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".
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.
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.
Toilets - 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.
There is a study from the USA 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.
But for aesthetes, there is currently only one solution. And that is called stuul.