Remember: The earlier treatment is started, the better the prognosis. Don’t let embarrassment stand in the way of your getting help for your child. Consult your child’s pediatrician or head directly to the nearest gastroenterologist for help. An Ounce of Prevention Encopresis is one of many illnesses that snowballs into a bigger problem when left untreated, so staying on top of your child’s gastrointestinal health is key to both treatment and prevention. You may be able to avoid ever having to deal with the problem if you invest in the following preventive care: Breastfeed, if possible. Breastfed babies generally have more and looser stools, producing anywhere from 5 to 40 bowel movements per week compared to 5 to 28 among formula-fed babies. Stock up on healthy foods, and clear the shelves of junk food. Encourage an active lifestyle to combat our culture’s sedentary lifestyle. Find a doctor who respects the pros and cons of antibiotics and prescribes them only when necessary. After your child completes a trial of antibiotics, re-inoculate your child with healthy intestinal flora by having her take a quality probiotic along with prebiotics. Consult your child’s doctor for details. Monitor your child’s frequency and consistency of poops. Obviously, you want to give your child some privacy at some point, but teach your child what’s normal — one to three snaky poops daily. Normalize discussion of poop, so your child will not hesitate to let you know when she’s having trouble. Healthy pooping is a key factor in your child’s health; don’t be squeamish. If your family trends on the more humorous side of life, consider reading “Pinching a Loaf and Other Poophemisms” for ideas on how to make the subject matter even more accessible. Transition your family from sitting to poop to squatting to poop. This more natural way of pooping enables everyone in the family to poop without pushing, it’s more fun, and it just may save you a ton of money on toilet paper! To all those parents and their children out there who struggled with or are currently struggling with encopresis, we feel for you. Please post a comment to share your journey with other parents out there who may need support, encouragement, and information. Let us know how you approached this condition — what helped and what didn’t. Help shorten the journey from illness to wellness for others! – – – – – – – – Disclaimer: This blog post on Encopresis provides general information and discussion about medical issues and health-related subject matter. The words and other content provided in this post, and in any linked materials, are not intended and should not be construed as medical advice. If you or any other person has a medical concern, consult with an appropriately licensed physician or other health care professional immediately and do not rely on the information presented in this post. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog post or in any linked materials. If you think you may have a medical emergency, call your doctor or 911 immediately.
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Sit, Squat, or in Between? How Body Position Affects Elimination
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!
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5 Problems With Sitting On Your Toilet
Whether you’re already a believer in the benefits of squatting to eliminate, or you’ve stumbled onto this site as your first introduction to the whole concept, here’s the low-down on why squatting to poop is in your best interest and why using the Squatty Potty® is the most convenient and effective way to improve your bathroom posture. HEALTH PROFESSIONALS KNOW THE BENEFITS OF SQUATTING TO ELIMINATE Medical doctors, naturopaths, and assorted holistic health professionals have pointed out the hazards of the modern toilet for years. There is empirical evidence that elevating your feet during elimination is healthier. The modern day toilet is convenient, but has one major fault; it requires us to sit. While sitting to do our business may be considered “civilized”, studies show the natural squat position improves our ability to eliminate. Better elimination may decrease many modern day ailments including bloating, straining, hemorrhoids and constipation. UNDERSTAND THE PROBLEM Primary (simple) constipation is a consequence of habitual bowel elimination on common toilet seats. A considerable proportion of the population with normal bowel movement frequency has difficulty emptying their bowels, the principal cause of which is the obstructive nature of the recto-anal angle and its association with the sitting posture normally used in defecation. FIX THE PROBLEM The alignment of the anorectal angle associated with squatting permits smooth bowel elimination. This prevents excessive straining with the potential for resultant damage to the recto-anal region and, possibly, to the colon and other organs. There is no evidence that habitual bowel elimination at a given time each day contributes considerably to the final act of rectal emptying. The natural behavior to empty the bowels in response to a strong defecation reflex alleviates bowel emptying by means of the recto anal inhibitory reflex. THE ONLY NATURAL DEFECATION POSTURE FOR A HUMAN BEING IS SQUATTING 5 PROBLEMS WITH SITTING ON YOUR TOILET 1. CONSTIPATION The National Institutes of Health (NIH) defines constipation as having fewer than three bowel movements per seven days. According to the NIH about four million Americans suffer from constipation. Are you one of these people? Do you know someone who is? One of the biggest obstacles to your success may be not realizing you’re constipated in the first place. The bowel is the body’s main elimination organ, yet amongst many Americans today, this central elimination system is compromised, as evidenced by high rates of constipation. The National Institutes of Health estimates that 4-10 million Americans have chronic constipation (defined as having a bowel movement less than three times per week), and as many as 63 million people are suffering at any time from occasional constipation. Squatty Potty® toilet stools create healthy toilet posture to relieve and prevent constipation in the following 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 the small intestine clean, and opens the outlet valve, to allow wastes to pass freely. The sitting position defeats the purpose of both valves, making elimination difficult and incomplete, and soiling the small intestine. 2. HEMORRHOIDS Hemorrhoids (HEM-uh-roids) are swollen and inflamed veins in your anus and lower rectum. When we’re standing or sitting the bend, called the anorectal angle, is kinked which puts upward pressure on the rectum and keeps the feces inside. The sitting posture actually keeps us in ‘continence mode’. We thank our lucky stars for this muscle when we don’t want to go but when we need to go, and sit on our toilet to do it – it sure makes elimination difficult and incomplete, creating the need to STRAIN. By age 50, about half of adults have had to deal with the itching, discomfort and bleeding that can signal the presence of hemorrhoids. The veins around your anus tend to stretch under pressure and may bulge or swell. Swollen veins — hemorrhoids — can develop from an increase in pressure in the lower rectum. THE GOOD NEWS ABOUT HEMORRHOIDS… Hemorrhoids can heal without relapse when the squat posture is adopted for bowel movements. 3. COLON DISEASE Eliminating completely and often helps maintain good colon health. Many studies point to fecal buildup in the colon as a cause of diseases including colon cancer. And when there is buildup in the colon, our bodies can’t absorb all the nutrients from the food we eat, leaving us without the energy we could enjoy if our colons were healthy. 4. URINARY DIFFICULTY/INFECTIONS Urinary flow is usually stronger and easier when women squat to urinate. The bladder is emptied more completely when squatting rather than sitting or “hovering”. Squatting can help reduce episodes of urinary tract infections in both frequency and intensity. Now, that is good news! 5. PELVIC FLOOR ISSUES A 2008 study by Kaiser Permanente published in Obstetrics & Gynecology found that one-third of women suffer from one or more pelvic floor disorders. In addition, aging, obesity, and childbirth increase the likelihood of experiencing these issues. Although pelvic floor disorders are more common in women, men also suffer from similar symptoms; the National Health and Nutrition Examination Survey reports that nearly one in every five men ages 60 and older experience incontinence. A network of ligaments, muscles and connective tissues, the pelvic floor acts as a “hammock” to support the pelvic organs, including the bladder and rectum – and in women, the uterus and vagina. Pelvic floor disorders, also called pelvic floor dysfunction, occur in both men and women when muscles and nerves in this area become damaged or weakened, causing the pelvic organs to prolapse (drop), which can lead to symptoms such as constipation and fecal and urinary incontinence. “Most pelvic floor disorders are tied to the de-evolution of our normal evolutionary biology,” said Dr. Jack Kruse, optimal health coach and Nashville, Tenn.-based neurosurgeon specializing in treating chronic pain, neck pain and back pain. “By correcting our bathroom posture, the Squatty Potty can be a huge help to people suffering from these health problems. Not only is the Squatty Potty aesthetically pleasing, but it also makes a tremendous amount of sense with how we should eliminate.” SQUATTY POTTY IS THE SIMPLE SOLUTIONAll these problems, and more, can be helped with the use of the Squatty Potty®. This innovative, health-giving toilet stool is easy to use and highly effective in positioning the colon for effortless bowel movements. Unlike other contraptions you may have tried to assist in achieving a simulated or full squatting position over your toilet, the Squatty Potty mimics a natural squat posture, is ergonomic, comfortable, sturdy, convenient and affordable. It even slides out of the way under your toilet when not in use.
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Don’t Get Your Colon in a Knot: The Anxiety-Pooping Connection
Do you have trouble pooping whenever your routine is disrupted — when out of town for business or on vacation or even just when you’re away for the weekend, for example? If so, you’re not alone; by one estimate, 40 percent of people experience traveler’s constipation (i.e., difficulty in emptying the bowels while away from home). To the other extreme, many people get diarrhea when they’re nervous. In fact, anxiety to the point of fear may even cause a person to literally poop their pants. Of course, poop problems are often and primarily diet related (the quality and quantity of the food and beverages consumed), but it’s no surprise that your brain and your mindset play an important role in how well, or not so well, you poop. After all, your bowels and your brain are connected. Some doctors even refer to the gut as “the second brain” — an organ that can receive signals from and send signals to the brain. The connection is the enteric nervous system (ENS), a subdivision of the body’s autonomic nervous system (ANS), the part of the nervous system that controls unconscious bodily functions, such as breathing, heartbeat, and digestion. The ENS division of the ANS directly controls the gastrointestinal system. So, even though nothing you are consciously thinking is at fault, the problem could still be all or mostly “in your head.” Although the problem may be in your head, the solution is likely to require attention to four areas: Diet Exercise Relaxation Squatting Diet and Nutrition The recipe for healthy pooping is almost cliché: Drink plenty of water and eat foods high in fiber. By “water,” we mean water without a whole lot of coffee or tea, alcohol, or sugary drinks (even fruit juice). By “foods high in fiber,” we mean fresh vegetables and fruits, nuts, and healthy whole grains. The idea here is to regulate the colon. While we often think of water and fiber as foods that loosen stools and make you empty your bowels more, regulating the colon can help to alleviate diarrhea, too. Caffeine, you may be surprised to know, is counterproductive, because it is a diuretic which dehydrates the body, and because it stimulates the hypersecretion of gastric acids. And alcohol — which a lot of us like to drink when we’re on vacation or with clients during an overnight business trip — is generally considered a toxic substance that irritates the bowel and can even trigger an attack of irritable bowel syndrome (IBS). Of course, if you have an acute bout of diarrhea or constipation, shifting from your normal diet can help: Diarrhea: If you have diarrhea, consider the BRAT diet — bananas, rice, applesauce, and toast, all of which have the effect of binding loose and runny stools. Yogurt may also help, making for a BRATY diet. Constipation: Fluids and fiber are your go-to foods for curing constipation. Legumes (beans, lentils, and peas), broccoli and spinach, nuts and seeds, berries, and most fruits (except bananas), are great choices. Chocolate may also help, but avoid cheese at all costs (because cheese is about as low in fiber as you can get). Exercise Exercise, or any physical activity, promotes overall health, including bowel health and activity. A sedentary lifestyle contributes to constipation by slowing the digestive system. Engaging in a consistent exercise routine, exercising at the same time every day, is best, even when you’re on the road. One caution: Strenuous exercise can lead to dehydration, so increase your water intake accordingly. Relaxation Stress and anxiety contribute to both constipation and diarrhea, so learn to stay relaxed throughout the day. We understand that life can be stressful and that you cannot possibly eliminate all the stressful situations (and people) in your life, but you can change the way you respond to stress. Practices such as mindfulness meditation are very helpful for throttling your stress response, because they train your mind to stay in the present instead of allowing regrets of the past or concerns about the future from triggering emotional reactions. Yoga, mindfulness, and other relaxation techniques are also helpful in eliciting the relaxation response — a psychological state of deep restorative rest that alleviates stress and anxiety and helps to regulate blood pressure, heart rate, and oxygen consumption. Practicing Yoga or mindfulness meditation 15 to 20 minutes a day has proven useful for treating gastrointestinal disorders, as well, specifically IBS and inflammatory bowel disease (IBD). Squatting While most doctors provide much of the same advice we present in this post, few doctors focus on one of the most important factors that contribute to bowel regularity — posture. In fact, the Squatty Potty itself was conceived shortly after a therapist recommended to our founder’s mother that she try squatting to relieve her constipation. In other words, when you assume the position to ease your burden, “don’t sit, squat,” she was told. And the same goes for you… give your poop a free corridor to exit the building. Squatty Potty can help. And if you commonly suffer from traveler’s constipation, consider getting another Squatty Potty to take along with you — the Porta Squatty. The take-away lesson here is this: If you’re worried about pooping, stop. That worry and others could be contributing to your pooping problems, and that is something that we here at Squatty Potty cannot accept. We are committed to helping you eliminate your poop, and in so doing, rectify poop related issues. Instead of worrying, take steps to regulate your bowel movements — eat right, drink plenty of water, exercise, relax, and … squat!
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Restoring Intestinal Flora Leads to a Healthy Gut and Happy Poop
At Squatty Potty, we are committed to improving the pooping experience one stool at a time, but we realize that assuming the proper stance is only one of many factors that impact the outcome. Another key to consistently good movements is related to the microorganisms that live inside you, specifically those that reside in your intestines — collectively referred to as intestinal flora or gut bacteria. If you have any doubt about the importance of gut bacteria on colon health and, subsequently, on the squatting experience, consider this: One of the most promising treatments for ulcerative colitis, diverticulitis, irritable bowel syndrome, and Crohn’s Disease is the Fecal Microbiota Transplant (FMT), is a procedure in which healthy bacteria from a donor’s fecal matter (or sometimes just the donor’s fecal matter itself) is transferred to the gastrointestinal track of the recipient. This procedure has been most successful in treating people who have an overgrowth of Clostridium Difficile bacteria, (C. diff for short). Want to know more? Visit The Fecal Transplant Foundation online today. As it turns out, the average person lugs around about four pounds of gut bacteria, some harmful, some beneficial, some neutral. When the balance of beneficial and harmful bacteria get out of whack, the harmful bacteria proliferate like microscopic rabbits, the colon gets irritated, and you pay the price… in the bathroom, if you’re lucky enough to get there in time. While an overgrowth of harmful bacteria causes diarrhea, a scarcity of bacteria contributes to constipation. Unlike other components of stool, bacterial cells retain moisture. When your gastrointestinal tract has too few bacteria to loosen the feces and keep them moist, stools become dry, hard, and more difficult to pass. Although the treatments for chronic constipation and diarrhea vary depending on the cause, in many cases, the solution is the same — restore the healthy balance of intestinal flora, which calls for a three-pronged approach: Stop killing your intestinal flora. Reintroduce the beneficial bacteria whose populations have been decimated by antibiotics, poor diet, infection, or other causes. Feed the beneficial bacteria to enable them to crowd out the harmful critters. Stop Killing Your Intestinal Flora Assuming you were born vaginally, as opposed to caesarian, and were breast-fed, you inherited a healthy dose of beneficial intestinal flora from your mom. It was the best gift she could ever give you. An infant’s intestinal flora triggers early development of the immune system. A recent study conducted by researchers at NYU’s School of Medicine and Stanford University’s School of Medicine shows that the intestinal flora of infants born vaginally differs significantly from that of infants born caesarian, which may partially explain the increasing incidence of childhood asthma, allergy, and other illnesses related to the immune system. Since birth, your intestinal flora has been under siege. Antibiotics, in particular, can decimate gut bacteria, both harmful and beneficial, and alter the delicate balance of your intestinal flora. Environmental toxins, including pesticides, food additives, and chemicals in everything from the air we breathe and the water we drink to the household cleaners we use and the clothes we wear, can disturb the balance. Bacterial and viral infections of the gut can also disrupt the balance, increasing populations of harmful microbes while decreasing populations of beneficial microbes. The first step to restoring a healthy balance is to stop or at least reduce these attacks on your intestinal flora. Here are four suggestions: Find a doctor who fully appreciates the importance of gut bacteria on your health and is careful in prescribing antibiotics. If you’re not sure where to start, consider searching the Institute for Functional Medicines’ practitioner search tool. Functional Medicine doctors are like detectives — they like to get to the root cause of illness and know a lot about gut health. Eat a healthy diet, primarily plant-based, along with protein sources that haven’t been subjected to large doses of antibiotics (grass-fed beef, for example, and milk that’s free of antibiotics and growth hormone). Reduce or eliminate consumption of sugar and artificial sweeteners along with starchy foods (simple carbohydrates), such as wheat products, potatoes, rice, and high-glycemic fruits. Drink plenty of pure water — at least about two liters (a half gallon) a day. Reintroduce Beneficial Bacteria: Probiotics Although nothing can match the diversity of microorganisms you were given at birth and acquired throughout the course of your life, you can put your intestinal flora on the road to recovery through the use of probiotics — beneficial microorganisms (live bacteria and yeasts) found in certain foods, including: Yogurt Kefir Sauerkraut Also available as probiotic supplements in pill, powder, or pearl form Tip: If you’re taking a probiotic supplement, look for a quality product that contains at least five billion colony forming units (CFUs) containing lactobacillus and bifodobacterium. Other bacterial strains can be very helpful, as well, but these are the two biggies. Feed Your Beneficial Bacteria: Prebiotics A sick gut is often the product of an unhealthy diet, not just your diet, but the diet you feed the microorganisms in your gut. With probiotics, you merely plant the seeds. Prebiotics are the fertilizer — the “soil” conditioners — that enable the probiotics and other beneficial microbes already in your gut to flourish. Actually, prebiotics are plant fibers (consisting of soluble fiber and non-digestible sugars) that can travel down through the small intestine to the large intestine undigested and feed the beneficial bacteria that reside within the bowels. In a way, prebiotics are even more important than probiotics. With probiotics, you plant only a few strains of beneficial microbes in your gut. With prebiotics, you nourish the diverse collection of microbes that you have acquired via birth and through your many years of life. Combining pre- and probiotics is optimal, because the two work synergistically to boost populations of beneficial bacteria throughout your gut. If you eat a healthy high-fiber diet, you’re already doing plenty to feed your intestinal flora. If you’re not getting enough fiber in your diet, however, taking a prebiotic supplement may help. Keep in mind that nutrition is about more than just your body; you need to think about those trillions of hungry microbes in your gut, the microbes you literally cannot live without. Keep them healthy and they will reward you a trillion-fold. Tune in next week for more about pre- and probiotics. – – – – – – – – Disclaimer: This blog post on intestinal flora provides general information and discussion about medical issues and health-related subject matter. The words and other content provided in this post, and in any linked materials, are not intended and should not be construed as medical advice. If you or any other person has a medical concern, consult with an appropriately licensed physician or other health care professional immediately and do not rely on the information presented in this post. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog post or in any linked materials. If you think you may have a medical emergency, call your doctor or 911 immediately.
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The unexpected side-effect of Autism and how the Squatty Potty helps
To date, studies show that 1 in 68 children are diagnosed with autism. Autism is referred to as Autism Spectrum Disorder or ASD and is a developmental disability that can cause a range of mild to severe social, communication and behavioral challenges. There is no “look to autism,” but behaviors, social skills and communication can be markedly different in people with ASD than people without the disorder. Symptoms of Autism Spectrum Disorders vary- and one symptom that parents tend to focus on are the GI issues that can come with an autism diagnosis. Many children with autism suffer from issues involving the gut and their bowel movements (or lack thereof!) Constipation tends to be a common issue in the Autism Community and a common discussion amongst parents- parents that are always trying to find tools that help! Studies from Autism Speaks, and the Centers for Disease Control and Prevention (CDC) “recently found that children with autism are more than 3.5 times more likely to suffer chronic diarrhea or constipation than are their normally developing peers. Other researchers have found a strong link between GI symptoms and autism severity in children. Some experts have even proposed that toxins produced by abnormal gut bacteria may trigger or worsen autism in some children.”According to renowned pediatric gastroenterologist, Dr. Timothy Buie at Massachusetts General Hospital, some behavioral signs of GI discomfort in ASD include: Tapping chin Excessive coughing Applying pressure on the abdomen (lying over arms of couch) Chewing of clothes (can also be teething/sensory seeking behavior) Feeding/eating disorders Excessively chewing food or food refusal (difficulty swallowing due to inflammation or eosinophilic gastroenteritis-may be painful to swallow) Hitting/fisting the jaw Sleep disturbances Eating to relieve discomfort Behavior changes, especially self-injurious, aggressive or mouthing behaviors Toileting and potty training can be a difficult thing to teach, even with typical developing children. Kids with autism have unique issues that can arise. Many of our kids have sensory issues that hinder a smooth transition to potty training- they don’t like the bright lights in the bathroom, the echo-sounds of running water, the dangling of their feet from a large, hard toilet. Many kids with autism have rigid diets, causing constipation and encopresis which in turn causes pain, making toileting a scary and painful experience. Communication can be limited and as parents we have to set a toileting routine. When we realized that our children had some of these “gut issues,” we started doing some research. As parents, we sought out information to help our kids with this very real problem. We looked to The Thompson Center for Autism in Columbia, MO and found a tool-kit produced in the ATN/Autism Speaks partnership and found many useful suggestions and ideas. In the process, we saw the Squatty Potty on a favorite show, Shark Tank, and thought, maybe it could help! We ordered two and now, it is an integral tool in our bathrooms- it helped our son feel more comfortable in his toileting routine and helped our older daughter deal with painful constipation as a young child. Our goal at Ella’s Hope for Autism, our non-profit helping families and organizations, and Autism Support Now Behavioral Services, our agency providing therapies to individuals aged 2-18, has always been to help educate and advocate for families that are affected with autism. Our mission is to promote autism awareness and support families affected by autism spectrum disorders. We are committed to funding programs and organizations that provide early intervention services and therapies, family support, education, advocacy and opportunities with the purpose of improving the quality of life for individuals with autism and their families. We offer support to organizations that provide services for children with autism and to organizations that conduct research on the causes and effects of autism. To find out more information, please visit us at http://ellashope.org/donate-now/ and http://autismsupportnow.com/ Bio information: Hope McPheeters is the Executive Director of Ella’s Hope for Autism, a 501c3 non-profit helping families across Missouri, Kansas and Illinois. She volunteers as the Parent and Community Specialist for Autism Support Now Behavioral Services and advocates for individuals through local school districts and organizations. She lives in Kansas City, with her husband and two children, who are both on the autism spectrum.
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