Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
23 Sep

You Don’t Know Squat

A while back, I gave a bit of Link Love to Nature’s Platform (thanks, NeoPaleo), a contraption that fits over regular toilets and allows users to squat instead of sit. I included it mainly for the laughs, a bit of tongue-in-cheek (no, not that cheek – the other one!) ribald humor that was somewhat relevant to the Primal lifestyle (because let’s face it, Grok was definitely a squatter), but then I got to thinking: maybe there really is something to squatting. At the very least, I owed it to our bowels to look a bit deeper into the subject, to try to get to the bottom of it, as it were.

I’ve always been one to pull up a stool, have a seat, and ruminate on the past. Learn from what our ancestors did. They made mistakes, sure, but they also made great strides, and to simply wipe that history clean and discard the wisdom contained therein is foolish. If we do that, we risk flushing vital information down the toilet. This is of course old news to most of our regular readers, who take the concept to heart, especially in regards to evolutionary diet and fitness. With every fiber of our being, we pattern our behavior after our ancestral history, because that’s when the formative years of human evolution occurred. Homo sapiens have been eating certain things and exercising a certain way for hundreds of thousands of years, and it doesn’t make sense to mess with a good thing.

So where does historical defecation posture fit into all this? Well, if you’re going by years, we’ve been eating grains far longer than we’ve been sitting down to poop. There have been a few exceptions, of course. Moenjo-daro, a 2600 B.C. Indus Valley city-settlement, featured advanced “Western style” toilets, for example, and the Pharoahs and upper-class Romans may have sat to handle their business (they certainly had toilets). Up until the 19th century, though, sitting toilets were a luxury reserved for the affluent. And even then, the sitting toilet was only widely adopted in the West. Everyone else squatted – and most continue to do so today. I go to Thailand fairly often. I can vouch for the prevalence of squat toilets. We’re the weird ones for sitting down to poop, if you want to go by sheer numbers. Worldwide, sitting is actually just the number two method.

If you want to be anal about it, there may actually be some concrete physiological benefits to squatting.

Straining

For one, squatting opens up the recto-anal angle, allowing the squatter to be a bit more lax when handling business. Sitting down to poop, on the other hand, constricts the passageways and requires more straining to push things through. The Israeli researcher Dr. Berko Sikirov, an especially adamant proponent of the squat method, identified the “underlying mechanism” behind constipation: “the obstructive nature of the recto-anal angle” in the sitting position. Constipation often leads to excessive straining (“at least three-fold more than in a squatting posture”), which has been fingered as a probable cause of colonic diverticulosis by Sikirov.

Hemorrhoids

Hemorrhoids are another fixture of Western society that don’t enjoy the same prevalence in “squatting” countries. Sikirov assumed the defecation posture might be the culprit, so he gathered a relatively small group of hemorrhoid sufferers – twenty of them, to be exact – and “treated” them with the squatting method. The results were noteworthy: more than half showed marked improvement within weeks or days, while the rest took a bit longer. Everyone improved. Unfortunately for us, the necessary follow up research (on account of the small sample size) has yet to be conducted. The American Society of Colon and Rectal Surgeons don’t seem interested in the possible therapeutic value of squatting. In fact, you might even say Sikirov is the butt of their jokes.

Other Claims

Colon cancer is relatively rare in third-world countries, and now that the fiber hypothesis is all but dead, some suggest chronic constipation (possibly from sitting to poop) is to blame. These claims seem a bit more dubious, judging from this study’s (PDF) conclusion: that aberrant crypt foci (ACF) is the most likely cause of colorectal cancer, and that a cause-and-effect relationship between constipation and cancer cannot be established. Squatting may help clear the road, but I doubt it’s the key to preventing colon cancer.

Proponents also claim that seated toilet-induced “fecal stagnation” causes appendicitis and Crohn’s disease, both of which are rare in traditional cultures and relatively common in westernized cultures. I lean toward diet being the general cause, but I admit defecation positions and their possible health ramifications aren’t my area of expertise, so I’ll relay the information all the same. The appendix, seen here right next to the ceceum, may be vulnerable to fecal blockage (which is actually one of the official possible causes of appendicitis when waste is eliminated from a sitting position. In a stunning display of disturbing imagery, the folks at Nature’s Platform liken it to squeezing a toothpaste tube in the center and seeing both the bottom and top inflate with paste: when sitting, the ceceum cannot be completely vacated and the contents spill out haphazardly, presumably into the adjacent appendix and small intestine, causing appendicitis and Crohn’s disease. When one squats, however, the ceceum is squeezed empty from its base by the right thigh.

As I said earlier, I can’t make the call. Nature’s Platform seems well-sourced, and the references that offer free abstracts or texts check out just fine. There are obvious benefits to squatting – reduced constipation, less straining – and there’s definitely a strong evolutionary precedent for it, but the claims about cancer, appendicitis, and Crohn’s disease aren’t exactly verifiable. I’d say that squatting to eliminate is technically Primal, but I don’t think it’s necessary. Can’t hurt to try, though (unless you have bad knees and joints, of course). In fact, I’d urge you to give it a shot at least once, as long as you’re physically able. A few of our forum members seem to enjoy it.

Let me know what you think. Ever tried it? Will you now? Experiences? Thanks, everyone!

Photo Credit: Nature’s Platform

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Great post, pooping is a very forgotten aprt of leading a very healthy life. Get rid of all that toxic waste!

    TOM

    Tom wrote on October 12th, 2010
  2. Note about the splash issue: I learned this in College. Take a few sheets of toilet paper and lay it flat on the water where your poop will fall. This will eliminate any splash and noise.

    ColdsnapBryan wrote on November 1st, 2010
  3. I’ve been having trouble going for ages, tried this and no issue at all… I’m convinced!

    PixieKitten wrote on January 27th, 2011
  4. I do this when I go (only at home though) I started doing this all of a sudden, and I found it comfortable. I started thinking it was bad and tried to break this habit, but after reading this I think I should just forget about that and do my business!

    Danny wrote on January 30th, 2011
  5. You won’t slip if you put the seat up, wear your vibrams to perch on the rim. Pants off when time permits other wise just drop ’em and exercise a little common sense.

    neil wrote on February 2nd, 2011
  6. “more than half showed marked improvement within weeks or days, while the rest took a bit longer.”

    Mark, I’m really surprised you posted this one about hemorrhoids. This kind of healing is going to happen in that time frame anyway, and “took a bit longer” should be well below your concern for good science.

    Richard Gay wrote on February 5th, 2011
    • Take a fresh look at the table he linked to. All those people had already had hemorrhoids for months and many for years… so you can hardly claim it was “going to happen in that time frame anyway.”

      Essentially, they have served as their own control group. Science! Whee!

      Jen wrote on September 10th, 2011
  7. i always squat like today when my poop wouldnt come out in skool i had to squat how many times do u poop in a day

    mary wrote on March 9th, 2011
  8. Go camping and poop in the woods. Your life will never be the same (for better or for worse, depending on who you are).

    jchensley wrote on March 24th, 2011
  9. This is my first post ever on MDA.
    And I just have to say…
    Because of this post, I just had the greatest crap of my life.
    Woo!

    brandon wrote on April 19th, 2011
  10. Now I’m really angry. I had a hysterectomy for the sole purpose of fixing my pelvic floor. The fix didn’t last and it was “fixed” again. The second fix had to be fixed. The third doctor did the best job, but it needs to be fixed again. They all made it sound like it was just my “weak tissue”. Now I know better.

    Frieda wrote on April 21st, 2011
    • Wait… didn’t they have you do PC/pelvic floor exercises?

      mm wrote on September 10th, 2011
  11. Tried squatting for the first time after stumbling upon the technique after hem surgery. I’m a believer!

    After the surgery for the first 10 days, I strained like no ones business to move anything and it wasn’t complete. It was painful, time consuming and inefficient.

    I tried for the first time to squat yesterday. A little nervous, the job was done completely, with little to no strain, and very quickly. I was amazed.

    I did it again for the second time today and had the same results.

    I only wish I would have known about this years ago. It would have “eliminated” a lot of issues I’ve dealt with in this area.

    pd wrote on April 24th, 2011
  12. I got the lillipad platform! I had horrible pain and a hemorrhoid after I gave birth and I googled stuff until I came across the info about squatting. Out of desperation, I tried it. I didn’t climb up on my toilet, though… I just used a container and tried squatting like the picture, hanging onto my tub because I kept falling backward. I was REALLY desperate. I cried every time I had to go.

    Anyway, we eventually got a lillipad. I don’t care who knows about it. It looks like a pretty piece of furniture. I actually took it with us last week when we visited our in-laws because I don’t want to and can’t go sitting anymore. I feel like I’ve been eliminating the retard way my entire life and I can’t go back.

    B wrote on May 12th, 2011
  13. Squating to poop works great for me. I’m not quite hardcore enough to go in the woods behind my house, but I use the “poop box” discussed on underground wellness youtube channel. Ever since I started using it, poops come out very easy and almost always very clean :D.

    James wrote on May 15th, 2011
  14. Ever “been” to a campground or public toilet in France?
    Used to joke about the “Hollywood footsteps” provided to squat on in a china base over a hole in the ground.

    Tony Dl wrote on May 22nd, 2011
  15. I squatted to poo for the first time ever today, and did it again the 2nd and 3rd time. so much poop was coming out it was incredible. i’ve not felt this kind of clarity in years

    daniel wrote on May 24th, 2011
  16. Not to get too graphic, but if you eat plenty of salads and avoid starches, you will evacuate without the least strain and spend scarcely a moment on the toilet. You’ll find that cleaning yourself is a lot easier as well.

    Aside from plenty of salad, we make a “green drink” daily: blend a bunch of kale, broccoli flowers, piece of ginger, piece of turmeric, half a dozen tomatoes, and a cup of very strong green tea. Add water to taste. Drink it down. You get a lot of veggies in a hurry, and a lot of anti-oxidants as well.

    Jim wrote on May 27th, 2011
  17. I gave myself a perianal haematoma from straining my pooper too hard, its extremely painful. Alas, I attempted the method below: sit on the seat, bring your knees up to your chin and put your feet in the toilet seat. Best poop I ever pooped. Slipped out like I’d been drinking WD40. I have to offer my total support for the elevated squat. Because of the sitting method, my ass hurts from blood pooling in it =(

    Perianal Haematoma wrote on June 13th, 2011
  18. You know what squatting is great!! I have had 4 kids and was having trouble with a prolapsing bladder/uterus. So rather than have surgery to basically tie everything back up – I did some research and found out that hardly any women in the squatting parts of the world have this problem. So…………legs up on garbage can/kids potty seat or yeah rim. I did this for literally only 2 weeks (well 13 days to be exact) and no longer felt like my insides were going to fall out on the ground. Now when we go camping (well in the RV) i take my poop stool – my husband cracks up everytime he sees me walking to the public toilets with my bright orange stool. LOL I LOVE TO SQUAT!! YAHOO.

    Tanya wrote on July 28th, 2011
  19. This is the best squat bench I have found to date. It is simple, well made, fits into any bathroom and reasonably priced, and the design is completely comfortable and natural. Best of all it is not a bulky contraption. Chcek out the website: thegravitystool.com

    Helen wrote on August 4th, 2011
  20. I just started reading about the Primal Blueprint thing and I find out I don’t know squat. I’ve got a long way to go.

    Phillip wrote on September 15th, 2011
  21. Are you familiar with PostSecret?

    Well, I saw one today that seemed fitting:
    http://3.bp.blogspot.com/-NE4sqn4TZLI/Tn6sud9dAcI/AAAAAAAAP-c/pJB0FqTscJ8/s400/onback.imsoafraiditisgoingtohappenagain.jpg

    Sure, the reference is probably to it being wall-mounted, but it’s a toilet all the same! And as a recent engineering grad, I can admit: Yes, some of our ideas are idiotic!

    ElleHad wrote on September 29th, 2011
  22. I am an airline pilot sitting (not there) in a hotel room and I just went to poop after working out. I’m a hemorrhoid sufferer and I was thinking there has to be a better way…so I googled and voila! here is the answer. I’ve definitely got to give it a try on my next effort. BTW, where did the the phrases “give a sh*t” and “take a sh*t” originate? As George Carlin said, it’s really more correct to say that one is going to “leave a sh*t”. More research!!

    DWP wrote on October 10th, 2011
  23. I’ve done this for a year now. When I began, I had hemorrhoids….not anymore. Unbelievable.

    scott wrote on December 31st, 2011
    • This really works great. All the bloating, excess gas is all gone.

      Richie wrote on March 17th, 2012
  24. As a Restorative Exercise Specialist™ (biomechanics and natural movement)my grand daddy of all goals is to get myself into a proper squat. Not the kind of squat that causes you to pee on your shoes in the woods (like the one in the photo at the top of the post *notice there isn’t a lumbar curve), but a squat with an UNTUCKED tailbone.I like the Squatty Potty, I can do a proper squat supporting my own weight over the toilet. Hamstrings and calf muscles need to be lengthened in order to do a proper squat, esp. if you have been wearing positive heeled shoes and sitting in chairs most of your life.

    Barbara wrote on February 3rd, 2012
  25. maybe im doing something wrong but i cant squat like that without falling on my ass

    Taylor wrote on March 3rd, 2012

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