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Medical Case Studies
Squatting is the healthy, natural way to eliminate

The Squatty Potty® toilet stool as treatment of constipation: a prospective, longitudinal cohort study

Gregory S. Taylor MD, Lisa Mitchell RN

ABSTRACT Background: The Squatty Potty is a thoughtfully designed toilet stool which comfortably delivers all the health benefits of squatting during elimination. Squatty Potty users have reported subjective improvement in constipation, hemorrhoids, rectal prolapse, and irritable bowel syndrome. Other users claim improvement in urinary incontinence, migraine headaches, toddler potty training, and even pain due to pregnancy. This study is designed to objectively evaluate Squatty Potty as a treatment for constipation.

Materials and methods: 200 participants with constipation were recruited via the Squatty Potty website. Participants completed a validated constipation scoring system to describe their baseline constipation symptoms. Participants then received a Squatty Potty and used it for one month. Squatty Potty use was the only change to their treatment. At the end of the month, participants completed the same constipation scoring system. The data was analyzed using chi-squared analysis for statistical significance.

Results: 153 participants completed the trial. There were 91 women and 62 men. The average age of participants was 39.6 years (range 9-82). The average duration of constipation was 10-20 years. The use of Squatty Potty for 1 month significantly improved constipation symptom scores for all participants as a whole (p < 0.01). Squatty Potty use also significantly improved constipation scores for women (p<0.01), men (p<0.01), those with hemorrhoid symptoms as well as those without hemorrhoid symptoms (p<0.01).

Conclusions: Squatty Potty toilet stool use for one month achieves statistically significant improvement in constipation symptoms in men and women.
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Influence of Body Position on Defecation in Humans

Summary: This medical study compares three positions for defecation by measuring abdominal pressure and the anorectal angle simultaneously. It concludes that the greater the hip flexion achieved by squatting, the straighter the rectoanal canal will be, and accordingly, less strain will be required for defecation.
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Impact Of Ethnic Habits On Defecographic Measurements

Summary: The main goal of this study was to compare Iranian and European habits of bowel evacuation on defecographic measurements. Patients were instructed to defecate using two types of toilet: an unraised, ground-level style (common in Iran), and a bowl with attached tank style (common in Western countries). It concluded that the use of the Iranian-style toilet yielded a much wider anorectal angle, and a larger distance between the perineum and the horizontal plane of the pelvic floor than the European style. Bowel evacuation was also more complete using the Iranian-style toilet.
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Comparison of Straining During Defecation in Three Positions

Summary: The aim of this study was to compare the straining forces applied when sitting or squatting during defecation. The study confirmed that sensation of satisfactory bowel emptying in sitting defecation posture necessitates excessive expulsive effort compared to the squatting posture.
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