What Is the Best Poop Position?

The Squatty Potty is put to the test.

Previously, I’ve talked about the potential efficacy of prunes and dried figs to keep us regular. What influence does body position have on defecation? While squatting continues to be the traditional position for people in Asia and Africa, Westerners have become accustomed to sitting on toilet seats. When we do that, we sit upright, and our poop is forced to make a nearly 90-degree turn, the “anorectal angle,” which you can see below and at 0:37 in my video The Best Poop Position for Constipation.

Now, that’s a good thing in terms of keeping us from pooping our pants every time we sit down. But when it comes to doing our business, toilet posture defeats the purpose of our body’s brilliant design—like trying to drive a car without releasing the parking brake. Yet, many physicians are hesitant to discuss “such an unmentionable bodily function,” or they may just be ignorant. Doctors don’t know squat.

Of course, this is coming from someone who owns a company selling people squatting platforms for their toilets. In a previous video, I talked about those little footstools you can use to raise your knees when you assume a pooping position, but they were not found to make a difference in terms of self-described difficulty in defecating or the average time spent emptying one’s bowels. Those stools give only a measly four-inch boost, though, while the Squatty Potty is twice that height. What happened when it was put to the test?

Researchers implemented a “Defecation Posture Modification Device,” i.e., Squatty Potty, and it worked! Participants reported increased feelings of bowel emptiness, reduced straining, and about a minute less of on-the-pot reading time. The only downside is the discomfort. Even just a six-inch riser was found to cause such extreme discomfort in research participants in a previous trial that they abandoned trying to study it.

How else can we get that same change in angle you get from raising your feet? How about just tipping forward, as shown below and at 2:14 in my video?

Look familiar? It is like that famous sculpture by Rodin, The Thinker. And indeed, Cleveland Clinic researchers set out to study “The Thinker” position for defecation. They were able to show the anorectal angle, as measured using cinedefecography—your SAT word for the day, basically meaning x-ray poop movie—opening to more than 130 degrees. That’s better than simply raising your feet, which opens the angle to only around 90 degrees. So, “The Thinker” position may be a more efficient method for defecation. It may also help with constipation, but it has not yet been formally put to the test.

As an aside, you can imagine how the worst position might be flat on your back using a bedpan. Because of the spike in blood pressure in the heart and brain when bearing down, straining while passing stool is associated with sudden death from a heart attack and stroke. In fact, it has been found to be the daily activity most often occurring at the time of death in Japan, and those who can’t get out of bed would seem to be especially at risk. That’s why, if at all possible, it can help to sit people up in bed to cause less strain on the system.

It’s important to take a step back, though, in this sitting versus squatting debate, as a nearly 50-year-old commentary did. Yes, the squatting position is called natural since it is used by so-called primitive peoples who easily pass large stools, such that squatting advocates blame the porcelain throne for all manner of Western maladies. But does the position really make a difference if you’re eating the right foods? “The man who squats because he has no modern plumbing also tends to eat food that is less refined”—that is, more natural foods that haven’t had their fiber processed out. Adding fiber to the diet can enable constipated patients to poop effortlessly without having to squat over a hole in the ground. So, maybe if we just change the design of our diets, we don’t have to change the design of our plumbing.

Doctor’s Note

The video on prunes that I referred to is Prunes: A Natural Remedy for Constipation.

I previously talked about poop position in Should You Sit, Squat, or Lean During a Bowel Movement?.

How Many Bowel Movements Should You Have Every Day? Check out the video to find out.