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The Modern Toilet: Convenience or Causing Constipation?

In 1596 Sir John Harrington invented a flushing lavatory with a cistern. However, the idea failed to catch on. In 1775 Alexander Cumming was granted a patent for a flushing lavatory. Joseph Brahmah made a better design in 1778.

Flushing toilets were a luxury at first and they did not become common till the late 19th century. In the early 19th century working class homes often did not have their own toilet and had to share one.

About 1900 some houses were built for skilled workers with bathrooms and inside toilets. However, it was decades before inside toilets became universal.1

Did this modern convenience of an indoor flushing toilet really help us? Yes, it is convenient. I don’t want to walk outside at night to go to the bathroom, however from an anatomical perspective this is making our bowel movements more difficult.

In Western culture, everywhere we go there are toilets that we sit on to go to the bathroom. However, in many other parts of the world they squat over a hole to go to the bathroom and that is anatomically how we were made to have a bowel movement. I have seen this in Asia, the Middle East and Africa during my travels. Many Westerners have a challenging time when traveling and they come upon these original “squatty potties.” This is a toilet I encountered in Hong Kong.

When we squat our pelvic floor muscles are more relaxed and in an opened position making it easier to let the waste out of our bodies. When we sit, and our legs are approximately at a 90* angle our pelvic floor muscles are not as open in this position. Also, the curve of our colon is in a straighter line pointing down when we squat, and our pelvis is tucked versus when we sit there is a bend our poop has to go around to escape, making it more difficult.

For most of us this isn’t a problem. We have probably adapted to sitting on the toilet to poop if we were raised in a Western culture, however I’m sure we have all had those times we have a hard stool or feel constipated and we try to squirm around on the toilet seat to find a way to relieve ourselves. Eventually most of us are able to poop and move on with our lives, but not everyone has it so easy. I see a lot of people with complaints of constipation and I think a lot of it has to do with our Western society. We drink coffee, soda and energy drinks instead of water. We eat fast food and processed food in our hurried lifestyle instead of fresh fruits, vegetables and other whole foods. We work long hours sitting at our desks. We commute long hours sitting in our cars or on public transportation. We don’t exercise and move regularly. Then we go home and sit on our comfortable height toilets and have difficulty having a bowel movement.

A lot of constipation has to do with our diet, what we drink and how much we exercise, however for many of my clients they work on all those things to be as healthy as possible and still are unable to have comfortable, easy bowel movements. Besides digging a hole in the backyard to go to the bathroom in, what else can we do?

The squatty potty is a great invention. I have no affiliation with them, but they make a very practical product and they have a great commercial for their product. (Watch it here: The squatty potty helps put your colon and pelvic floor in the ideal anatomical position to poop.

If you have cleaned up your diet, started exercising regularly, purchased the squatty potty and still can’t poop, then a pelvic floor physical therapist, such as myself, can help assess if there is a muscular reason why you have difficulty pooping. We look, feel and test your pelvic floor muscles to learn if they contract properly, if they relax fully and if they push out when you are telling them to push out a poop or if they are actually doing the opposite of what they are supposed to be doing. We also will test the muscles around your hips and buttocks to make sure they aren’t tight and inflexible and holding everything in. I feel my patient’s colons to find out if they are tight and full and if so I teach them colon massage to help stimulate all that poop to move along.

If you have tried all the things you know you should do to live a healthy life and still have difficulty pooping, go see a pelvic physical therapist. We can help poop be a normal part of your life and not something that is taking up all your time and energy.



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