What is the best position to poo?
The short answer is it depends. Your pelvic health physio will individualise the position they advise depending on your specific presentation. They will do this by first assessing your underlying issue so they can treat all the causes as the advice for someone with pelvic organ prolapse (rectocele) will differ from someone who does not have effective pelvic floor coordination (dyssynergic defecation). Many people don’t realise that the position you sit on the toilet significantly affects how easily and completely you empty your bowels. Western toilets are often too high and have you in a seated position with hips at roughly 90 degrees however this isn’t actually the best position to get your poo out most easily.
Why position matters
Ever noticed that you often have the best poo of your life when you go camping and have to dig a hole to poo? This is not just because you were more relaxed and happier on your holiday, there are biomechanics at play. The puborectalis muscle (part of the pelvic floor) slings around the rectum, creating a kink or angle. When sitting upright, this muscle is more tense, leading to more of a kink but in a more of a squat position the puborectalis relaxes, allowing the rectum to straighten out a bit and this lets your poo to pass more easily with less straining.
Give this position a try:
• Sit upright and lean forward slightly, you can res your forearms on thighs if this feels comfortable
• Feet Supported on a stool/ toilet rolls / yoga blocks so that your knees are higher than your hips
• Relax your belly, let it bulge out rather than sucking in -you can make a low “moo” sound to encourage relaxation of the pelvic floor rather than tightening.
It is not just about position; your pelvic floor physio will want to know about lots of other things that may affect your bowel function. Here are a few…
· Bowel habits pattern – frequency and consistency- they will get out a poo chart and may get you to do a poo diary
· Onset, duration and triggers for symptoms
· Your medical history
· Time you spend on the toilet
· Any straining, urgency or incomplete emptying you may have
· What medications you are taking
· Your obstetric history - have you had vaginal deliveries, were instruments used, did you have a tear?
· Your surgical history - any pelvic/ abdominal or colorectal surgery
· Your usual bladder function - often bladder and bowel (and sexual) dysfunction occur together
· Psychological factors – such as anxiety/ previous trauma/ bowel related fear avoidance
· What are your behavioural habits - do you delay/ defer often
Want to know more and get a specific assessment? Book an appointment – call 8239 2811.