Squatty potty: does position help

At a glance

The idea behind a squatty potty or toilet stool is simple: by raising your feet and leaning forward, you straighten the angle between the rectum and the anal canal, making it easier for stool to pass. This reduces the need to strain.

The concept has been widely popularised, and many people with colorectal conditions describe it as a helpful addition to their routine. This guide examines what the position actually does, what people report, and whether it is worth trying.

The anatomy behind it

When you sit on a standard toilet in an upright position, the puborectalis muscle — which wraps around the rectum — maintains a natural kink in the bowel. This kink helps maintain continence when you are standing and sitting normally.

When you squat or simulate a squatting position (knees raised above hips, leaning forward), this muscle relaxes and the anorectal angle straightens. The pathway for stool becomes more direct. Less effort is needed to pass stool.

What people report

People who use a toilet stool commonly describe:

  • Less straining — the stool passes more easily
  • Faster bowel movements — less time spent on the toilet
  • More complete emptying — reduced feeling of incomplete evacuation
  • Less discomfort — particularly relevant for people with hemorrhoids or fissures

Not everyone notices a dramatic difference, but the majority of accounts describe some improvement, particularly among people who were previously straining regularly.

How to use the position

The basic setup

  1. Place a stool or raised platform in front of the toilet
  2. Sit on the toilet and place both feet on the stool
  3. Your knees should be above your hips — roughly at a 35-degree angle
  4. Lean slightly forward, resting your forearms on your thighs
  5. Relax and breathe — do not strain

What to use

  • A dedicated toilet stool (squatty potty or similar)
  • A step stool from a hardware shop
  • A stack of books
  • A small box
  • Anything stable that raises the feet 15 to 20 centimetres

The branded products look tidy and are designed to tuck under the toilet, but the position is what matters, not the product.

For specific conditions

Hemorrhoids

Less straining means less pressure on the hemorrhoidal blood vessels. People with hemorrhoids describe the elevated position as reducing the discomfort of bowel movements and potentially reducing bleeding.

Anal fissures

Less straining means less stretching of the fissure. Combined with soft stools, the elevated position can make bowel movements less painful. It does not treat the fissure itself, but it creates better conditions for healing.

Constipation

The position helps with the mechanics of evacuation. It is not a laxative and does not soften stools — it simply makes the physical act of passing stool easier. It works best alongside adequate fibre, hydration, and other constipation management.

Pelvic floor dysfunction

For people with difficulty coordinating their pelvic floor muscles, the position can help by naturally relaxing the muscles involved in defecation. It is sometimes recommended alongside pelvic floor therapy.

The evidence

Studies on toilet positioning generally support the idea that a squatting position reduces straining and time spent on the toilet. The evidence is not dramatic — it is a modest improvement, not a revolution. But for something that costs almost nothing and has no downside, the risk-benefit calculation is straightforward.

The practical message

A toilet stool is one of the simplest things you can try. It costs little, takes seconds to use, and has no risks. Whether it makes a dramatic difference or a subtle one varies by person, but the overwhelming direction of both research and personal accounts is positive. If straining during bowel movements is part of your experience, it is worth a try.

When to seek care

If you experience any of the following, seek urgent medical care:

  • Persistent constipation despite posture and dietary changes
  • Rectal bleeding that is new or worsening
  • Severe straining that causes pain
  • Any symptoms that concern you

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