Constipation: a matter of position

Who would have thought that the position you take to go to the bathroom would affect stool expulsion?

In fact, modernization is not always synonymous with efficiency. Of course, sitting on a toilet seat is far more comfortable than squatting behind a tree, but at what cost? Have you ever noticed that babies of walking age crouch down to relieve themselves? Instinctively, they seem to know the best position to help pass stool.

Considering the thousands of people suffering from intestinal disorders with constipation at the top of the list, this is information that needs to be shared. Let’s talk a little about anatomy to better understand the importance of the position to adopt to have a bowel movement.

The role of the anal sphincter is to retain stool by contracting or to allow defecation by relaxing. To help maintain continence, there is also a turn between the rectum, the part of the intestine where the stool awaits expulsion, and the anus (the outlet). This bend, called the ano-rectal angle, blocks the passage and keeps the faeces inside. Even when sitting on the toilet bench, the progress of the stool can be slowed by this difficult passage, leading to constipation and the complications that result (hemorrhoids, fissures, fistulas). To simulate the squatting position, simply raise your legs to 35 degrees by placing your feet on a small bench. The turn that blocks the passage of the saddle is then straightened, leaving it free.

A few studies have been published on the subject, including one in 2003 by Dov Sikirov, an Israeli doctor. He asked 28 volunteers with normal bowel movements to defecate in three different positions: sitting on a toilet 40 cm high, 30 cm high, or squatting over a plastic container. They were asked to rate the duration of defecation as well as the effort required on a 4-point scale (from “effortless” to “difficult”). The crouching subjects took 51 seconds to defecate compared to 130 seconds for those sitting on the toilet.

People suffering from constipation could reduce their discomfort by familiarizing themselves with the use of a footrest, which could soon become the norm for many of them. They are available in wood or hard plastic and in different heights to accommodate people of all sizes.

For more information on intestinal disorders:

The 5 Messengers of the Body, Gisèle Frenette, The White Dolphin, 2014

All about bowel health, Gisèle Frenette, Quebec-Books, 2012