Squat Toilets for Optimized Health
A squat toilet (or squatting toilet) is a toilet used by squatting, rather than sitting. There are several types of squat toilets, but they all consist essentially of a toilet pan or bowl at floor level. Such a toilet pan is also called a “squatting pan”. The only exception is a “pedestal” squat toilet, which is of the same height as a sitting toilet. It is in theory also possible to squat over sitting toilets, but this requires extra care to prevent accidents as they are not designed for squatting.
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A squat toilet may use a water seal and therefore be a flush toilet, or it can be without a water seal and therefore be a dry toilet. Dry toilets can save tons of water and used as fertilizers, but those individuals who manufacture American law forbid is use as garden or agricultural fertilizer.
The term “squat” refers only to the expected defecation posture and not any other aspects of toilet technology, such as whether it is water flushed or not.
Squat toilets are used all over the world, but are particularly common in France as well as many Asian and African countries, including those with a large proportion of Muslim or Hindu faith (due to the practice of anal cleansing with water).
Squat toilet at a motorway service station near Toulouse, France. In areas of Europe where squat toilets are used, they are usually public toilets
Squat toilets are used in public toilets, rather than household toilets, because they are perceived by some as easier to clean and more hygienic, therefore potentially more appropriate for general public use. For instance this is the case in parts of France, Italy, Greece, or the Balkans, where such toilets are somewhat common in public toilets (restrooms).
Just like the junk food, junk medicine and junk everything trends in most of modern society, a trend towards more sitting toilets in countries that were traditionally using squat toilets can be observed in some urban and more affluent areas, in areas with new buildings (as well as hotels and airports) or in tourist regions.
Of all human bodily functions defecation is perhaps the least understood and least studied while remain one of the most important areas of holistic medicine, if only because of the microbiota’s key role in health and longevity.
Normal, maybe, if you’re eating a fiber-deficient diet. But not normal for our species. Defecation should not be a painful exercise. This is readily demonstrable. For example, the majority of rural Africans eating their traditional fiber-rich, plant-based diets can usually pass, without straining, a stool specimen on demand.
See, the rectum may need to accumulate four or five ounces of fecal matter before the defecation reflex is fully initiated, and so if you don’t even build up that much over the day, you’d have to strain to prime the rectal pump.
Hippocrates thought bowel movements should ideally be two or three times a day, which is what you see in populations on traditional plant-based diets, on the kind of fiber intakes you see in our fellow great apes, and what may be more representative of the type of diets we evolved eating.
Straining super bad
- F Cosci. “Bowel obsession syndrome” in a patient with chronic constipation. Gen Hosp Psychiatry. 2013 Jul-Aug;35(4):451.e1-3. doi: 10.1016/j.genhosppsych.2012.05.006.
- A R Walker. Colon cancer and diet, with special reference to intakes of fat and fiber. Am J Clin Nutr. 1976 Dec;29(12):1417-26.
- S A Walter, L Kjellström, H Nyhlin, N J Talley, L Agréus. Assessment of normal bowel habits in the general adult population: the Popcol study. Scand J Gastroenterol. 2010 May;45(5):556-66. doi: 10.3109/00365520903551332.
Normal versus Optimized
Today, the primacy of its importance continues, with some calling for bowel habits to be considered a vital sign of how the body is functioning, along with blood pressure, and heart and breathing rates. Although we may not particularly like hearing the details of someone else’s bowel movement, it is a function that nurses and doctors need to assess.
Surprisingly, the colon remained relatively unexplored territory, one of the body’s final frontiers. For example, current concepts of what “normal” stools are like primarily emanate from the detailed records of 12 consecutive bowel movements in 27 healthy subjects from the United Kingdom, who boldly went where no one had gone before. Those must have been really detailed records.
The reason we need to define normal, when it comes to bowel movement frequency, for example, is how else can we define concepts like constipation or diarrhea if we don’t know what normal is. Standard physiology textbooks may not be helpful in this regard, implying that anything from one bowel movement every few weeks or months to 24 a day can be regarded as normal. Once every few months?
- J Christensen. The response of the colon to eating. Am J Clin Nutr. 1985 Nov;42(5 Suppl):1025-32.
- J Rogers, A H Raimundo, J J Misiewicz. Cephalic phase of colonic pressure response to food. Gut. 1993 Apr;34(4):537-43.
It seems somewhat optimistic, though, to expect the average American to adopt a rural African diet. We can, however, eat more plant-based and bulk up enough to take the Hippocratic oath to go two to three times a day.
No need to obsess about it. In fact, there’s actually a “bowel obsession syndrome,” characterized in part by ideational rambling over bowel habits, but three times a day makes sense. We have what’s called a gastrocolic reflex, which consists of a prompt activation of muscular waves in our colon within 1 to 3 minutes of the ingestion of the first mouthfuls of food. Even just talking about food can cause your brain to increase colon activity. This suggests the body figured that one meal should be just about enough to fill you up down there. So, maybe we should eat enough unprocessed plant foods to get up to three a day, a movement for every meal.
The Sixth Vital Sign
- D M Tucker, H H Sandstead, G M Logan Jr, L M Klevay, J Mahalko, L K Johnson, L Inman, G E Inglett. Dietary fiber and personality factors as determinants of stool output. Gastroenterology. 1981 Nov;81(5):879-83.
- D J Jenkins, C W Kendall, D G Popovich, E Vidgen, C C Mehling, V Vuksan, T P Ransom, A V Rao, R Rosenberg-Zand, N Tariq, P Corey, P J Jones, M Raeini, J A Story, E J Furumoto, D R Illingworth, A S Pappu, P W Connelly. Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Metabolism. 2001 Apr;50(4):494-503.
- I Taylor. A survey of normal bowel habit. Br J Clin Pract. 1975 Nov;29(11):289, 291.
- R M Holl. Bowel movement: the sixth vital sign. Holist Nurs Pract. 2014 May-Jun;28(3):195-7. doi: 10.1097/HNP.0000000000000024.
Compared to rural African populations eating traditional plant-based diets, white South Africans and black and white Americans not only have more than 50 times the heart disease, 10 times more colon cancer, and more than 50 times more gallstones and appendicitis, but also more than 25 times the rates of so-called pressure diseases—diverticulitis, hemorrhoids, varicose veins, and hiatal hernia.
Bowel movements should be effortless. When they’re not, when we have to strain at stool, the pressure may balloon out-pouchings from our colon, causing diverticulosis, inflate hemorrhoids around the anus, cause the valves in the veins of our legs to fail, causing varicose veins, and even force part of the stomach up through the diaphragm into our chest cavity, causing a hiatal hernia, as I covered previously.
Humans use one of two types of defecation postures to defecate: squatting, or sitting. People use the squatting postures when using squat toilets or when defecating in the open in the absence of toilets. The sitting posture on the other hand is used in toilets that have a pedestal or “throne”, where users generally lean forward or sit at 90-degrees to a toilet seat.
In general, the preferred posture is largely a cultural decision. However, people need to adapt their defecation posture to the toilet type available to them, e.g. while travelling or if moving to another country.
The sitting defecation posture involves sitting with hips and knees at approximately right angles, as on a chair. So-called “Western-style” flush toilets and also many types of dry toilets are designed to be used in a sitting posture.
Sitting toilets only came into widespread use in Europe in the nineteenth century.
Special devices exist in the form of “wrap-around foot stools” to allow users of western-style toilets to defecate in a posture that is somewhat similar to squatting.
The squatting defecation posture involves squatting, or crouching. It requires standing with knees and hips sharply bent and the buttocks close to the ground. Squat toilets are designed to facilitate this posture. These kinds of toilets are widespread in countries with a Muslim or Hindu majority and are often set up to enable anal cleansing with water (see Islamic toilet etiquette).
In a 2003 study, it was found that both the time needed for sensation of satisfactory bowel emptying and the degree of subjectively assessed straining in the squatting position were reduced sharply in all volunteers compared with both sitting positions (P < 0.0001). In conclusion, the present study confirmed that sensation of satisfactory bowel emptying in sitting defecation posture necessitates excessive expulsive effort compared to the squatting posture.
Straining in the squatting position while defecating may increase the risk of severe hemorrhoids. Prolonged and repeated straining on a sitting toilet has the same effect.
People who are not used to squat toilets, as well as overweight people, people with disabilities, and elderly people tend to find squatting as a defecation posture difficult, and may therefore prefer sitting. But evolutionary and biologically, squatting will be best to preserve Life and health.
- ^ Singer, C.; Holmyard, E.; Hall, A.; Williams, T.; et al., eds. (1958), A History of Technology, Vol. IV: The Industrial Revolution, c. 1750 to c. 1850, Oxford, UK: Oxford Clarendon Press, pp. 507–508, ISBN 9780198581086, OCLC 490984504
- ^ Hindman, Nate C. (January 23, 2014) [October 1, 2012]. “Squatty Potty Wants to Revolutionize Toilet Sitting”. The Huffington Post.
- ^ “Comparison of straining during defecation in three positions: results and implications for human health”. https://www.nih.gov/. Retrieved 5 January 2019. External link in |website= (help)
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a b Seow-Choen F, Tan K (2009). Bland KI, Sarr MG, Buechler MW, Csendes A, Garden OJ, Wong J, eds. Chapter 85:Hemorrhoids. General Surgery: Principles and International Practice (2nd ed.). Springer. p. 857. ISBN 9781846288326.