Constipation
Constipation, especially when chronic, can have very damaging effects on the colon. The colon is constantly extracting water from its contents, to transform liquid wastes into solid. As a result, if elimination is not regular and complete, the wastes will dry and become cemented to the walls of the colon.
Constipation has been shown to increase the risk of colon cancer and has been implicated in diverticulosis and appendicitis. "Cumulative lifetime use of commercial laxatives was also associated with increased risk of colon cancer."
Squatting prevents 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.
To summarize, the colon is equipped with an inlet valve (the ileocecal valve) and an outlet valve (the puborectalis muscle). Squatting simultaneously closes the inlet valve, to keep the small intestine clean, and opens the outlet valve, to allow wastes to pass freely. The sitting position defeats the purpose of both valves, making elimination difficult and incomplete, and soiling the small intestine.
The sphincter muscle, commonly regarded as the outlet valve, is actually not capable of preventing incontinence. It involves voluntary effort and is only for short-term emergencies. Maintaining continence requires the continuous grip of the puborectalis muscle. This grip is not released in the sitting position, so it must be forced open by straining. Straining repeatedly over a number of years can lead to hemorrhoids, which can therefore be classified as a repetitive strain injury.
Doctors have long recognized the connection between sitting toilets and constipation. For example, F.A. Hornibrook in The Culture of the Abdomen, published in 1933:
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Man's natural attitude during [elimination] is a squatting one, such as may be observed amongst field workers or natives. Fashion, in the guise of the ordinary water closet, forbids the emptying of the lower bowel in the way Nature intended. Now in this act of [elimination] great strains are imposed on all the internal organs….
It is no overstatement to say that the adoption of the squatting attitude would in itself help in no small measure to remedy the greatest physical vice of the white race, the constipation that has become a contentment.
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These sentiments are echoed in Our Common Ailment, written by H. Aaron and published in 1938:
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When the thighs are pressed against the abdominal muscles in this position, the pressure within the abdomen is greatly increased, so that the rectum is more completely emptied. Our toilets are not constructed according to physiological requirements. Toilet designers can do a good deal for people if they will study a little physiology and construct seats intended for proper [elimination].
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