Squat or Sit? The Straight Poop

comparative-angleBy Dr. Mercola

Is the Western toilet in part responsible for problems like hemorrhoids, constipation, IBD (Inflammatory Bowel Disease), appendicitis, and even heart attacks?

If you examine the data, there is a great deal of evidence this is true. The modern toilet has required us to change the position we use to evacuate our bowels, which changes the anatomy of… well, a poop, to put it bluntly.

Infants instinctively squat to defecate, as does the majority of the world’s population. But somehow the West was convinced that sitting is more civilized.

Sitting on the modern Thomas Crapper-style sit-down toilet is designed to place your knees at a 90-degree angle to your abdomen. However, the time-honored natural squat position places the knees much closer to your torso, and this position actually changes the spacial relationships of your intestinal organs and musculature, optimizing the forces involved in defecation.1

Sitting to evacuate your bowel requires you to apply additional force (straining), which has some unwanted biological effects, including a temporary disruption in cardiac flow.

Can the Toilet Be Blamed for Increasing Rates of Colon and Pelvic Disease?

Squatting is the way our ancestors performed their bodily functions until the middle of the 19th Century. Chair-like toilets were reserved for the royals and the disabled. But the “progress” of westernized societies may be partly to blame for higher rates of colon and pelvic disease, as described by a report in the Israel Journal of Medical Science:2

“The prevalences of bowel diseases (hemorrhoids, appendicitis, polyps, ulcerative colitis, irritable bowel syndrome, diverticular disease, and colon cancer) are similar in South African whites and in populations of prosperous western countries. Among rural South African blacks with a traditional life style, these diseases are very uncommon or almost unknown.”

As globalization continues to make its way across the world, squat toilets are being converted to sitters. For example, Thailand’s Health Ministry just announced it will replace squat toilets with the sit-down varieties at all public facilities.3 This may be a bad thing for public health, as a wide range of health problems have been associated with the transition from squatting to sitting. In fact, health problems potentially stemming from the sitting position include the 15 outlined in the following table.

Appendicitis Constipation Hemorrhoids
Incontinence Colitis Crohn’s Disease
Diverticulitis Contamination of the Small Intestine Gynecological Disorders, including Pelvic Organ Prolapse and Uterine Fibroids
Colon Cancer Hiatal Hernia and GERD Pregnancy and Childbirth
Prostate Disorders Sexual Dysfunction Reduced Risk of Cardiac Events

The Straight Poop

Evidence suggests bowel and pelvic problems may be related to improper potty posture. Only with the traditional squat position is your body aligned in a way that promotes complete bowel emptying. As you can see from the diagram, squatting actually straightens and relaxes your rectum.

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