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Nurture Her

Poopy, Poop, Poop, Poop!

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Today I am going to talk about poop.  Well, actually I am going to talk about the verb –  to poop, or pooping.

Didn’t you have to suppress a giggle when you read the word pooping? I did. 😉 But then, I always did find potty humour funny. (And it’s a good thing too because I have a 5 yr old and a 4 month old.  I wipe bums a lot).

But back to pooping.  Did you know you are doing it wrong?

Yup, I said it.  From a pelvic health perspective, I’m about 99% sure that you as a woman, man or child are pooping wrong. And if you are a “hoverer”, I’m 100% certain you are.

Look, its not your fault. You can absolutely blame it on your toilet.  Did you know the modern porcelain throne you are so familiar with didn’t come into popular usage until the late 19th century? And did you know that most of the world’s population still doesn’t even use one?

In our human quest for cleanliness, the flush toilet makes great sense because it improves sanitation – keeping our waste away from our drinking water means less disease transmission.  But there are still “1st world” countries out there that use an alternative that is still clean (think France or Japan).

So how are North American toilets contributing to bad pooping? In a nutshell, they decrease the ano-rectal angle. Say what??  The ano-rectal angle is exactly what it sounds like – it’s the angle formed where the rectum meets your anus, and its important anatomy when we are talking about poop.  It’s also primarily maintained by your puborectalis muscle (more important pelvic anatomy).  When you are sitting or standing at rest, that angle is usually around 90-100o (I found it varied in couple of studies I looked at).  For the sake of this discussion, lets say it’s 90o. That angle is important because it helps keep your poop inside you when you don’t want it coming out.  In people who suffer from fecal incontinence, this angle is often larger (around 115o).

And that makes total sense.  If we are thinking about poop traveling along in your colon, its transit is going to get a bit more difficult if it suddenly has to make a right angle turn.  That’s to your advantage when you add in your muscles (sphincters) because it means you aren’t going to have an accident.

But wait, didn’t I say that the ano-rectal angle is around 90o when you are sitting?  Yes, I did.  And don’t we sit on toilets?  Yes, we do. So what happens when the poop builds up there and its time to let it out?

Trouble, that’s what! Our modern flush toilets do us no favours for eliminating that waste. Elimination becomes more difficult and we often have to strain. And sometimes we don’t fully empty. STRAINING IS BAD! It’s bad for many reasons! To name a few… When you strain, you aren’t just pushing poop.  You are also pushing down all your internal organs which can lead to prolapse in women and prolapse is very yucky! Men, you aren’t off the hook.  It can affect prostates too). That pressure can also cause hemorrhoids. And you are just wreaking havoc on your pelvic floor.  NOT EMPTYING IS BAD TOO! Poop matter that builds up in the colon is often pointed to as a factor that might tip the scale toward bowel diseases including cancer.  Its also one of the reasons its recommended to have a high fiber diet – a colon that’s not all gunked up is a happy colon.

So what’s better than sitting to poop?  SQUATTING.

When you squat, your knees are higher than your hips.  Your feet are fully supported. This in turn helps the puborectalis muscle to relax.  When it relaxes, it increases the ano-rectal angle, opening up the pathway for the poop and decreasing resistance. (Voila – less pressure is needed to poop!)

But now on to the practical side of things – I don’t expect North America to switch to the squat toilets you see in France or Japan any time soon.  Plus it would probably cost you an arm and a leg to bring one over for your home.  And although I once took a class where the teacher said it was okay to pee occasionally in the compost to speed things up, I really wouldn’t poop (GROSS!).  So here’s what you can do:

1) Make sure your feet are supported when you are on the toilet. (No dangling! This is especially important with your children who have little legs!)

2) Find a way to get your knees higher than your hips when you are on the toilet.

The most simplistic solution is to put a foot stool in every one of your bathrooms.

It’s not quite the perfect squat position, but it will help a lot.

And if you want to get really sophisticated, you can buy a Squatty Potty (available at Bed Bath and Beyond now I think).

We have squatty potties in all the bathrooms of our home and I love them.  They tuck in under the toilet bowl so they don’t need a lot of room (you just pull it forward to use).  They also mimic the true squat position more than anything else I’ve found. And as an added bonus, they come in different heights for the varying heights of toilets out there… or legs – I have the tall one for my 5 yr old.  For an amazing and hilariously entertaining video about unicorns and squatty potties, click here.

So, if you are a person that spends a really long time in the bathroom to poop (ie. you have a bathroom reader of some sort in there), or you struggle with constipation, or you have a prolapse, or you just had a baby, or you have any kind of pelvic floor trouble (that includes stress incontinence), or you are potty training a kid… go into your bathroom and figure out how you are going to change what you are doing.  Dust off that footstool or order a Squatty Potty or get your husband who’s handy to make you one.  But do it today! You should be pooping AT LEAST once a day.  Add that up over all the days in your lifetime and you can see what a powerful impact this will have as you age.

Even if you don’t have any trouble with poop related matters, change what you are doing anyway.  Just because you don’t now, doesn’t mean you won’t later.  An ounce of prevention is worth a pound of cure.

**And a note to all the “hoverers” out there.  STOP IT!!! NOW!! I don’t care if you are in a public washroom.  Pad the seat with toilet paper and sit down! You are wreaking havoc on your pelvic floor and although I’m sure you are a really nice person, I really don’t want to see you in my office for that reason. As if sitting didn’t tension the pelvic floor muscles enough, hovering is worse! That goes for pee too!

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