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.


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 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. “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
  2. 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
  3. I tried your procedure (Name) and it is awesome, my bowels do feel really clean after squatting, but I wouldn’t recommend fat people to try this it might actually break the toilet seat no offence.

    Jason wrote on March 18th, 2014
  4. Im 22 years old, and Ive been doing this my whole life, or at least as far back as I can remember: it may be f*d up, but i get both my feet up on the toilet bowl into a full squat every time i take a dump. Exceedingly relieving.

    fduppooper wrote on March 24th, 2014
  5. All my life for some reason I’ve been a squatter , I live in america i just cant poop by just sitting on the toilet . To this day in the 19 years and some months of life , I have never suffered from constipation or hemroids as many sitters do. I’m not sure if its correlation or causation but either way i think I will be a squatter all my life

    Jay wrote on June 7th, 2014
  6. First of all, love all the puns.

    Secondly, I love going camping, especially primitive camping. The first couple times I squatted in the woods to poop, it was awesome; I still enjoy it to this day. I like to call it “poo with a view”. 😛 I never thought about trying it at home, but hey, why not!

    K*Lo wrote on September 10th, 2014
  7. So what do you do if you have limited dorsiflexion?

    terry wrote on October 6th, 2014
  8. My people! I finally found them! And here I always thought I was the only one who squats. I’ve been squatting all my life just cause (I guess I failed poty-training lol) and people always told me it’s weird but they can suck it. It’s healthy :) and effortless

    Mnish wrote on October 22nd, 2014
  9. This is a disgusting topic. Shame on all those who could not stop themselves from sharing their revolting, dirty habits!

    Derrick Koh wrote on December 26th, 2014
  10. I’m telling you baby: once you go squat, there’s no going back! I feel I’ve actually gained:
    – Less flatulence
    – No stress on my colon, bladder, or rectum
    – Less time invested in doing these business
    – And the best of all: GREAT OVERALL EXPERIENCE!

    It’s a must try.

    Squatting Westerner wrote on December 31st, 2014
  11. The squatty potty saved my life. As aout menopausal woman suffering from a rectocele nd pelvic prolapse I was never able to fully eliminate stools. It always felt like some was still stuck in my rectum and indeed it was. Impossible to fully evacuate, even when doing contortions and splitting with wads of paper to get it all out (it was filling the pocket created by the herniated rectum and getting stuck instead of coming out. . Then I saw the show Shark tank nd saw the squatty potty. The very next day I went out to the mall and bought one. I cancelled my surgery now I can feel normal nd avoid surgery and all its risks. Squatting is necessary for those of us who have rectocele.

    neeters wrote on May 17th, 2015
  12. Neeters, sitting with your feet propped up is not squatting. Footstools like the Squatty Potty are taking advantage of the public’s ignorance about this. Almost everyone can learn to squat if they practice every day. The benefits of really squatting are much greater. Nature designed humans to squat, not to sit on a toilet seat with our feet elevated.

    Jonathan wrote on May 21st, 2015
  13. I am very familiar with this topic and it is very true as far as emptying out . It works ! I have been doing this for years because I have problems ever since I had my gall bladder removed. If I do feel bloated I assume the position and it helps.

    Barb wrote on August 7th, 2015

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