Squatting aligns the rectum more naturally for stool passage, reducing straining and haemorrhoidal pressure. Learn why Indian toilets help and how to replicate this with a footstool.
The Anorectal Angle and Why It Matters
The human rectum and anal canal are not a straight tube. When you sit on a standard Western toilet, the puborectalis muscle maintains a kink — called the anorectal angle — of approximately 90–100 degrees. This kink helps maintain continence but also means stool must turn a corner to exit, requiring more muscular effort.
When you squat fully, the puborectalis muscle relaxes and the anorectal angle straightens to approximately 126–140 degrees. Stool can now exit in a more direct path with significantly less effort and pressure on haemorrhoidal veins.
Why Traditional Indian (Squat) Toilets Help Piles
Traditional Indian squat toilets reproduce the natural squatting position that the human body evolved with. In this position:
- Anorectal angle is more open (more natural)
- Puborectalis muscle is fully relaxed
- Abdominal muscles help gently compress the colon
- Stool moves more easily with less straining
- Less time needed for a complete bowel movement
Population studies suggest that countries where squat toilets are predominant have lower rates of haemorrhoidal disease and colon cancer, though multiple dietary factors also play a role.
How to Replicate Squatting on a Western Toilet
You do not need to switch to a squat toilet. A simple footstool placed in front of the toilet and raised 20–25 cm changes the sitting angle significantly:
- Feet rest on the stool at ankle height
- Knees are raised above hip level
- This creates a partial squat that relaxes the puborectalis sufficiently
- Stool exits more easily with less effort
Commercial "Squatty Potty" style stools are widely available. A simple wooden stool or stacked books work equally well.
Frequently Asked Questions
**Q: Will switching to a squat toilet cure my existing piles?** A: No. Squatting reduces straining and prevents progression, but it does not shrink or remove existing haemorrhoidal tissue. It is a preventive and supportive measure, not a treatment.
**Q: Is squatting safe for elderly patients with piles?** A: Full squatting may be difficult for elderly patients with knee or hip issues. A footstool providing a partial squat (20–25 cm raised) achieves most of the anorectal angle benefit without requiring full squatting.
Book a Consultation at RectoRelief Hospital
For comprehensive piles prevention and treatment guidance, consult Dr. Sudhanshu Chaudhary at RectoRelief Hospital — Noida, Bijnor or Basta.