The researchers found the anorectal angle had greater widening in the squatting position. Participants also had less abdominal straining while squatting.
People who strain excessively are more prone to developing tears of the anal lining, known as a fissure. One study in Pakistan looked at participants who had chronic anal fissures with symptoms such as painful defecation, passage of blood from the rectum and difficulty sitting.
Participants adopted a squatting posture on a modified toilet seat (with their hips flexed and feet resting on an elevated stool) to help mimic a squatting position. They were found to have significantly reduced symptoms compared to the sitting position.
Although squatting may be helpful for people with chronic constipation, it’s no panacea. Other factors, such as diet, exercise, medications and fluid intake, can affect the frequency and consistency of bowel motions.
Some people naturally take a bit longer to go to the toilet because of a condition called “slow transit constipation”, which squatting is unlikely to alleviate.
The benefits of squatting – and harms of sitting – are at times overstated. There’s no firm evidence to suggest, for instance, that squatting can prevent or cure haemorrhoids.
And although it’s an intriguing concept, there is no firm data that the sitting position causes colonic diverticulosis (pouches in the wall of the colon).
Nor is there evidence to suggest that the sitting position leads to a greater risk of developing colon cancer.
Squatting to go to the toilet isn’t free from risks. It has been shown to induce a small rise in blood pressure in both healthy and hypertensive patients.
Some strokes have been found to occur during squatting and defaecation. But whether the squatting posture during defaecation puts patients at a significantly greater risk of heart disease or stroke remains debatable.
While it’s difficult to draw definitive conclusions given the lack of long term-studies, squatting has clear benefits. If you have a regular toilet and would like to obtain some of the benefits of squatting, you can use a modified toilet seat and foot stool, which allows you to flex your hips and elevate your feet.