The Ideal Poop Position (According To Science)

If you’ve ever had a difficult bowel movement, you’ve probably noticed that adjusting your position on the toilet can make a difference. 

The reality is, your position matters more than you may realize when it comes to effective evacuation. So whether you regularly experience symptoms of constipation or you’re just looking to optimize, I’m going to break down what we know about the best position for comfort and function, and why and how it works. 

We’ll also take a look at other factors that influence chronic constipation, and what else you can do from a functional medicine perspective (without laxatives). 

Bowel Movements and Your Anatomy 

Before we get into the best posture for pooping, let’s take a look at what’s going on inside your body when you have a bowel movement. Before a bowel movement, stool is held in your rectum (at the end of your large intestine). 

Most of the time, your rectum is held at a slight angle by a muscle called the puborectalis. This helps keep waste inside until you’re ready to go. 

Then, when you’re ready for a bowel movement, the rectum contracts, signaling the puborectalis to relax and allowing the rectum to straighten and let stool out. 

The problem is that sitting on a modern Western toilet doesn’t allow the kink in your bowel to fully straighten, meaning that you may need to strain more to get a bowel movement out. 

Sitting vs. Squatting: What the Science Says

Research and evolutionary biology generally agree that squatting is the body’s natural (and most effective) defecation posture. This is because squatting straightens the anorectal angle, relaxing the rectal muscles and uses gravity to assist in elimination. 

In cultures where traditional squatting remains the norm, such as parts of Africa and Asia, people have been found to have lower rates of constipation and complications like hemorrhoids. (1) 

While researchers can’t say for sure whether this is due to squatting (several other factors, like differences in diet, could also play a role), it’s likely that this is at least part of the puzzle. 

A 2019 study also found that using a toilet posture modification device (i.e. a “potty stool”) reduced bowel movement duration and straining. (2) Participants noted more complete elimination. And a complete squat wasn’t required to see these benefits: just raising the knees above the hips while leaning forward. 

Other studies have also shown that using footstools and similar devices helps participants poop with less effort and discomfort, and squatting may lead to less pelvic floor dysfunction and fewer cases of hemorrhoids. (3) 

Do You Need a Special Footstool Or Device? 

Squatting has been the default poop posture for most of human history (and still is in many parts of the world). But in the Western world, our modern toilets prioritize comfort over this natural function. 

We’re starting to see more and more products, including stools like the Squatty Potty, that are designed to bridge this gap. These tools can definitely help (and they’ve probably helped bring more awareness to the benefits of a squat position), but you can also use things you already have at home to achieve the right posture, as I’ll break down below. 

The Best Poop Posture, Step By Step 

For the best chance at a comfortable and complete bowel movement (without using a squat toilet), here’s how to get into the optimal posture. 

1. Sit comfortably on the toilet.
2. Place your feet on a stool. You can also use an upside down box or a stack of books or yoga blocks. The goal is to have your knees above your hips, at about a 35 degree angle. 
3. Lean forward slightly with your elbows resting on your thighs. 
4. Relax your belly and pelvic floor muscles. Take a few deep breaths to help with this. 
5. Don’t strain or force. If it doesn’t come easily, it’s sometimes best to take a break and try again later. 

This supported squat position helps to align your rectum and relax your muscles, and uses the natural force of gravity to help you go. 

Leaning Forward vs. Leaning Backward

Leaning forward, especially with your knees elevated, mimics a squat and is generally considered to be the most effective position. (2) But some people find that they need to lean back to have a bowel movement. 

In these cases, your body may be compensating for poor positioning. Adopting the rest of the supported squat position may eliminate the need to lean backwards (which can actually create more of a bend in the rectum). However, everyone is different! If you feel better leaning back, especially if you don’t have to strain, listen to your body. 

What Happens If You Don’t Go Correctly? 

We rely on bowel movements for natural detoxification. If you’re not pooping at least once daily (and ideally 2-3 times per day), you’re likely not detoxifying effectively, which can lead to a buildup of toxins, increased inflammation, and numerous related health issues. 

Straining regularly can also lead to pelvic floor dysfunction over time. And chronic constipation, if not addressed, can lead to hemorrhoids, anal fissures, or other complications. 

Taking a step back though, chronic constipation doesn’t usually result strictly from a faulty poop posture. Your position is important and makes a difference (whether you’re constipated or not), but if you regularly struggle to evacuate your bowels, there is likely something bigger going on with your gut health. 

Root Causes of Constipation 

As a functional medicine practitioner, I’m always looking for the root cause of any symptom or dysfunction.  Chronic constipation doesn’t happen for no reason, and there are often gut, hormonal, or other imbalances we need to address in order to really solve the problem (and get you feeling your best). 

Sometimes, the root cause of constipation, especially occasional constipation, is something really simple, like dehydration (more common than you would think) or a lack of fiber in the diet. 

But if addressing these more basic things doesn’t make a difference, and/or if you’ve been experiencing other symptoms alongside constipation, we may need to look deeper. 

Root causes of constipation may include: 

• Dehydration 
• Lack of insoluble fiber and/or a low quality diet
• Hormonal imbalances
• Gut dysbiosis; SIBO 
• Low vagal tone 
• Lack of exercise
• Low stomach acid 
• Digestive conditions including IBS (irritable bowel syndrome) or ulcerative colitis
• Toxin overload 
• Chronic stress 

Specialized testing can help us determine what’s really going on with your digestive system, so that we can make a better roadmap for healing. 

Other Tools for Better Pooping 

Keeping in mind the importance of addressing the root cause of chronic constipation and other digestive symptoms like bloating, here are a few things you can do beyond adjusting your toilet position to achieve a better poop (and better digestive health). 

• Stay hydrated. Even if you drink a lot of water you can be dehydrated, depending on factors like how much you’re absorbing and how much you’re sweating. Try adding electrolytes to your water for better absorption, and include lots of hydrating foods in your diet. 
• Eat lots of insoluble fiber. Insoluble fiber (fiber that doesn’t dissolve in water) helps to keep things moving through your digestive tract. Some of my favorite sources of insoluble fiber include chia seeds, almonds, artichokes, and leafy greens. 
• Supplement with magnesium. Magnesium (which many people in the US don’t get enough of through diet) helps to promote muscle relaxation and can be very supportive for those with constipation. (4) Try my formulation, The Magnesium, here.
• Support your mind-body connection. Chronic stress slows down digestion. (5) Incorporate deep breathing, meditation, and/or vagus nerve stimulation into your daily routine to help restore balance. Regular exercise is also important. 

READ MORE: How to Achieve the Perfect Poop: Gut Health Secrets For Better Digestion 

Posture Is One Piece of the Puzzle 

Supporting your body’s natural biomechanics with the ideal position can go a long way towards more regular, comfortable, and complete bowel movements. 

And if you’re struggling with persistent digestive issues or constipation, it may be time to go deeper and investigate what’s going on behind the scenes. For help with this and to improve your overall wellness, schedule a consultation with our functional medicine telehealth team. 

READ NEXT: The 7-Second Poop Method For Constipation Relief 

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.

Sources

• Sikirov, D. (2003). Comparison of straining during defecation in three positions: results and implications for human health. Digestive diseases and sciences, 48, 1201-1205.
• Bhattacharya, S., Chattu, V. K., & Singh, A. (2019). Health promotion and prevention of bowel disorders through toilet designs: A myth or reality?. Journal of education and health promotion, 8(1), 40.
• Modi, R. M., Hinton, A., Pinkhas, D., Groce, R., Meyer, M. M., Balasubramanian, G., … & Stanich, P. P. (2019). Implementation of a defecation posture modification device: impact on bowel movement patterns in healthy subjects. Journal of clinical gastroenterology, 53(3), 216-219.
• Mori, S., Tomita, T., Fujimura, K., Asano, H., Ogawa, T., Yamasaki, T., … & Miwa, H. (2019). A randomized double-blind placebo-controlled trial on the effect of magnesium oxide in patients with chronic constipation. Journal of neurogastroenterology and motility, 25(4), 563.
• Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol, 62(6), 591-9.