In short, if you have no issues opening your bowels at the moment, you don’t especially need a footstool.
If, however, you suffer from constipation, haemorrhoids or pelvic floor disorders, it might be worth trying a footstool. It can sometimes help these conditions by promoting more efficient bowel movements and reducing straining.
We evolved to open our bowels while squatting down, a position that aligns the rectum properly and relaxes the puborectalis muscle, facilitating easier bowel movements.
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Historically, and in some cultures today, people pass stools in a squatting position. But our modern-day toilets make us do this in a more upright, seated position.
In theory, when we sit like this, the puborectalis muscle remains partially contracted, creating a kink in the rectum that can possibly make defecation more difficult.
One study published in the Journal of Clinical Gastroenterology in 2019 investigated the effect of posture on defecation.
The study found that using a footstool while sitting on the toilet significantly reduced the time needed for defecation and decreased the subjective sensation of straining.
But only 52 participants took part in the study and the symptoms are, of course, subjective.
Another study of 28 participants, published in Digestive Diseases and Sciences in 2003, found both the time needed for the sensation of satisfactory bowel emptying and the degree of straining in the squatting position, were reduced sharply in all volunteers compared with sitting positions. But, again, it wasn’t a big study.
We do often advise footstools for children with constipation and, anecdotally at least, this does seem to help a bit.
Overall, it’s unlikely to do any harm, so it might be worth a try if you suffer from any of the conditions mentioned.
Do combine it with simple measures to reduce constipation too – such as increasing your fluid and fibre intake.
This article is an answer to the question (asked by James Coopman, via email) 'Should I use a footstool when I’m pooping?'
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