As much as we’d like to pretend otherwise, we’ve all been there. Sitting, straining, waiting for that satisfying plop – to no avail.
If that’s you, there are plenty of ways to improve your time on the porcelain throne, such as adding fibre to your diet, staying hydrated and getting regular exercise.
All those habits take time to get right. But there’s one easy upgrade you can make right now.
“The simplest thing to do is raise your knees above the angle of your waist,” says gastroenterologist Dr Trisha Pasricha, assistant professor at Harvard Medical School. “You can do that with a stool. You can do that with a stack of books. You can even do it with high heels, depending on how high they are.
“But once you do that, even healthy people who don’t identify as having trouble pooping find it much easier.”
The studies – yes, scientists have looked at this closely – back Pasricha up. For instance, in 2019, researchers at Ohio State University investigated the impact of pooping posture among 52 adults.
Participants recorded their bowel movements for two weeks unaided, and two weeks with a ‘defecation postural modification device’ – in other words, a footstool.
More than 1,100 poops later, the scientists found that using a stool helped speed up toilet time, reduce straining, and improve how empty participants felt afterwards.
Why? Pasricha says it's simply because lifting your knees can help your rectum relax.
“The rectum is a little bit like a reservoir where poop can sit and wait for you to go to the bathroom,” she explains. “It’s very accommodating. It has this muscle that wraps around the rectum, almost like a sling, called the puborectalis muscle.
“In a way, this is good. You don’t want to release those contents when you’re not ready. But when we’re sitting at a 90-degree angle, that muscle has choked your rectum closed.”
In short, this means pooping is more difficult when you’re sitting bolt upright on a toilet seat. But the same cannot be said for those who squat.
“When you squat, you straighten up your rectum,” says Pasricha. “At that angle, the puborectalis muscle relaxes, and that tube is straight again, so poo can flow out more easily.”
Indeed, an Iranian review of 42 studies (yes, 42) concluded that squatting to poop – instead of sitting on a toilet – vastly reduces the likelihood of constipation and haemorrhoids.
Squatting is the norm in many countries around the world – but in the US and Europe, we’re used to our toilets.
“We’ve decided that the right way to poop is to sit on a chair,” says Pasricha. “I get it – squatting is not appealing to me. Toilets are better for balance. They’re less stress. You’re not worried about falling into a hole on the floor.
“But we’re actually working against ourselves physiologically, by creating this barrier in the rectum.”
For those of us who are wedded to our water-closets, adding a footstool can give us many of the benefits of squatting without the hole in the ground.
In a similar way, raising your knees above your hips allows your rectum to open up, so your poop can pass more easily.
True, having a footstool doesn’t always help you pass a stool. For instance, an Australian-Israeli study found the method didn’t make much difference for their 41 participants, all of whom had constipation.
But Pasricha says that it can be a simple fix to “a man-made, self-created problem that works against our own physiology.”
And, if you want to perfect your pooping posture even further, a Japanese study found that leaning forwards, rather than sitting upright, also helps open your back passage.
So if things aren’t moving, remember: it’s not you – it’s your angle.
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