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. Islam prescribed this method of pooping 1400 years ago even for peeing.

    All the benefits identified with modern technology was identified 1400 years ago.

    Than will ye not believe?

    Just like this Islam is the solution to all the world problems.

    Believe so that ye may prosper.

    Jazaks

    Say wrote on March 7th, 2012
  2. I find that sitting and leaning forward at about a 30 degree or less angle allows for flow and as it flows gradually straighten to 90 degree….plop…

    Eve wrote on March 19th, 2012
  3. I just tried it then and i have to say that im never gonna poop sitting again!

    Pudgee wrote on May 3rd, 2012
  4. The reason all Americans have bad knees is because we’ve been able to sit on a toilet our whole life. If we squatted just 1-3 times a day like the rest of the world, we’d all be in good shape.

    BShaw wrote on May 9th, 2012
  5. Its also pretty convenient to put your feet on the rim of the toilet and squat poop that way. be careful of the splash though! LOL

    brennen wrote on May 12th, 2012
  6. Hello
    There are alaturca toilets in Turkey used traditionnaly but be quited through the modern life although it s more hygienic and healthy especially at public areas.
    Here is some picture and information about it

    http://en.wikipedia.org/wiki/Squat_toilet

    http://www.coroflot.com/yasemintekmen/product-designs/9

    rachel wrote on June 8th, 2012
  7. We, Indians, have been squatting in natural posture for ages and have been following the same now. But many urban indians are following the western culture and changing to WC (Western Commode), what a paradox

    Shashi wrote on June 13th, 2012
  8. Some people and some sites that sell squatting stools and platforms warn that toilets may break or come loose from the floor. I’m curious about this, whether it really happens frequently or if it is a warning designed to sell products. I find it easy to put my feet on the rim of the seat, but I’m concerned now about possible injury or destruction of the toilet.

    Victoria wrote on July 23rd, 2012
  9. Wondering now if the added weight on assuming the squat position on the toilet seat might damage or destabilise the toilet itself, and so we should get squat stools, just adds comic urgency (pun intended) to the saying
    “It’s no use standing on the seat, the bugs in here can jump six feet”

    Tony Dowell wrote on July 24th, 2012
  10. Haven’t tried squatting in a long time but there is a lot of theory that regular sitting toilets cause people to have prostatitis like pain by weaking pelvic muscle flexibilty and strength. People in India and China where squating is prevelant do not have this problem.

    Microbrain wrote on August 5th, 2012
  11. Squat toilets are fine most of the time, and much more sanitary because you don’t have to touch anything. Only problem I see is that in much of the world they aren’t connected to a functioning sewer system that prevents sewer gas from backing up. Also, they are fine when you are young, with both legs and your balance intact. If you are handicapped, elderly, drunk, in high heels etc. they are probably impossible.

    Bill wrote on August 30th, 2012
  12. since it is proved beyond all doubt that squatting is the healthier and more ergonomic way to poop, I hope this fact is brought more and more to the public domain as many unsuspecting people over here in India and other developing nations are unsuspectingly going in for the western sitting loo not knowing what is in store for them and their bowels.

    also, even though you may continue sitting, at least allow your children to follow their correct instincts to squat as it is really the right way to do it

    over here we get dual commodes which is a sitting loo that has squatting supports on the rim below the seat. this i feel is the most considerate – giving people a choice depending on how they are inclined to do the job.

    kieran wrote on October 8th, 2012
  13. My 5 yr old and 2 yr old sons perch in a squatting position to poop. I taught them that. Glad to know that it really is the best position for pooping.

    The Crunchy Mama wrote on October 25th, 2012
  14. I have been squatting for over 5 years now and love it. Besides a couple of loose toilets, I have no problems and the time I’m in the bathroom is so minimal when compared to my father.

    For those of you who feel uncomfortable with hip or leg strain while in the squatt position, look up the Egoscue Method, which is postural alignment therapy(which I also do), get you body back into anatomical alignment and watch the strain fade away. It’s all about the posture!

    Joshuah Joseph wrote on December 11th, 2012
  15. I have been born in the Western world, but I have been squatting for my whole life, I don’t know why, but it’s the only way it works for me. I can only use the sitting position if I can really not hold it anymore, but for the mild urge, the only way is squatting. I use regular Western toilets, though, it is supposed to be dangerous, but as I said, I cannot do it otherwise. I stumbled on this site while looking for a special toilet seat to install in a new house that better suits my life-long habits.

    Yla wrote on January 5th, 2013
  16. Tried a pseudo-squat with a foot stool and it’s already helped! I’ve always felt like I was never evacuating totally and I would spend 20 mins. on average on the toilet; I could feel things open up even in the pseudo-squat. I’m totally having my husband build a platform. Darn you, Western notions of proper evacuation procedures!

    Babs wrote on January 19th, 2013
  17. I am Chinese and I’d just returned home after ten years of stay in France.
    I find the pictures very interesting on Nature’s Platform, where they put the ‘platform’ over the seat. It reminds me of the platform my grandma installed for my grandpa over the traditional toilet that requires squatting, so that he could sit to finish what he had to finish. In fact, he had previously risen up a bit too fast and had hit himself on the head over the plumbing. He was sent immediately to the hospital and was diagnosed having a cerebral hemorrhage. He was 65 at the time.
    I’ve just googled around in Chinese, and it is interesting to note that, while it is pretty much well accepted among Western readers who are interested in non-conventional medicines, squatting to evacuate is highly criticized in the Chinese blogosphere.
    For those who are interested and can manage to read Chinese, please read this article from a very popular website on science. http://www.guokr.com/article/317652/
    Globally, the author argues that a bigger recto-anal angle will help to release the tension and to alleviate the difficulty for those who suffer from constipation. But if you are constipated, you will be so even if you squat. I can prove that. I suffered of it when I was a teenager, probably because I loved reading too much. Now I am not, though I use a sitting toilet.

    As Mark said, there might not be a cause and effect link between constipation and squatting. Habit changing, such as travelling may make you constipate. The fact that you suppress your need to evacuate every time you deem it inappropriate will train your body to hold it.

    For information, I do find that bending to one’s knees helps when one is sitting.

    That’s my tuppence contribution. Thanks for reading.

    linocarre wrote on January 28th, 2013
    • Constipation is sometimes caused by incomplete development of the nerves that generate peristalsis. This is a mild form of Hirschsprung’s Disease. The nerves toward the end of the colon are sparse or nonexistent. If so, squatting will help, but will not cure it.

      Jonathan wrote on January 29th, 2013
  18. Just squat over a small, low pail on the floor beside the toilet. Then transfer the contents to the toilet. Then you can sit on the toilet to wipe. The pail should contain some water, otherwise it’s too messy.

    squatter wrote on March 7th, 2013
  19. I poop sitting down and my friend said that wasn’t normal

    Meow wrote on March 8th, 2013
  20. I’ve tried pooping while squatting both on the toilet rim and on the seat, facing forward and also facing the tank. But this was just way too precarious, hard on my feet, and limited leg spread.

    What I do now is simply squat on the flat, 3″ wide bathtub rim and poop into a small pail (containing some water) located on the floor below while I’m lightly grasping a hand-hold on the opposite wall in front of me for balance. This position has been reasonably comfortable–even for several minutes when necessary.

    pallmall wrote on March 20th, 2013
  21. I tried the “potty squat” and wound up peeing on my cat who was in the bathroom with me. It was just a teeny sprinkle, but it happened. It was hilarious!! He never noticed, and I cleaned him up right away.

    Gina BonBon wrote on May 7th, 2013
  22. All you Primal people still poop into water!? What would a caveman do? Why, poop in a bucket of course. Check out humanure.com. Joseph Jenkins is a minor god. Also, what a load of caca talking about women tearing etc. while squatting through childbirth. I’m a birth doula and this is an especially effective position for birthing. The hips are opened and maximum space is made for baby’s passage through the bones. I gave birth to two healthy babes while squatting.

    Eleim wrote on May 22nd, 2013
  23. I used to go regularly to a certain bookshop to look at a certain section of books, but would always have to leave before I was ready to because of the sudden overwhelming urge to poop. I used to joke that it was the fault of the bookshop somehow as it seemed to happen every time I went in there. Now I know the reason why. The section I was looking at was level to the flood and I had to squat to look at the books!

    Lisa wrote on August 24th, 2013
  24. You really should not give people the idea of squatting on a porcelain toilet. They are not made to handle this and people can be severely injured when they break under the pressure, as I recently saw on Reddit: http://imgur.com/a/GMHNn (graphic image)

    Ash wrote on November 6th, 2013
  25. “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.”

    Hahahaha I just love what you did here!!! Really made my day. Awesome article

    Raoul wrote on February 28th, 2014
  26. I recently tried this out and SQUATTING REALLY IS BETTER, after I finished my business my bowels felt completey empty.

    This is my procedure for squatting on ‘modern’ western toilets:

    1. Take off pants and underpants completey and place aside – (OPTIONAL, you can also take off your shirt)

    2. Next don’t sit on the toilet but, place my legs on the seat

    3. Finally go into the squatting postion and release you bowels clean

    I hope many other people try out squatting, it really helps!

    Name wrote on March 18th, 2014

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