Why posture matters in defecation: why squatting may be easier
Short answer: When squatting, the hips flex more, the angle between the rectum and anal canal (anorectal angle) widens and the passage straightens. In small studies this angle was about 100° sitting and about 126° squatting, and people reported less straining and quicker satisfactory emptying when squatting. Raising the feet on a footstool brings a seated position closer to squatting.
What changes anatomically?
The rectum stores stool before evacuation; where it meets the anal canal there is a bend called the anorectal angle. The puborectalis muscle slings around this area, maintaining the angle and supporting continence; during defecation it and the anal sphincters relax. Squatting flexes the hips more, helping the angle widen and the passage straighten, so emptying may need less effort.
Has the effect of squatting been studied?
In Sakakibara et al., six healthy volunteers were assessed with imaging and pressure measurements: the anorectal angle during defecation was about 100° sitting and 126° squatting – a small study, so not fixed values for everyone. In Sikirov's study of 28 healthy volunteers comparing a standard toilet, a lower toilet and squatting, participants reported less straining and reaching satisfactory emptying faster when squatting.
Can a similar posture be achieved on a Western toilet?
Raising the feet on a stool lifts the knees and increases hip flexion – close to, but not the same as, full squatting. In a study of 52 volunteers, using a footstool was associated with less straining, shorter defecation time and better emptying; the design does not prove superiority, but foot support may improve comfort for some people.
Bowel and anal complaints: assessment in Ataşehir, Istanbul
Posture is not a treatment on its own. Long-lasting constipation, painful bowel movements, bleeding or anal swelling need examination – they may relate to haemorrhoids or an anal fissure. See also Botox for anal fissure.
The clinic is in Atatürk Mahallesi, Ataşehir, in Metropol İstanbul Block B. Besides the Barbaros, İçerenköy, Küçükbakkalköy, Kayışdağı, Yenisahra and Ferhatpaşa neighbourhoods of Ataşehir, we see patients from Kadıköy (Kozyatağı, Bostancı, Göztepe, Erenköy), Ümraniye, Maltepe, Çekmeköy, Sancaktepe, Üsküdar, Kartal and other districts of Istanbul.
Frequently asked questions
Is a squat toilet healthier than a sitting toilet?
Small studies suggest squatting may mean less straining and quicker comfortable emptying than sitting; comfort varies, and squatting may not suit people with knee or hip problems.
Why does squatting make defecation easier?
Hip flexion relaxes the puborectalis and widens the anorectal angle – about 100° sitting vs about 126° squatting in one study.
Does a toilet footstool help?
In a 52-volunteer study it was linked to less straining, shorter time and better emptying; it approximates but does not equal squatting.
Is changing posture enough for constipation?
No. Persistent constipation, bleeding or pain should be examined.
Related guides
Sources
Sikirov D. Comparison of straining during defecation in three positions. Digestive Diseases and Sciences. 2003;48(7):1201–1205 ↗Sakakibara R et al. Influence of body position on defecation in humans. Lower Urinary Tract Symptoms. 2010;2(1):16–21 ↗Modi RM et al. Implementation of a defecation posture modification device: impact on bowel movement patterns in healthy subjects. J Clin Gastroenterol. 2019;53(3):216–219 ↗This content is for general information and does not replace personal diagnosis or treatment.
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