Two people are sitting on the stoop of a brownstone. One is squatting and one is sitting more like you would in a chair.

Does Posture Improve Bowel Movements?

According to recent studies, around 10 to 15 percent of people in North America experience IBS symptoms.1 Both the IBS-C and IBS-M subtypes include constipation and bowel movements that require straining. People with IBS also often report that their bowels do not feel empty after a bowel movement. This may result in increased straining and spending a longer time on the toilet.2

There are many treatments for IBS-related constipation. Some treatments, like laxatives, should only be used for a short time. Other treatments like dietary changes and medicines that relax muscles in the bowel can be used for longer.2 Recently, defecation postural modification devices (DPMDs) have become more popular in the US to improve bowel movements in a non-invasive way.3

What are DPMDs and how do they work?

To have a bowel movement, the autonomic or unconscious nervous system has to work with the conscious nervous system. The autonomic nervous system acts independently to squeeze the colon and rectum to move stool down. The conscious nervous system is under our control when we strain to push the stool out.3

The levator ani muscles are wrapped around the rectum. They stay contracted to prevent us from having a bowel movement unintentionally. They also contract during kegel exercises or when you stop the flow of urine. While these muscles are helpful for most of the day, they can interfere with bowel movements. They must be relaxed to pass stool. It is thought that people with IBS may have an issue coordinating the autonomic and conscious muscle movements. This is called dyssynergic defecation.3

In eastern cultures such as the Middle East, Africa, and Asia, it is common to squat during a bowel movement. Squatting relaxes the levator ani muscles. It removes tension on the rectum to allow for a more gently bowel movement. Western cultures like the US have moved away from squatting. Sitting on a toilet, however, does not put the hips at the same angle as squatting.3

DPMDs like the Squatty Potty® were introduced to mimic the squatting position. The device sits near the toilet and raises both feet 7 to 9 inches off of the ground. If you choose not to buy a DPMD, they can be easily made at home. A stool similar in height or 2 blocks similar in height can be placed near the toilet to rest the feet on.3

Do DPMDs work?

A 2019 study looked at the effects on DPMDs on a group of healthy participants. They asked the participants to record time spent passing stool, incomplete emptying of the bowels and straining while passing stool. They found that DPMDs improved all three variables. Participants spent less time on the toilet, reported complete emptying, and their bowel movements required less straining.3

DPMDs may be a cheap and safe alternative for people living with chronic constipation. They may be especially helpful for people living with dyssynergic defecation. Relieving constipation improves the quality of life. It can also reduce outpatient visits and the cost of laxative or muscle-relaxing medication.3 Less straining also reduces the risk of hemorrhoids or anal fissures, which are small tears in the anus.4 On their own or in combination with other therapies, DPMDs may be effective in relieving constipation.

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