As that wise children’s book has taught us, Everybody Poops.
But as you sit on that toilet, browsing your phone, waiting for the poop to drop, have you ever taken the time to tune in to how you poop? Do you push? Squeeze? Play a more passive role? How are you sitting? And is how you are sitting the most supportive for your flow?
The toilet is such a ubiquitous piece of equipment, most of us have probably never stopped to consider its function in relation to our health. And as it turns out, they could have been designed better for our bods. That’s where our friends TUSHY come in, with a tool to help you go!
HOW WE POOP
Let’s break it down (hehe) and very briefly walk you through the journey your food takes through your body. The mouth is the start of the digestion process. Chewing, obviously, helps break food down into smaller pieces. Your saliva has enzymes in it to help break the food down even more (for example, turning starches to sugar) as well as moistens your food producing something called a “food bolus” so that it is easier for you to swallow. (Hey, thanks saliva!) Your food bolus (what fun to say!) then travels through the throat and esophagus into the stomach. In the stomach, acids as well as digestive juices from your pancreas, liver, and gallbladder, work to continue breaking down that bolus even further (1). From the stomach, the food moves through the small intestine and is broken down even furtherrrrr by digestive juices. Nutrients are being absorbed into your bloodstream via little hair-like projections called microvilli in the small intestine. By the time your bolus has made it to the end of the small intestine, what is left is water, electrolytes and waste products (such as dead cells and plant fibers – ya know, the indigestible stuff) (2). Enter your colon (aka the large intestine) where all that water is absorbed leaving you with…STOOL!
Muscles in the colon separate waste into smaller bits that are then pushed down into the rectum – the next stop on your bolus’ journey. (What a ride, eh?!) When the rectum is “occupied” the rectal walls stretch which signals a message to your brain and the brain decides whether the contents of the rectum can be emptied at that point in time. (Like, are you at the dinner table when the sensors go off or what?) (1). Waste is held in the rectum with the help of something called the puborectalis muscle, which creates a bend in the rectum so all can’t fly loose (remember that name! We’re coming back to it later). The sphincter muscles in the anus are also at play here. These are circular muscles that usually maintain constriction – keepin’ it all in there!) but when it’s time for you to, “make a deposit”, the rectal walls contract to increase pressure. These muscle contractions are what allow you to poop! (3) Cool, right?!
Okay, but what if the brain decides it’s not time to go?
Well our body makes sure the waste stays in the rectum through a number of ways. One such way is our dear friend, the puborectalis muscle. The puborectalis muscle is a U shaped muscle that is slung around the rectum, creating a bend in the lower part. This bend helps to keep the poop inside until you’re ready (3). Having a hard time picturing it? Well, here’s a picture to help:
Those sphincter muscles we mentioned earlier also help you hold in that poop. You have both external and internal sphincters and it’s their role to keep the anal tube closed until the brain decides the the waste should be released. The internal sphincter is controlled automatically by the autonomic nervous system and keeps you from releasing poop in situations like when you’re asleep. The external sphincter is consciously controlled. It’s the external sphincter that we tighten when we realize we need to poop, and it the external sphincter we consciously relax when we’re finally sitting on the toilet, ready to go (1).
So, there you have your basic run-down of what makes up your back door.
So why might sitting on the toilet not be the best option for pooping?
It’s all because of that little muscle, the puborectalis muscle. When you’re going about your day, it’s resting angle is at 90 degrees, and this angle (known as the aorecetal angle) does some heavy lifting to keep your poop in the rectum (4,5).
So what does this have to do with the toilet you ask?
It’s been suggested that the problem with sitting on the toilet is, well, the sitting! When we sit, the bend caused by the puborectalis muscle doesn’t completely go away, making it necessary for you to push harder to get the poop out (3). Why is this not so great? It can make pooping even harder if you’re experiencing constipation. And, pushing and straining to get that poop out can cause hemorrhoids (6). Hemorrhoids are swollen veins found in the rectum or anal canal. They can be both inside the rectum (known as internal hemorrhoids) or near the anal opening (external hemorrhoids) and can cause bleeding, pain, discomfort, and irritation around the anus (6). Not so great.
so what should we do?
If we shouldn’t sit on the toilet, what are our options? It’s been suggested that squatting is a good alternative. When we squat, we lower our bum to the floor, and this angle causes the puborectalis muscle to relax more and the aorecetal angle to decrease . This lessens the the bend in the colon, creating a straighter path for the poop to travel. Which means, less pushing is need from you! (3). Check out the picture below to see what we mean.
But no one wants to pop a squat on the toilet. Enter tools like the TUSHY Ottoman, that help mimic a squatting position by giving your feet a lift as you sit. Think of it as a footstool, for your stool! This more closely mimics a squat, therefore smoothing out that bend in your rectum caused by the puborectalis muscle. Pooping with the TUSHY Ottoman could alleviate and prevent problems like hemorrhoids (3), a great thing to remember if you’re pregnant as they’re so common during pregnancy (thanks, baby!). Pooping with your feet up could also help if you’re constipated, encouraging a bowel movement, while also decreasing your need to push (8) (although remember, always go visit your doctor if you’re concerned). Not concerned by hemorrhoids or constipation? Fair enough. How about this; It has also been shown to help people poop quicker!
And these benefits aren’t just conjecture! Studies have shown the benefits of squatting vs. sitting. In one study, it was shown that squatting led the volunteers to strain less when pooping and also caused them to spend a shorter time on the toilet compared to when they were sitting (9). Another study found that squatting aids brought down the time of the bowel movements, positively influenced straining patterns, and helped empty the bowels (10). (quick fun fact, in this study they were called ‘Defecation Posture Modification Device’. Just rolls off the tongue right?) There are also x-rays taken from studies that show that in a squatting position, the rectum is straighter than when compared to sitting. The belly also experiences less pressure when you squat, possibly because you strain less when you squat (3).
For those who think this sounds great, but have tiny bathrooms, don’t worry. The TUSHY Ottoman is designed to fit around the base of your toilet, so it doesn’t take up space and the streamlined design doesn’t make you look like a geriatric patient. Who knew pooping could be so pretty? So c’mon everybody! Let’s get squatting and get your own Defecation Posture Modification Device, aka, the TUSHY Ottoman right this way.
Written By: Martha Michaud
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
(1) “Digestive System (Anatomy): How It Works.” WebMD. WebMD, August 14, 2018. https://www.webmd.com/heartburn-gerd/your-digestive-system#1.
(2) “Slide Show: See How Your Digestive System Works.” Mayo Clinic. Mayo Foundation for Medical Education and Research, September 27, 2018. https://www.mayoclinic.org/digestive-system/sls-20076373?s=5.
(3) Khatri, Minesh. “Squatty Potty (Poop Stool): Does It Really Work?” WebMD. WebMD, October 8, 2019. https://www.webmd.com/digestive-disorders/squatty-potty-what-is#1.
(4) Lametti, Daniel. “ How Bathroom Posture Affects Your Health.” Slate Magazine. Slate, August 26, 2010. https://slate.com/technology/2010/08/how-bathroom-posture-affects-your-health.html.
(5) Altomare, D F, M Rinaldi, A Veglia, A Guglielmi, P L Sallustio, and G Tripoli. “Contribution of Posture to the Maintenance of Anal Continence.” International journal of colorectal disease. U.S. National Library of Medicine, February 2001. https://www.ncbi.nlm.nih.gov/pubmed/11317698.
(6) “Hemorrhoids.” Mayo Clinic. Mayo Foundation for Medical Education and Research, July 3, 2019. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268.
(7) “TUSHY: TUSHY Ottoman.” Bidet Attachments by TUSHY. Accessed November 12, 2019. https://hellotushy.com/products/tushy-ottoman.
(8) Cirino, Erica. “How to Make Yourself Poop” Healthline. Healthline, October 30, 2017. Accessed November 12, 2019. https://www.healthline.com/health/digestive-health/how-to-make-yourself-poop#treatments
(9) Sikirov, Dov. “Comparison of Straining during Defecation in Three Positions: Results and Implications for Human Health.” Digestive diseases and sciences. U.S. National Library of Medicine, July 2003. https://www.ncbi.nlm.nih.gov/pubmed/12870773.
(10) “Implementation of a Defecation Posture Modification Device: … : Journal of Clinical Gastroenterology.” LWW. Accessed November 12, 2019. https://journals.lww.com/jcge/Fulltext/2019/03000/Implementation_of_a_Defecation_Posture.21.aspx.