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Clinical trials to compare sitting and squatting
Having been accepted as a mundane, albeit necessary, artifact, the toilet is paid no particular attention beyond our need to find one when we need one. One curious doctor, however, devised an experiment that put the toilet to the test. Dr. Rad Saeed, a radiologist at the Tabriz University of Medical Sciences in Iran, conducted clinical trials to compare sitting and squatting in their effectiveness for emptying the bowel.1
Participants were asked to complete a bowel movement while squatting, and another while sitting on a toilet. Prior to their eliminations, participants were administered barium, a contrast agent that coats the lining of the intestinal tract in order to make it clearly visible on x-rays. X-rays were then taken during elimination in both positions.
The x-rays showed that the average distance between the pelvic floor2 and the perineum3 when squatting was 8.4 centimeters, and 6.6 centimeters when sitting. Dr. Saeed attributes the difference to the participants having to strain to poop when sitting on the toilet, causing the pelvic floor to be pushed downward.
When squatting, the puborectalis muscle relaxed completely, allowing the rectum to widen and align with the anal canal, resulting in the easy passage of waste. When using the toilet, the puborectalis muscle did not fully relax, resulting in the rectum remaining bent, which restricted the passage of waste and caused participants to strain to achieve elimination.
It’s worth noting that a full 25% drop in the position of the pelvic floor occurred with a single use of the toilet. Over time, a sagging pelvic floor can adversely affect the pelvic nerves that help control the bladder, bowel, uterus and prostate. Also, over time, straining to poop can lead to diverticula4, fissures5 and hemorrhoids6.
Dr. Saeed concluded that compared to sitting, squatting not only promotes a quicker, easier and more complete elimination, it considerably reduces the risk of developing a number of bowel and pelvic conditions.
2 The pelvic floor is a hammock of muscles and connective tissue in the lower abdomen that supports the abdominal and pelvic organs to keep them in place.
3 The perineum is the area between the anus and the vagina or testes.
4 Small, poop-filled sacs that form along the colon wall
5 Small tears in the mucus membrane that surrounds the anus
6 Swollen veins in the rectum or around the anus