Did You Know?

Toilet Sitting 101

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Did you know there’s a right and a wrong way to sit on the toilet? Most people don’t realize that their position when having a bowel movement is key to solving lots of GI complaints like bloating, gas, and constipation. The right position can also help improve more serious GI conditions such as diverticulosis, small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS). Squatting is the most natural stance for giving birth and, it turns out, for having a bowel movement.

A squatting position helps to straighten the anorectal angle and keeps the knees pressed up against the abdomen, increasing intra-abdominal pressure, which helps to push the stool out. Over a billion people throughout the world don’t have access to toilets and squat over a hole instead. Interestingly, people in countries where squatting is the norm have much less constipation and colon cancer, probably because their diets, like their bathrooms, are less refined.

I’m not suggesting that you get rid of your modern plumbing, but sometimes getting back to nature isn’t such a bad thing. This is why I recommend a bathroom stool (no pun intended!) for everyone – a small stool (the height of your toilet to half a foot shorter) that you put your feet on to draw your legs up and closer to your chest when sitting on the toilet.

This lets you approximate a squatting position while maintaining the luxury of a toilet rather than a hole in the ground. If you’re flexible, drawing your feet up and placing them on the toilet seat works great, too—but be careful not to fall off! If you need to be resourceful outside the home, you can utilize a stack of magazines or books, or turn a small bathroom garbage can upside down (I often resort to this in hotel rooms!). I find that constipation is rarely entirely due to position, but every little bit counts in our quest for stool nirvana, so consider trying a squat to see if it helps.

While those experiencing constipation, bloating, hemorrhoids or other GI conditions can greatly benefit from a squatting position, the average healthy person can benefit as well. Complete evacuation with each bowel movement is an important determinant for overall health. In fact, a study published in March of this year in the Journal of Clinical Gastroenterology used a toilet stool in healthy subjects to assess the effects on bowel movement patterns. 52 female participants with a mean age of 29 were included in the study. Of the 52 healthy subjects, 15 reported incomplete evacuation, 23 reported straining, and 29 observed blood on their toilet paper within the last year. The use of the bathroom stool significantly reduced straining, increased bowel emptying, and decreased BM time. Do yourself a favor and change your position starting today. Your colon will thank you!

Robynne Chutkan, MD

Robynne Chutkan, MD, FASGE, is the founder of Gutbliss Rx. She is an integrative gastroenterologist and the bestselling author of Gutbliss, The Microbiome Solution, and The Bloat Cure. Educated at Yale and Columbia, she’s been on the faculty at Georgetown University Hospital since 1997 and is the founder of the Digestive Center for Wellness, an integrative gastroenterology practice incorporating microbiome analysis and nutritional counseling as part of the therapeutic approach to digestive disorders. An avid runner, snowboarder, and yogi, she is passionate about helping her patients live not just longer lives, but dirtier ones!

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