The classic 175 year old Western toilet may be in part
responsible for increasing bowel and pelvic problems, including
constipation, hemorrhoids, colitis, appendicitis, colon cancer
and others
Modern toilets place you in a sitting position as opposed to the
more traditional squatting position with your knees to your
chest; sitting to empty your bowel results in more straining
because your intestinal organs are not in an optimal position
for elimination
Squatting actually straightens your rectum, relaxes your
puborectalis muscle, and allows for complete emptying of your
cecum and appendix without straining, which prevents fecal
stagnation and the accumulation of toxins in your intestinal
tract
Squatting has been scientifically shown to relieve constipation
and hemorrhoids, but additional research needs to be done
Non-westernized societies, in which people squat, do not have
the high prevalence of bowel disease seen in developed nations;
in some cultures with traditional lifestyles, these diseases are
uncommon or almost unknown
By Dr. Mercola
Is the Western toilet in part responsible for problems like
hemorrhoids, constipation, IBD (Inflammatory Bowel Disease),
appendicitis, and even heart attacks?
If you examine the data, there is a great deal of evidence
this is true. The modern toilet has required us to change the
position we use to evacuate our bowels, which changes the
anatomy of well, a poop, to put it bluntly.
Infants instinctively squat to defecate, as does the majority
of the world's population. But somehow the West was convinced
that sitting is more civilized.
Sitting on the modern Thomas Crapper-style sit-down toilet is
designed to place your knees at a 90-degree angle to your
abdomen. However, the time-honored natural squat position places
the knees much closer to your torso, and this position actually
changes the spacial relationships of your intestinal organs and
musculature, optimizing the forces involved in defecation.1
Sitting to evacuate your bowel requires you to apply
additional force (straining), which has some unwanted
biological effects, including a temporary disruption in cardiac
flow.
Can the Toilet Be Blamed for Increasing Rates of Colon and
Pelvic Disease?
Squatting is the way our ancestors performed their bodily
functions until the middle of the 19th Century. Chair-like
toilets were reserved for the royals and the disabled. But the
"progress" of westernized societies may be partly to blame for
higher rates of colon and pelvic disease, as described by a
report in the Israel Journal of Medical Science:2
"The prevalences of bowel diseases (hemorrhoids,
appendicitis, polyps, ulcerative colitis, irritable bowel
syndrome, diverticular disease, and colon cancer) are
similar in South African whites and in populations of
prosperous western countries. Among rural South African
blacks with a traditional life style, these diseases are
very uncommon or almost unknown."
As globalization continues to make its way across the world,
squat toilets are being converted to sitters. For example,
Thailand's Health Ministry just announced it will replace squat
toilets with the sit-down varieties at all public facilities.3
This may be a bad thing for public health, as a wide range of
health problems have been associated with the transition from
squatting to sitting. In fact, health problems potentially
stemming from the sitting position include the 15 outlined in
the following table.
Appendicitis
Constipation
Hemorrhoids
Incontinence
Colitis
Crohn's Disease
Diverticulitis
Contamination of the Small Intestine
Gynecological Disorders, including Pelvic Organ Prolapse
and Uterine Fibroids
Colon Cancer
Hiatal Hernia and GERD
Pregnancy and Childbirth
Prostate Disorders
Sexual Dysfunction
Reduced Risk of Cardiac Events
The Straight Poop
Evidence suggests bowel and pelvic problems may be related to
improper potty posture. Only with the traditional squat position
is your body aligned in a way that promotes complete bowel
emptying. As you can see from the diagram, squatting
actually straightens and relaxes your rectum.
"For safety, nature has deliberately created
obstacles to evacuation that can only be removed by
squatting. In any other position, the colon defaults to
'continence mode.' This is why the conventional sitting
position deprives the colon of support from the thighs and
leaves the rectum choked by the puborectalis muscle.These
obstacles make elimination difficult and incomplete like
trying to drive a car without releasing the parking
brake.
Chronically incomplete evacuation, combined with the
constant extraction of water, causes wastes to adhere to the
colon wall. The passageway becomes increasingly constricted
and the cells start to suffocate. Prolonged exposure to
toxins will often trigger malignant mutations."
He goes on to explain how the kink where your sigmoid joins
your rectum (refer to the colon diagram above) serves an
important function in continence. It "applies the brakes" to the
flow of peristalsis, reducing the pressure on your puborectalis
muscle. According to Isbit's article, squatting offers seven
advantages:
Makes elimination faster, easier and more complete. This
helps prevent "fecal stagnation," a prime factor in
colon cancer, appendicitis and IBD
Protects the nerves that control the prostate, bladder
and uterus from becoming stretched and damaged
Securely seals the ileocecal valve, between the colon
and the small intestine; in the conventional sitting
position, this valve is unsupported and often leaks
during evacuation, contaminating the small intestine
Relaxes the puborectalis muscle which normally chokes
the rectum in order to maintain continence
Uses the thighs to support the colon and prevent
straining. Chronic straining on the toilet can cause
hernias, diverticulosis, and pelvic organ prolapse
A highly effective, non-invasive treatment for
hemorrhoids, as shown by published clinical research
For pregnant women, squatting avoids pressure on the
uterus when using the toilet; daily squatting helps
prepare pregnant women for a more natural delivery
Hemorrhoid Prevention
Two common problems are hemorrhoids and constipation.
Unfortunately, many people needlessly suffer because they are
too embarrassed to broach the topic with their healthcare
providers. Fortunately, these all-too-common problems can be
resolved with similar strategies because they share the same
causative factors, including the typical Western diet,
inadequate exercise, chronic dehydration, and stress. Surveys
suggest that, in westernized countries, as much as half the
population over age 40 may suffer from hemorrhoids.
Hemorrhoids are veins in the wall of your rectum and anus
that have become twisted, swollen and inflamed. They can form
either internally or externally, and the resulting lumps can
cause pain and bleeding.
Hemorrhoids are most often created by an increase in
pressure, usually from straining to have a bowel movement.
Hemorrhoids are common in people with chronic digestive
disturbances especially constipation. They are also seen in
the elderly, and during pregnancy. If you're pregnant, the
additional pressure your growing baby places on your uterus can
result in hemorrhoids. Childbirth can increase the problem, but
fortunately, most hemorrhoids caused by pregnancy resolve after
delivery.
There is research casting doubt on the theory that
hemorrhoids are caused by insufficient dietary fiber, but
instead by other factors such as the loss of the "ancestral
diet," and the straining associated with defecating from a
sitting position.4
Dr. Berko Sikirov, an Israeli physician who studied the
health effects of squatting for elimination, found that
hemorrhoids were virtually eliminated when hemorrhoid sufferers
switched their toileting position from sitting to squatting.5
Sikirov concluded hemorrhoids result from continual aggravation
and injury from excessive straining by defecating in the sitting
position. Straining is necessary to overcome the constriction in
the rectum designed to maintain continence.
To prevent hemorrhoids, you should also stay hydrated with
adequate
water daily, seek to control your emotional stress, and get
plenty of exercise. Make sure your
diet includes plenty of probiotics, such as those present in
traditionally
fermented foods like sauerkraut and other fermented
vegetables, which are important for maintaining optimal
intestinal flora. For a complete discussion of
hemorrhoid prevention and treatment, refer to my earlier
article on this topic.
Occasionally a deficiency of bioflavonoids allow blood
vessels to break easier and if this is the case a supplement
called rutin is particularly helpful at correcting. If you
bruise easily this is a strong suggestion that you would benefit
from taking rutin.
Natural Constipation Relief Strategies
Constipation and hemorrhoids are two sides of the same coin.
Your risk for hemorrhoids increases greatly if you have
recurring episodes of constipation. One of the biggest
hindrances to your success may be not realizing you're
constipated in the first place. Regular bowel movements are
extremely important for your health because, without them,
toxins accumulate and are recirculated in your bloodstream. If
elimination is not regular and complete, the wastes will dry and
become cemented to the walls of your colon.
Constipation has been shown to increase your risk of colon
cancer and has been implicated in diverticulosis and
appendicitis. The cumulative lifetime use of commercial
laxatives has been associated with increased risk of colon
cancer.6
Conventional medicine typically defines constipation as fewer
than two or three bowel movements a week. But you should really
be having one bowel movement a day, and preferably two or
three. So if you are having less than one bowel movement
per day, you should take steps to increase them. Some of the
common causes of constipation include laxative abuse,
hypothyroidism,
IBD, and ignoring the urge to go. If you consistently ignore
the urge to have a bowel movement for instance, to avoid using
a public toilet eventually you may stop feeling the urge.
Laxatives are NOT a good option as your body may become
dependent on them. Laxatives may decrease your colon's ability
to contract and can even eventually damage your large
intestine's nerves, muscles, and other tissues. This applies to
both pharmaceutical laxatives, as well as herbs like cascara.
Fortunately, although constipation is very common, it is also
usually temporary and relatively easy to resolve without
resorting to laxatives. Squatting is one of the best
interventions, preventing constipation in four ways:
Gravity does most of the work. The weight of the torso
presses against the thighs and naturally compresses the
colon. Gentle pressure from the diaphragm supplements the
force of gravity.
The ileocecal valve, between the colon and the small
intestine, is properly sealed, allowing the colon to be
fully pressurized. The pressure creates a natural laxative
effect. In the sitting position the IC valve is unsupported
and tends to leak, making it difficult to generate the
required pressure.
Squatting relaxes the puborectalis muscle, which
normally chokes the rectum to maintain continence.
Squatting lifts the sigmoid colon to unlock the "kink"
at the entrance to the rectum. This kink also helps prevent
incontinence, by taking some of the pressure off the
puborectalis muscle.
Preventing and treating constipation is very similar to
preventing and treating hemorrhoids. Pay attention to your diet,
exercise, hydration and stress level. Consume probiotic-rich
foods and possibly add a probiotic supplement.
Chia and organic psyllium are excellent sources of soluble and
insoluble fiber, aloe vera and magnesium supplements can also be
useful tools to speed up your bowel movements.
For a complete discussion of
constipation prevention and treatment, refer to my earlier
article on this topic.
Are You Ready to Assume the Position?
The scientific benefits of squatting have sparked efforts to
design devices that help would-be squatters to return to a more
natural pooping position. However, if you've been using a
sit-down toilet your entire life and haven't squatted since
childhood, squatting may present somewhat of a physical
challenge to say the least!
Various devices have appeared in the marketplace to assist
with this problem, such as the Squatty Potty, developed by
Robert Edwards, a 37 year-old contractor and designer in Utah
who sought a way to help his mother relieve her problems with
constipation and hemorrhoids.7
You may wish to check out some of these contraptions on the
Internet.8
Squatting involves strength and flexibility that adults tend to
lose over time, but children have naturally. These devices
special toilets and stools that get your body into a more
"squatty" position may help you get closer to the ideal.
Another advantage of squatting? Killer thighs. Nothing builds
your thighs like a squat. Adding some
squats at the gym will undoubtedly help you with your squats
in the bathroom!
ฉ Copyright 1997-2012 Dr. Joseph Mercola. All Rights Reserved.