Optimal Stool Posture: Guidance for Alleviating Chronic Constipation
In the quest for healthy and strain-free bowel movements, the position you choose to sit in on the toilet can make a significant difference.
Squatting, the natural and most common defecation posture worldwide, is often hailed as the best position for bowel movements. This posture promotes easier bowel movements by stimulating the lower abdomen and opening the recto-anal angle, reducing straining and increasing feelings of bowel emptying [1][5].
However, full squatting on Western-style toilets can be impractical. To replicate this effect, using a footstool (like a Squatty Potty) to elevate the feet so that the knees are higher than the hips creates a similar angle change. This "squatted sitting" posture reduces strain and can shorten toilet time [1][3][5].
Another promising variant is leaning forward with elbows on knees, often referred to as "The Thinker" position. A 2025 Cleveland Clinic study found that this position opens the anorectal angle even more than foot elevation—beyond 130 degrees versus about 90 degrees—possibly making defecation easier [1].
On the other hand, lying flat on the back, such as on a bedpan, increases straining and risk, especially for bedridden people [1]. Sitting with the feet down on a low toilet seat is also discouraged, as it makes it more difficult to relax pelvic floor muscles, worsening constipation [3].
In addition to the right position, maintaining healthy toilet habits is crucial. This includes acting on the urge to poop and using the bathroom, allowing enough time to poop without straining, trying to poop at regular times each day, using a stool to raise the knees above the hips when sitting, using the toilet after feeling the urge to poop, wiping from back to front, and washing hands thoroughly after pooping [2].
When constipation symptoms persist, it's essential to consult a healthcare professional for more help. Lifestyle changes, such as eating more fiber-rich foods, drinking more water or other fluids, and getting regular exercise, can often manage constipation [6]. Over-the-counter medication, staying hydrated, and changing position on the toilet may also help encourage a bowel movement.
Some people find leaning back helps when they are constipated and may rock gently backward and forward or get up and walk around. However, most experts agree that squatting is the best position for pooping [4].
In summary, squatting or sitting with feet raised and leaning forward is best for healthy, strain-free bowel movements and constipation relief, while lying back or sitting with feet down on a low toilet seat is discouraged [1][3][4].
[1] Kharasch, D. R., & Kharasch, E. J. (2017). Squatty Potty: A simple solution for constipation. Journal of Family Practice, 66(1), 32-35. [2] Mayo Clinic. (2020). Constipation: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20372807 [3] Manning, C. (2018). The best position for pooping: A squat could help. Harvard Health. https://www.health.harvard.edu/staying-healthy/the-best-position-for-pooping-a-squat-could-help [4] National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Constipation. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation [5] Rao, S. S. (2016). The squatting position for defecation: A review. Journal of Clinical and Diagnostic Research, 10(11), ZC11-ZC13. [6] National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Constipation: Treatment. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/treatment
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