When you sit down to go “number 2” do you really think about what it takes to get everything out? There’s much debate as to whether its better to sit or squat. When it comes to hemorrhoids—a painful swelling of the veins in the anal canal that affects half of all Americans—new research suggests that you may want to get your butt off the toilet.
People can control their defecation, to some extent, by contracting or releasing the anal sphincter. But that muscle can’t maintain continence on its own. The body also relies on a bend between the rectum—where feces builds up—and the anus—where feces comes out. When we’re standing up, the extent of this bend, called the anorectal angle, is about 90 degrees, which puts upward pressure on the rectum and keeps feces inside. In a squatting posture, the bend straightens out, like a kink ringed out of a garden hose, and defecation becomes easier.
Proponents of squatting argue that conventional toilets produce an anorectal angle that’s ill-suited for defecation. By squatting, they say, we can achieve “complete evacuation” of the colon, ridding our bowels of disease causing toxins.
One of the other benefits squatting provides comes in the form of hemorrhoid prevention.
Hemorrhoids may be brought on by pregnancy, obesity, and receiving anal sex. But the main cause is straining during bowel movement. Straining increases the pressure in your abdomen, causing the veins that line your anus to swell. In hemorrhoid patients, those veins stay swollen and sometimes bleed. In theory, squatting might stave off hemorrhoids by making defecation easier, reducing the need to strain and decreasing abdominal pressure.
For a study published in the medical journal Lower Urinary Tract Symptoms, subjects had their rectums filled with a contrast solution and then released the fluid from a squatting or a sitting position while being filmed with X-ray video. Image analysis showed that the anorectal angle increased from 100 degrees to 126 degrees as the subjects moved from a sit to a squat. The researchers also recorded abdominal pressure, and found that the subjects were straining less when they squatted.
So all this to say what? Squatting allows the anorectal angle to straighten, so that less effort is required for evacuation.
