Sit less, Squat more.
"We were not meant to sit on toilets" proctologist Michael Freilich famously told TIME magazine in 1978, after President Carter had hemorrhoid troubles. "We were meant to squat in the field".
Medical background
Our human body is designed to eliminate waste by squatting, not sitting.
The puborectalis muscle forms a sling around the lower rectum. It wraps the last piece of the intestine like a horseshoe and bends it. The kink in the intestine is important: it prevents the intestinal contents from leaving the body unintentionally.
→ Sitting and standing tightens the puborectalis muscle like a bend in a garden hose, causing blockage to the rectum.
→ Squatting is our natural defecation posture since prehistory. It relaxes the puborectalis muscle allowing for an easier, faster and healthier elimination.
Proctologist Dr. med. Daniel Sterzing
"By using the toilet stool, we adopt a squatting position on the toilet, which is much more natural and makes the whole emptying process much easier. Our western toilets are simply too high up for this physiological position. With a toilet stool, the feet are higher and the rectoanal angle is larger and therefore more optimal for emptying."
Daniel Sterzing, MD, is a surgeon, visceral surgeon and proctologist and works at the Proctology Centre Berlin.
Why is the squatting posture healthier?
THE SCIENCE BEHIND IT
There is a famous study from the US that has investigated the use of a “device for changing posture during defecation” and its effects on bowel movement on 52 healthy volunteers.
The study showed a positive influence on the duration of the bowel movement, the load, and the complete emptying of the bowel. The scientists, therefore, concluded that such a device is a non-drug option for people suffering from insufficient bowel evacuation or increased bowel load.
Anyone who has problems emptying their bowels should of course always have this clarified by a doctor first, so that no illness requiring treatment such as diabetes is hidden behind it.
If this can be safely excluded, if the diet and the amount of exercise are right, then it makes sense to take advantage of the benefits of the squatting position. In principle, all toilet stools can support this.
Our toilets at home - comfortable but unhealthy
For the intestinal health in the western world, it would be better if the sitting toilet had never been invented. Because only in the squatting position can the Puborectalis muscle be completely relaxed.
And indeed: In rural areas of Asia and Africa, where squat toilets still predominate today, hemorrhoids are not a widespread disease.
But don’t worry, this is not a plea to give up the comfortable sitting toilet.
It is enough to put your feet 20 – 30 centimeters higher. As soon as the upper and lower leg describe an acute angle of about 35 degrees, the muscle can be loosened, the kink in the rectum disappears and intestine remains can leave the body without further effort as if through in a downpipe.
Improved bowel evacuation through squatting posture
The squatting position relaxes the pelvic floor and straightens the bowel, which facilitates bowel evacuation. A study by Dr. Saeed Rad shows that the angle in the rectal area is greater in the squatting position (132-180 degrees) than in the sitting position (92 degrees). This reduces straining and enables complete evacuation.
Test subjects reported a better emptying sensation in the squatting position. Dr. Rad concludes that squat toilets provide more efficient bowel evacuation.
Prevention of constipation and bowel cancer
The squatting posture can prevent constipation and bowel cancer. Constipation, a common disease of civilization, is often aggravated by sitting during defecation.
In the squatting position, gravity helps, the bowel is gently compressed, which relaxes the puborectal muscle and makes bowel movements easier. Long-term use of laxatives for constipation can lead to colon polyps and colon cancer.
Scientists suspect that the lower rate of bowel cancer in developing countries is linked to the widespread squatting posture.
Preventing hemorrhoids by squatting
The squatting posture can prevent and relieve hemorrhoids. Proctologist Michael Freilich and Dr. Berko Sikirov found that the sitting toilet encourages excessive pressing, which promotes haemorrhoids. In one study, the symptoms of 18 out of 20 patients improved with the squatting posture.
This change in posture not only relieves the bowel, but also the heart and supports a natural
healing process for haemorrhoids.
Protection against cardiovascular attacks
The squatting posture can prevent cardiovascular attacks during bowel movements, especially in heart patients. Dr. Sikirov found that straining hard on the sitting toilet puts a strain on the heart and can lead to serious incidents such as fainting, collapse or death.
The squatting posture relieves the heart and could prevent such tragic events. It also prevents urinary
incontinence and bladder infections as it has a positive effect on the bladder.
Prevention of urinary incontinence and helping with prostate problems
The squatting posture can prevent urinary incontinence. Studies show that people who use squat toilets are less likely to suffer from urinary incontinence. This is because the squatting position relaxes and strengthens the pelvic floor, which increases the pressure.
A strong pelvic floor supports the bladder, bowel and uterus. Pushing in a sitting position, on the other hand, overstretches the pudendal nerve, which can lead to urinary incontinence. It therefore also makes sense for (older) men to urinate while sitting - or even better while squatting. This relieves some of the pressure on the prostate and makes it easier to empty the bladder. In addition, the squatting posture trains the knee and leg muscles and improves concentration.
View all related studies (list)
Studies on the health benefits of squatting when having a bowel movement, including the use of toilet stools:
- Sikirov, D. - Comparison of Straining During Defecation in Three Positions. Results and Implications for Human Health, Digestive Diseases and Sciences, Juli 2003
- Sohrabi et al.: Squatting and risk of colorectal cancer:a case-control study (Middle East Journal of Digestive Diseases, 2012)
- Sakakibara, Ryuji et. al - Influence of Body Position on Defecation in Humans
- Bhattacharya Sudip et al. - Health promotion and prevention of bowel disorders through toilet designs: A myth or reality? Journal of Education and Health Promotion, Februar 2019
- Trieu et al.: Using a footstool does not aid simulated defecation in undifferentiated constipation: A randomized trial (Gastroenterology, 2022)
- Dr. B.A. Sikirov - Etiology and pathogenesis of diverticulosis coli: a new approach, Medical Hypotheses, 26. Mai 1988
- Bockus, H.L. - Gastroenterology, (Philadelphia: W.B. Saunders Co., 1944), Vol. 2, Page 469
- Ghoshal UC et al. - Indian consensus on chronic constipation in adults: A joint position statement of the Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology. Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology, 2018
- Saeed Rad- Impact of Ethnic Habits on Defecographic Measurements. Arch Iranian Med, 2002
- Chuah KH, Mahadeva S. - Cultural Factors Influencing Functional Gastrointestinal Disorders in the East. Journal of Neurogastroenterology and Motility, Oktober 2018
- Dimmer, Christine, Brian Martin et al. - Squatting for the Prevention of Hemorrhoids, Department of Science and Technology Studies, University of Wollongong, NSW 2522, Australia, Townsend Letter for Doctors & Patients, Nr. 159, October 1996
- Dr. B.A. Sikirov - Management of Hemorrhoids: A New Approach, Israel Journal of Medical Sciences“, 1987
- Sakakibara, Ryuji et. al - Influence of Body Position on Defecation in Humans“ LUTS 2010, 2:16-21
- Modi, Rohan M. et al. - Implementation of a Defecation Posture Modification Device. Impact on Bowel Movement Patterns in Healthy Subjects. Journal of Clinical Gastroenterology, March 2019
Get your own stuul now.
Health Related Media Reviews
Why a Toilet Stool is the Best Choice
Don’t Sit, Squat – Poop Better with a Toilet Stool
Our modern sitting toilets force us into an unnatural position, often leading to digestive issues. The human body is designed to poop in a squatting position, not sitting. A toilet stool like the stuul helps you achieve this natural position, making it easier to go. Correct posture can not only reduce issues like constipation but also promote overall digestive health.
The Science Behind It: The Puborectalis Muscle
Within the body lies the puborectalis muscle, a band of muscle that wraps around the rectum like a sling. This muscle creates a kink in the rectum when we are sitting or standing, much like a bent garden hose. This kink helps keep the stool in, preventing accidental bowel movements. However, this kink also makes it harder to fully empty the bowels.
In a squatting position, which the stuul toilet stool enables, this muscle relaxes. The kink in the rectum straightens out, allowing the stool to pass through easily. This posture facilitates quicker and more complete bowel movements, reducing the risk of digestive issues like constipation.
Sitting vs. Squatting: A Big Difference for Your Digestion
Sitting on the toilet literally creates a "kink in the hose": The puborectalis muscle stays tense, making it harder to poop. Squatting, our natural posture for millennia, relaxes this muscle, making bowel movements easier. Doctors agree: Squatting is the healthiest way to poop. The stuul toilet stool provides the perfect solution to enjoy the benefits of squatting while using a modern toilet.
Why Comfortable Isn’t Always Better: Sitting Toilets as a Problem
For digestive health, it would be better if the sitting toilet had never been invented in the Western world. The comfort of sitting prevents full bowel evacuation, leading to long-term problems like hemorrhoids. In rural areas of Asia and Africa, where squat toilets are common, hemorrhoids are less of a concern.
But don’t worry, you don’t have to give up your comfortable sitting toilet! Simply raising your feet while pooping can make all the difference. With a toilet stool like the stuul, you can position your legs at the ideal angle to enjoy the benefits of squatting without sacrificing comfort.
Science Confirms: Toilet Stools Make a Difference
The benefits of a toilet stool are not just anecdotal—they’re scientifically proven. Popular author and doctor Giulia Enders vividly describes in her bestseller “Gut: The Inside Story of Our Body's Most Underrated Organ” how squatting makes pooping easier. An American study also confirmed the positive impact of toilet stools on the duration of bowel movements, the strain on the digestive tract, and complete bowel emptying.
The researchers concluded that a toilet stool like the stuul is an effective, non-medicated solution for people suffering from digestive issues or incomplete bowel evacuation.
Prevention and Relief of Hemorrhoids
Hemorrhoids, swollen blood vessels in the rectum and anus, are often caused by excessive straining during bowel movements. Using a bathroom stool can help reduce the pressure on the intestinal walls, preventing hemorrhoids. The stuul toilet stool offers a comfortable and effective way to ease bowel movements and provide relief from hemorrhoid discomfort.
Alleviating Digestive Issues and Promoting Pelvic Floor Health
For those suffering from digestive issues such as Irritable Bowel Syndrome (IBS) or constipation, a poop stool can be a real game-changer. By enabling a more natural position during bowel movements, the pressure on the lower digestive tract is reduced, which can alleviate bloating and improve bowel evacuation.
Moreover, a potty stool can also promote pelvic floor health, especially for women. Squatting helps reduce strain on the pelvic floor muscles, which is particularly beneficial during and after pregnancy, or for those dealing with pelvic floor weakness.
stuul – Style Meets Health
Whether you're looking to prevent hemorrhoids, relieve digestive issues, or support pelvic floor health, the stuul toilet stool is the ideal solution for anyone wanting to improve their health while adding stylish design to their bathroom. This poop stool offers the perfect combination of functionality and aesthetics.
