Defecation postures: Difference between revisions
Moribundum (talk | contribs) →Squatting: stool under the legs for pts w mobility problems |
Moribundum (talk | contribs) semi squatting - actually a method in between sitting and squatting for those with mobility issues + refs |
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Compared to the sitting defecation posture, the squatting defecation posture is more physiological, ideal and relaxed.<ref name="Ghoshal2018" /> This is because it allows for better relaxation of the [[puborectalis muscle]] with straightening of the anorectal angle, and for faster, easier and more complete evacuation of stool.<ref name="Ghoshal2018" /> The squatting position therefore prevents excessive straining and hence protects stretching of the nerves, such as the [[pudendal nerve]].<ref name="Ghoshal2018">{{cite journal |last1=Ghoshal |first1=UC |last2=Sachdeva |first2=S |last3=Pratap |first3=N |last4=Verma |first4=A |last5=Karyampudi |first5=A |last6=Misra |first6=A |last7=Abraham |first7=P |last8=Bhatia |first8=SJ |last9=Bhat |first9=N |last10=Chandra |first10=A |last11=Chakravartty |first11=K |last12=Chaudhuri |first12=S |last13=Chandrasekar |first13=TS |last14=Gupta |first14=A |last15=Goenka |first15=M |last16=Goyal |first16=O |last17=Makharia |first17=G |last18=Mohan Prasad |first18=VG |last19=Anupama |first19=NK |last20=Paliwal |first20=M |last21=Ramakrishna |first21=BS |last22=Reddy |first22=DN |last23=Ray |first23=G |last24=Shukla |first24=A |last25=Sainani |first25=R |last26=Sadasivan |first26=S |last27=Singh |first27=SP |last28=Upadhyay |first28=R |last29=Venkataraman |first29=J |title=Indian consensus on chronic constipation in adults: A joint position statement of the Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology. |journal=Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology |date=November 2018 |volume=37 |issue=6 |pages=526-544 |doi=10.1007/s12664-018-0894-1 |pmid=30617919 |pmc=6339668}}</ref> Damage of these nerves can lead to permanent problems with urinary, defecation and sexual function. The squatting position is often recommended for any kind of [[constipation]], including [[obstructed defecation syndrome]] and [[dyssynergic defecation]]. Chronic, excessive straining during defecation, which is more likely to be needed in the sitting position, may be associated with the development of hemorrhoids any of the spectrum of [[pelvic organ prolapse]] disorders, such as [[rectocele]], [[rectal prolapse]], etc. Straining in the squatting position while defecating may increase the risk of severe [[hemorrhoids]].<ref name=":0">{{cite book |veditors=Bland KI, Sarr MG, Buechler MW, Csendes A, Garden OJ, Wong J |work=General Surgery: Principles and International Practice |year=2009 |edition=2nd |publisher=Springer|isbn=9781846288326 |pages=857 |url=https://books.google.com/books?id=0sdcAQLAc-MC&pg=PA857 |title=Chapter 85:Hemorrhoids |vauthors=Seow-Choen F, Tan K}}</ref> Prolonged and repeated straining on a sitting toilet has the same effect.<ref name=":0" /> |
Compared to the sitting defecation posture, the squatting defecation posture is more physiological, ideal and relaxed.<ref name="Ghoshal2018" /> This is because it allows for better relaxation of the [[puborectalis muscle]] with straightening of the anorectal angle, and for faster, easier and more complete evacuation of stool.<ref name="Ghoshal2018" /> The squatting position therefore prevents excessive straining and hence protects stretching of the nerves, such as the [[pudendal nerve]].<ref name="Ghoshal2018">{{cite journal |last1=Ghoshal |first1=UC |last2=Sachdeva |first2=S |last3=Pratap |first3=N |last4=Verma |first4=A |last5=Karyampudi |first5=A |last6=Misra |first6=A |last7=Abraham |first7=P |last8=Bhatia |first8=SJ |last9=Bhat |first9=N |last10=Chandra |first10=A |last11=Chakravartty |first11=K |last12=Chaudhuri |first12=S |last13=Chandrasekar |first13=TS |last14=Gupta |first14=A |last15=Goenka |first15=M |last16=Goyal |first16=O |last17=Makharia |first17=G |last18=Mohan Prasad |first18=VG |last19=Anupama |first19=NK |last20=Paliwal |first20=M |last21=Ramakrishna |first21=BS |last22=Reddy |first22=DN |last23=Ray |first23=G |last24=Shukla |first24=A |last25=Sainani |first25=R |last26=Sadasivan |first26=S |last27=Singh |first27=SP |last28=Upadhyay |first28=R |last29=Venkataraman |first29=J |title=Indian consensus on chronic constipation in adults: A joint position statement of the Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology. |journal=Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology |date=November 2018 |volume=37 |issue=6 |pages=526-544 |doi=10.1007/s12664-018-0894-1 |pmid=30617919 |pmc=6339668}}</ref> Damage of these nerves can lead to permanent problems with urinary, defecation and sexual function. The squatting position is often recommended for any kind of [[constipation]], including [[obstructed defecation syndrome]] and [[dyssynergic defecation]]. Chronic, excessive straining during defecation, which is more likely to be needed in the sitting position, may be associated with the development of hemorrhoids any of the spectrum of [[pelvic organ prolapse]] disorders, such as [[rectocele]], [[rectal prolapse]], etc. Straining in the squatting position while defecating may increase the risk of severe [[hemorrhoids]].<ref name=":0">{{cite book |veditors=Bland KI, Sarr MG, Buechler MW, Csendes A, Garden OJ, Wong J |work=General Surgery: Principles and International Practice |year=2009 |edition=2nd |publisher=Springer|isbn=9781846288326 |pages=857 |url=https://books.google.com/books?id=0sdcAQLAc-MC&pg=PA857 |title=Chapter 85:Hemorrhoids |vauthors=Seow-Choen F, Tan K}}</ref> Prolonged and repeated straining on a sitting toilet has the same effect.<ref name=":0" /> |
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==Semi-squatting== |
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People who are not used to squat toilets, and people who do not have the flexibility, strength, or balance needed to lower into, sustain, or rise from a squatting position without pain or assistance may |
People who are not used to squat toilets, and people who do not have the flexibility, strength, or balance needed to lower into, sustain, or rise from a squatting position without pain or assistance may not find it easy to use the squatting posture. This may include the [[Old age|elderly]], [[Disability|people with disabilities]], [[overweight]] people or people suffering from a skeletal or muscular disease. |
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A semi-squatting position can be achieved by placing a stool or box under the feet while using a sitting toilet.<ref name="Krishnan2019" /> This raises the legs and allows for some degree of widening of the anorectal angle.<ref name="Krishnan2019" /> The anorectal angle can be further increased by leaning forwards in this semi-squatting position.<ref name="Krishnan2019" /> Using a box to raise the legs has been recommended for various straining related medical conditions such as [[obstructed defecation syndrome]],<ref name="Steele2020">{{cite book | vauthors = Steele SR, Maykel JA, Wexner SD |title=Clinical Decision Making in Colorectal Surgery |date=11 August 2020 |publisher=Springer International Publishing |location=Cham |isbn=978-3-319-65941-1 |edition=2nd |language=en}}</ref> and [[solitary rectal ulcer syndrome]].<ref name="Gouriou2018">{{cite journal |last1=Gouriou |first1=C |last2=Chambaz |first2=M |last3=Ropert |first3=A |last4=Bouguen |first4=G |last5=Desfourneaux |first5=V |last6=Siproudhis |first6=L |last7=Brochard |first7=C |title=A systematic literature review on solitary rectal ulcer syndrome: is there a therapeutic consensus in 2018? |journal=International journal of colorectal disease |date=December 2018 |volume=33 |issue=12 |pages=1647-1655 |doi=10.1007/s00384-018-3162-z |pmid=30206681}}</ref> |
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For elderly people or people with mobility issues, this "semi-squatting" position is closer to the more natural squatting position,<ref name="Krishnan2019" /> and gives some of the benefit of the squatting position and is one of the practical solutions for avoiding constipation.<ref name="Krishnan2019">{{cite journal |last1=Hari Krishnan |first1=R |title=A review on squat-assist devices to aid elderly with lower limb difficulties in toileting to tackle constipation |journal=Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine |date=April 2019 |volume=233 |issue=4 |pages=464–475 |doi=10.1177/0954411919838644 |pmid=30898031}}</ref> Various "squat assist devices" are also commercially available.<ref name="Krishnan2019" /> |
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==See also== |
==See also== |
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Revision as of 08:04, 4 January 2023
 | This article needs additional citations for verification. (November 2015) |
Humans use one of two types of defecation postures to defecate: squatting and sitting. People use the squatting postures when using squat toilets or when defecating in the open in the absence of toilets. The sitting posture on the other hand is used in toilets that have a pedestal or "throne", where users generally lean forward or sit at 90 degrees to a toilet seat.
In general, the preferred posture is largely a cultural decision. People adapt their defecation posture to the toilet type available to them, e.g. while travelling or if moving to another country.
Sitting
The sitting defecation posture involves sitting with hips and knees at approximately right angles, as on a chair. So-called "Western-style" flush toilets and also many types of dry toilets are designed to be used in a sitting posture.
Sitting toilets only came into widespread use in Europe in the nineteenth century.[1]
Special devices exist in the form of "wrap-around foot stools" to allow users of western-style toilets to defecate in a posture that is somewhat similar to squatting.[2]
Squatting
The squatting defecation posture involves squatting, or crouching. It requires standing with knees and hips sharply bent and the buttocks close to the ground. Squat toilets are designed to facilitate this posture.
Compared to the sitting defecation posture, the squatting defecation posture is more physiological, ideal and relaxed.[3] This is because it allows for better relaxation of the puborectalis muscle with straightening of the anorectal angle, and for faster, easier and more complete evacuation of stool.[3] The squatting position therefore prevents excessive straining and hence protects stretching of the nerves, such as the pudendal nerve.[3] Damage of these nerves can lead to permanent problems with urinary, defecation and sexual function. The squatting position is often recommended for any kind of constipation, including obstructed defecation syndrome and dyssynergic defecation. Chronic, excessive straining during defecation, which is more likely to be needed in the sitting position, may be associated with the development of hemorrhoids any of the spectrum of pelvic organ prolapse disorders, such as rectocele, rectal prolapse, etc. Straining in the squatting position while defecating may increase the risk of severe hemorrhoids.[4] Prolonged and repeated straining on a sitting toilet has the same effect.[4]
Semi-squatting
People who are not used to squat toilets, and people who do not have the flexibility, strength, or balance needed to lower into, sustain, or rise from a squatting position without pain or assistance may not find it easy to use the squatting posture. This may include the elderly, people with disabilities, overweight people or people suffering from a skeletal or muscular disease.
A semi-squatting position can be achieved by placing a stool or box under the feet while using a sitting toilet.[5] This raises the legs and allows for some degree of widening of the anorectal angle.[5] The anorectal angle can be further increased by leaning forwards in this semi-squatting position.[5] Using a box to raise the legs has been recommended for various straining related medical conditions such as obstructed defecation syndrome,[6] and solitary rectal ulcer syndrome.[7]
For elderly people or people with mobility issues, this "semi-squatting" position is closer to the more natural squatting position,[5] and gives some of the benefit of the squatting position and is one of the practical solutions for avoiding constipation.[5] Various "squat assist devices" are also commercially available.[5]
See also
References
- ^ Singer, C.; Holmyard, E.; Hall, A.; Williams, T.; et al., eds. (1958), A History of Technology, Vol. IV: The Industrial Revolution, c. 1750 to c. 1850, Oxford, UK: Oxford Clarendon Press, pp. 507–508, ISBN 9780198581086, OCLC 490984504
- ^ Hindman, Nate C. (January 23, 2014) [October 1, 2012]. "Squatty Potty Wants to Revolutionize Toilet Sitting". The Huffington Post.
- ^ a b c Ghoshal, UC; Sachdeva, S; Pratap, N; Verma, A; Karyampudi, A; Misra, A; Abraham, P; Bhatia, SJ; Bhat, N; Chandra, A; Chakravartty, K; Chaudhuri, S; Chandrasekar, TS; Gupta, A; Goenka, M; Goyal, O; Makharia, G; Mohan Prasad, VG; Anupama, NK; Paliwal, M; Ramakrishna, BS; Reddy, DN; Ray, G; Shukla, A; Sainani, R; Sadasivan, S; Singh, SP; Upadhyay, R; Venkataraman, J (November 2018). "Indian consensus on chronic constipation in adults: A joint position statement of the Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology". Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology. 37 (6): 526–544. doi:10.1007/s12664-018-0894-1. PMC 6339668. PMID 30617919.
- ^ a b Seow-Choen F, Tan K (2009). Bland KI, Sarr MG, Buechler MW, Csendes A, Garden OJ, Wong J (eds.). Chapter 85:Hemorrhoids (2nd ed.). Springer. p. 857. ISBN 9781846288326.
{{cite book}}:|work=ignored (help) - ^ a b c d e f Hari Krishnan, R (April 2019). "A review on squat-assist devices to aid elderly with lower limb difficulties in toileting to tackle constipation". Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. 233 (4): 464–475. doi:10.1177/0954411919838644. PMID 30898031.
- ^ Steele SR, Maykel JA, Wexner SD (11 August 2020). Clinical Decision Making in Colorectal Surgery (2nd ed.). Cham: Springer International Publishing. ISBN 978-3-319-65941-1.
- ^ Gouriou, C; Chambaz, M; Ropert, A; Bouguen, G; Desfourneaux, V; Siproudhis, L; Brochard, C (December 2018). "A systematic literature review on solitary rectal ulcer syndrome: is there a therapeutic consensus in 2018?". International journal of colorectal disease. 33 (12): 1647–1655. doi:10.1007/s00384-018-3162-z. PMID 30206681.