Digestive Diseases and Sciences

, Volume 48, Issue 7, pp 1201–1205 | Cite as

Comparison of Straining During Defecation in Three Positions: Results and Implications for Human Health

  • Dov Sikirov
Article

Abstract

The aim of the study was to compare the straining forces applied when sitting or squatting during defecation. Twenty-eight apparently healthy volunteers (ages 17–66 years) with normal bowel function were asked to use a digital timer to record the net time needed for sensation of satisfactory emptying while defecating in three alternative positions: sitting on a standard-sized toilet seat (41–42 cm high), sitting on a lower toilet seat (31–32 cm high), and squatting. They were also asked to note their subjective impression of the intensity of the defecation effort. Six consecutive bowel movements were recorded in each position. Both the time needed for sensation of satisfactory bowel emptying and the degree of subjectively assessed straining in the squatting position were reduced sharply in all volunteers compared with both sitting positions (P < 0.0001). In conclusion, the present study confirmed that sensation of satisfactory bowel emptying in sitting defecation posture necessitates excessive expulsive effort compared to the squatting posture.

straining sitting squatting defecation posture 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Gatewood WE: The mechanics of the colon. Northwest Med 29:1-7, 1930Google Scholar
  2. 2.
    Connel AM, Hilton C, Irvine G, Lennard-Jones JE, Misiewicz JJ: Variation of bowel habit in two population samples. Br Med J 2:1095-1099, 1965Google Scholar
  3. 3.
    Shorvon PJ, Mchugh S, Diamant NE, Somers S, Stevenson GW: Defecography in normal volunteers: results and implications. Gut 30:1737-1749, 1989Google Scholar
  4. 4.
    Altomare DF, Rinaldi M, Veglia A, Guglielmi A, Sallustio PL, Tripoli G: Contribution of posture to the maintenance of anal continence Int J Colorectal Dis 16:51-54, 2001Google Scholar
  5. 5.
    Tagart RE: The anal canal and rectum: their varying relationship and its effect on anal continence. Dis Colon Rectum 9:449-452, 1966Google Scholar
  6. 6.
    Timoshenko S: Theory of Elastic Stability. New York, McGraw-Hill, 1936Google Scholar
  7. 7.
    Haubruch W: Constipation. In Bockus Gastroenterology, 4th ed. J Berk (ed). Philadelphia, Saunders, 1985, p 111Google Scholar
  8. 8.
    Boles R: Constipation. JAMA 89:1766-1770, 1927Google Scholar
  9. 9.
    Singer C, Holmyard E, Hall A, Williams T: History of Technology. The Industrial Revolution 1750–1850, Oxford, Clarendon Press, 1958, pp 507-508Google Scholar
  10. 10.
    Burkitt D, Walker A, Painter N: Dietary fiber and disease. JAMA 229:1068-1074, 1974Google Scholar
  11. 11.
    Eastwood M, Smith A, Brydon W, Pritchard J: Colonic function in patients with diverticular disease. Lancet 1:1181-1182, 1978Google Scholar
  12. 12.
    Parks T, Connel A: Motility studies in diverticular disease of the colon. Gut 10:534-542, 1969Google Scholar
  13. 13.
    Weinreich J, Andersen D: Intraluminal pressure in the sigmoid colon. Patients with sigmoid diverticula and related conditions. Scand J Gastroenterol 11:581-586, 1976Google Scholar
  14. 14.
    McGuire J, Green RS, Haenstein V, Courter S, Braunstein JR, Plessinger V, Iglauer A, Noertker J: Bed pan deaths. Am Pract Dig Treatment 1:23-28, 1950Google Scholar
  15. 15.
    Schartum S: Ventricular arrest caused by the Valsalva maneuver in a patient with Adams-Stokes attacks accompanying defecation. Acta Med Scand 184:65-68, 1968Google Scholar
  16. 16.
    Benchimal A., Wang FU, Desser KB, Gartlan JL: The Valsalva maneuver and coronary arterial blood flow velocity. Ann Intern Med 77:357-360, 1972Google Scholar
  17. 17.
    Greenfield J: Transient changes in cerebral vascular resistance during the Valsalva maneuver in man. Stroke 15:76-79, 1984Google Scholar
  18. 18.
    Kapoor, W. N, Peterson J, Karpf M: Defecation syncope. Arch Intern Med 146:2377-2379, 1986Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Dov Sikirov

There are no affiliations available

Personalised recommendations