Defecation postures

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Some toilets allow the user to defecate in either the squatting or the sitting position

Humans mainly use one of two types of defecation postures to defecate: either squatting or sitting. People use the squatting posture 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 posture chosen is largely a cultural decision and is determined by early childhood habits[citation needed]. However, it may also be dictated by the available toilet type, as a squat toilet can only be used in a squatting position, whereas squatting on a toilet designed for sitting is not recommended. When people are travelling to different countries, they may therefore be forced to use a different defecation posture than what they are used to or prefer.

The squatting position is thought to have some health benefits, such as reducing constipation and straining.[1][citation needed]

Sitting[edit]

An example of the sitting posture.

The sitting defecation posture involves sitting with hips and knees at approximately right angles, as on a chair. Most Western-style flush toilets are designed to be used with a sitting posture.[2] The sitting posture is more widespread in the Western world, and less common in developing countries although this changing in some countries where a shift from squatting to sitting is being observed.[citation needed] Toilet seats are a recent development, only coming into widespread use in the nineteenth century.[3]

The sitting position has some advantages: It helps protect privacy and leaves little or no chance of getting fecal matter on clothes or ankles. It may feel more comfortable as it can minimize strain in thighs, calves, ankles and lower back[citation needed]. It is therefore often the preferred position of people with disabilities and elderly people.

Squatting[edit]

Further information: Squat toilet

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 and toilet squat stools are designed to facilitate this posture. They are more widespread in developing countries than elsewhere, particularly in those with a Muslim or Hindu majority. Anal cleansing with water, which is practised by most Muslims due to the Islamic toilet etiquette might be easier to do from a squatting position than from a sitting position.

Health aspects[edit]

The defecation posture may affect certain medical conditions, such as defecation syncope (fainting while defecating), as well as urination.[4]

The sitting position causes the defecating human to assume a narrow anorectal angle, which may be obstructive and causes difficulty in emptying the bowels.[5] The sitting position can cause the defecating human to repeat the Valsalva maneuver many times and with great force; this may overload the cardiovascular system and cause defecation syncope. Research comparing the length of time needed to defecate using various postures found that the sitting defecation posture requires "excessive expulsive effort compared to the squatting posture".[6] It has been aruged that squatting is "the only natural defecation posture".[7]

A sitting posture may increase diverticulosis of the colon. The magnitude of straining during defecation is at least three times greater than with the squatting posture.[8]

See also[edit]

References[edit]

  1. ^ Giulia Enders (2014) (in German), Darm mit Charme, Berlin: Ullstein, ISBN 978-3-550-08041-8 
  2. ^ Sikirov, Dov, MD (1990): "Cardio-vascular events at defecation: are they unavoidable?" Medical Hypotheses, 1990, Jul; 32(3): 231-3. PubMed
  3. ^ A History of Technology, Vol.IV: The Industrial Revolution, 1750-1850. (C. Singer, E Holmyard, A Hall, T. Williams eds) Oxford Clarendon Press, pp. 507-508, 1958.
  4. ^ A. Rane; A. Corstiaans (2008, Department of Urogynaecology, Townsville Hospital, Townsville, Queensland, Australia): Does micturition improve in the squatting position? in Journal of Obstetrics and Gynaecology, Volume 28, Issue 3 of April 2008, pages 317 - 319. Quotes: "Posture on the toilet is an important consideration during micturition", "the ability to squat in our population of volunteers was quite poor" (from the abstract).
  5. ^ Sikirov, D. (2003). "Comparison of straining during defecation in three positions: results and implications for human health". Digestive diseases and sciences 48 (7): 1201–5. PMID 12870773. 
  6. ^ http://www.springerlink.com/content/rlu7151837n07562/
  7. ^ Sikirov, B.A. (February 1989). "Primary constipation: an underlying mechanism". Med. Hypotheses 28 (2): 71–3. doi:10.1016/0306-9877(89)90016-9. PMID 2927355. 
  8. ^ Sikirov, B., A. (1988): Etiology and pathogenesis of diverticulosis coli: a new approach. Medical Hypotheses. May; 26(1): 17-20.