1493467999334 - Why you, too, should squat to poo

Why you, too, should squat to poo

Pooing is a fact of life, but advice from the experts suggests you might be doing it all wrong.

They say our toilets are unnatural and bad for our health, potentially leading to problems such as hemorrhoids, hernias, and constipation.

We may prefer not to talk about it, but everyone needs to empty their bowels on a regular basis.

Research shows we’re not supposed to sit when we s…. The widespread use of sitting toilets only took off in the western world in the 19th century, when sewage systems were developed to improve sanitation.

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Yet sitting is widely accepted in New Zealand. We go so far as to warn visiting Asians they should not squat on the toilet rim.

Which begs the question – could Elvis still be with us if only he’d squatted? (The King of Pop died after suffering a heart attack while sitting straining on the toilet.)


Historically, humans have squatted to defecate. It’s much healthier, and remains the preferred method across much of Asia and Africa.

“Ideally you should have your knees higher than your pelvis when you do a poo,” says Debbie Perry, a colorectal nurse with Auckland DHB.

In the squatting position, the end of the colon straightens out and excreting becomes as easy as squeezing a tube of toothpaste.

However in the sitting position the end of the colon stays kinked at a right-angle that you have to push past to get your business done.

That extra straining is known as “valsalva manoeuvre” – another example is if you close your mouth and block your nose, and try to exhale.

Repeated use of this manoeuvre puts extra pressure on your heart, and can lead to cardiac rhythm disturbances and reduced blood flow to the brain.

There is even a medical description, “defecation syncope”, for when you strain too hard and faint while pushing out a poo.

In some cases, this physical exertion can prove fatal.


Britain’s King George II blew a ventricle in his heart while going to the toilet in 1760, a few weeks before his 73rd birthday.

The monarch had woken at 6am, and headed into the bathroom with a cup of hot chocolate. Minutes later his valet heard a loud crash and rushed in to find the king lying dead on the floor.

Frank Nicholls, the king’s physician, later prepared a report for the Lord Chamberlain that detailed exactly how the king had expired while seated on his morning throne.

“The immediate cause of this distension of the aorta, as likewise of its being determined to that particular time, are naturally explicable, from his Majesty’s having been at the necessary-stool,” Nicholls wrote.

“As the office then required cannot be executed, but by such a pressure on all the contents of the lower belly, and consequently, on the great descending artery, as must, of necessity, subject the trunk of the aorta, and all its upper branches, to a surcharge with blood continually increasing.”

Translation: The king was straining to poo, and the pressure became too much for his heart.

Nicholls reassured the Lord Chamberlain the king likely died instantly.

“His death must have been attended with as little of that distress, which usually accompanies the separation of the soul and body, as was possible,” he wrote. 

Nicholls remarked the king’s death was an “extraordinary case”.

Perry adds you’d likely need to have something else wrong with you before suffering a fatal reaction on the toilet.

She explains those who repeatedly strain are more likely to suffer from hemorrhoids or prolapses.

“A prolapse is where the lining of the bowel comes down, and if it’s a bad prolapse it comes right through and you can see it outside,” she says.

“If you raise your knees above your hips when you have a poo, it will help to stop that from happening.”


Research from Israel published in 2003 illustrates how much easier it is to squat.

Twenty-eight volunteers recorded their bowel motions multiple times with a stopwatch while squatting, and again while using a traditional toilet.

The intrepid poo-ers also ranked the difficulty of how hard they had to push.

The results were published in a paper gloriously titled Comparison of Straining During Defecation in Three Positions: Results and Implications for Human Health.

They showed it took more than three times as long to defecate in the traditional sitting position – an average of 130 seconds, to be precise.

By comparison, it took the volunteers only 39 seconds on average to empty their bowels while squatting.

Researchers ruled out the possibility that those sitting were spending the added minutes reading the newspaper.

“The extra time spent in the sitting posture is necessary for excessive straining in order to push the faeces through the almost right rectoanal angle,” they wrote.

Squatting was much less effort. While sitting, a respectable 39 per cent reported their straining endeavours had been “Easy” or “Very Easy”. However that figure leaped to 82 per cent when they switched to squatting.

How, then, do we move to a daily squat? Clearly it’s unrealistic to replace all of New Zealand’s sitting toilets.


Enter the Squatty Potty.

The Squatty Potty has been a smash hit since launching in the United States several years ago.

The brain-child of a mom-and-pop family business in Utah, it went viral following a quirky marketing campaign that featured a unicorn pooing rainbow soft-serve.

An online video has been viewed more than 30 million times, and boasts of a “foot stool fit for a constipated king” (several centuries too late for poor King George, unfortunately).

Perry, the colorectal nurse, advises poo-thrifts they can make do with common household items to achieve the same effect.

“It doesn’t matter what you use to raise your knees,” she says. “Some people use books or toilet rolls under their feet.”

Meanwhile, my mission continues to raise awareness about proper poo practice.

I’ve held forth at length to my friends, one of whom went so far as to gift me a poop emoji cushion for Christmas in tribute to my ongoing toilet talk.

Several now say they think of me when they poo.

Which is a bit weird perhaps, but that’s the price you pay for being a poo evangelist.

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