The best position to poop for constipation is a supported squat, not the upright sitting position most modern toilets are built for. Many people try fiber, water, or laxatives to relieve constipation, but toilet posture can also affect how easily you empty your bowels. Research suggests that raising your knees above your hips helps straighten the anorectal angle, making bowel movements easier and reducing the need to strain.
This guide explains the science behind the best position to poop for constipation, why it works, and how to recreate it on a standard toilet at home.
Why Toilet Position Matters
A muscle called the puborectalis wraps around the lower end of the rectum. In a resting, seated position, this muscle pulls the rectum forward and creates a bend called the anorectal angle. That bend acts like a kink in a garden hose, and the sharper it is, the harder your body has to work to push stool through it.
When you sit upright on a standard toilet, the anorectal angle sits at roughly 90 to 100 degrees. When you squat with your knees raised above your hips, the puborectalis relaxes and the angle opens up. A Japanese videomanometric study using simultaneous fluoroscopic imaging found the anorectal angle increased from about 100 degrees during normal sitting to 126 degrees during squatting, a statistically significant difference (P < 0.05), straightening the pathway and making it easier for stool to pass [1].
What the Research Says: Squatting Is the Best Position
Most gastroenterologists and researchers who study bowel function agree that squatting is the most effective position for a bowel movement. A widely cited study by Dr. Dov Sikirov, published in the journal Digestive Diseases and Sciences in 2003, tested 28 healthy volunteers in three positions: sitting on a standard 41 to 42 centimeter toilet seat, sitting on a lower 31 to 32 centimeter seat, and squatting over a container. Each person recorded how long it took to feel fully empty and how much they had to strain, across six consecutive bowel movements in each position [2].
The results were significant. Bowel movements took an average of 51 seconds while squatting, compared to about 130 seconds on the standard-height toilet and 114 seconds on the lower seat [2]. Both the time needed for satisfactory emptying and the degree of straining were reduced sharply in the squatting position, and the difference held up across nearly all volunteers.
Squatting helps in a few concrete ways:
- It straightens the anorectal angle, so stool has a more direct path out.
- It relaxes the puborectalis muscle instead of keeping it tightened.
- Gravity and the pressure of the thighs against the abdomen do more of the work, so you rely less on straining and the Valsalva maneuver (holding your breath and bearing down), which is also easier on the cardiovascular system.
It is worth noting that not every claim about squatting is fully settled. A 2025 scoping review looked at the broader claim that squatting cultures have lower rates of hemorrhoids, diverticular disease, and chronic constipation, and found that most of the underlying studies are small and not tightly controlled [3]. So the connection between squatting and long-term digestive health is a reasonable, evidence-backed association rather than definitive proof. Changing your position is a helpful tool, not a guaranteed cure on its own.
Why Sitting Upright Is Less Effective
Modern toilets are designed for upright sitting, which is convenient but biomechanically inefficient. Sitting keeps the anorectal angle more sharply bent, so the body has to strain harder and longer to push stool past that bend. Over time, repeated straining may contribute to hemorrhoids and may worsen constipation symptoms in some people.
How to Recreate a Squat on a Regular Toilet
You do not need to squat over a hole in the floor to get the benefits of this position. A simple footstool, sometimes called a defecation posture modification device, raises your knees above your hip level while you stay seated. A prospective study of 52 healthy volunteers found that using a footstool this way significantly increased the sense of complete bowel emptying and reduced straining compared to standard sitting [4].
At a Glance: Best Toilet Stools for Better Bowel Positioning
If you want to recreate the squat position on a standard toilet, here are four footstool options covered in this guide:
- Best overall (adjustable to fit anyone): Squatty Potty Adjustable 2.0 Toilet Stool — converts between 7″ and 9″ with a removable topper, so one stool works for a whole household
- Best budget/classic option: Squatty Potty Original Toilet Stool, 7″ — the standard height used in most of the footstool research, simple one-piece design
- Best for comfort-height toilets: Squatty Potty Original Toilet Stool, 9″ — better fit if your toilet bowl sits 16.5 to 18 inches off the floor, or if you have shorter legs
- Best for travel or small bathrooms: Squatty Potty Fold N Stow Foldable Toilet Stool — folds flat for storage in shared bathrooms, guest rooms, or a suitcase
Here is how to set up the position correctly, based on patient education guidance from the Academy of Pelvic Health Physical Therapy (APTA Pelvic Health) [5]:
- Sit on the toilet as usual, then place a stool under your feet that is roughly 7 to 9 inches high, enough to bring your knees above your hips.
- Keep your feet about hip-width apart on the stool, lean your upper body forward, and rest your elbows on your knees [5].
- Let your abdomen relax and bulge slightly outward instead of tightening it. Avoid holding your breath and bearing down forcefully, since repeated hard straining raises the risk of hemorrhoids.
- Keep your back gently curved rather than perfectly straight. A slight forward lean helps the abdominal muscles work with gravity instead of against it.
If you do not have a dedicated footstool, a stack of books, a low box, or anything sturdy enough to safely support your feet at the right height will work just as well. What matters is the height of your knees relative to your hips, not the specific product you use.
The “Thinker” Position: A Middle Ground
Some people find a full squat uncomfortable or impractical. An alternative studied by researchers is sometimes called the Thinker position, named after Rodin’s sculpture. It involves leaning the upper body forward while resting the elbows on the knees, without necessarily raising the feet on a stool. A prospective study found this posture may be a more efficient method for defecation than sitting upright, and may be a useful technique when retraining patients with constipation, though it has been studied less extensively than full squatting or footstool use [6].
Hip-Flexed Sitting: Another Option
If a stool is not available, leaning your torso forward so your hips are flexed at roughly a 60-degree angle is a reasonable middle-ground option. Interestingly, the same videomanometric research that measured the anorectal angle found that hip-flex sitting alone did not significantly change the anorectal angle compared to normal sitting, unlike full squatting [1]. This suggests hip-flexed sitting may offer some comfort benefit but is not a substitute for the mechanical effect of true squatting or footstool use.
Position Alone Is Not a Complete Fix
Adjusting your posture can genuinely help, but constipation is usually caused by more than one factor, such as low fiber intake, dehydration, inactivity, stress, or an underlying health condition. Combining the right toilet posture with broader lifestyle changes gives you the best results. A few resources worth reading on constipationrelief.net:
- 5 Simple Morning Habits to Relieve Constipation Naturally for building a consistent daily routine
- 15 Best Natural Laxatives for Constipation if you want food-based options before reaching for medication
- The 10 Best Fruits for Chronic Constipation to add more fiber to your diet
- Can Gut Health Affect Constipation? to understand the deeper digestive connection
- Why Isn’t MiraLAX Working? if you are already using a laxative without relief
Long periods of sitting during the day and weak core muscles are also connected to constipation, and straining regularly can even lead to lower back discomfort. You can read more in Can Constipation Cause Back Pain?
When to See a Doctor
Changing your position on the toilet is a safe first step, but talk to a doctor if you notice any of the following:
- Fewer than three bowel movements a week for several weeks in a row
- Blood in your stool or sharp pain during bowel movements
- Unexplained weight loss
- No improvement even after trying laxatives or stool softeners
Frequently Asked Questions
What Is the Best Position to Poop for Constipation?
Yes, according to multiple studies. Squatting straightens the anorectal angle and relaxes the puborectalis muscle, which reduces straining time and effort compared to sitting upright on a standard toilet [1][2].
How high should a toilet footstool be?
Most research and patient education guidance recommend a height of around 7 to 9 inches, enough to lift your knees above your hip level while seated [5].
Can changing my toilet position cure chronic constipation?
Not on its own. Posture can reduce straining and make bowel movements faster and more complete, but chronic constipation often needs additional changes in diet, hydration, activity level, and sometimes medical treatment.
Is it safe to use a stack of books instead of a footstool?
Yes, as long as it is stable and raises your feet enough to bring your knees above your hips. The exact object does not matter, only the height and stability [5].
The Bottom Line
The research is fairly consistent: squatting, or recreating a squat with a footstool on a regular toilet, is the most effective position for people dealing with constipation. It shortens the time needed for a bowel movement, reduces the amount of straining required, and is easy and free to try. That said, it works best as one part of a broader approach that includes enough water, fiber, movement, and, when needed, guidance from a doctor.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making changes to your bowel management routine, especially if you have persistent or severe symptoms.
Affiliate Disclosure: This article contains affiliate links. If you purchase through our links, we may earn a small commission at no extra cost to you. Our recommendations are based on the available research discussed above, not on affiliate relationships.
References
- Sakakibara R, Tsunoyama K, Hosoi H, et al. Influence of Body Position on Defecation in Humans. LUTS: Lower Urinary Tract Symptoms. 2010;2(1):16-21. https://doi.org/10.1111/j.1757-5672.2009.00057.x
- Sikirov D. Comparison of Straining During Defecation in Three Positions: Results and Implications for Human Health. Digestive Diseases and Sciences. 2003;48(7):1201-1205. https://doi.org/10.1023/A:1024180319005
- Sitting vs. squatting: a scoping review of toilet postures and associated health outcomes. PMC. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12219158/
- Modi RM, Hinton A, Pinkhas D, et al. Implementation of a Defecation Posture Modification Device: Impact on Bowel Movement Patterns in Healthy Subjects. Journal of Clinical Gastroenterology. 2019;53(3):216-219. https://pubmed.ncbi.nlm.nih.gov/30346317/
- APTA Pelvic Health (Academy of Pelvic Health Physical Therapy). Proper Toileting Posture. Patient Education. https://www.aptapelvichealth.org/info/proper-toileting-posture
- Takano S, Sands DR. Influence of body posture on defecation: a prospective study of “The Thinker” position. Techniques in Coloproctology. 2016;20(2):117-121. https://doi.org/10.1007/s10151-015-1402-6
