Squat vs Sitting Toilet: Which Is Actually Better?

The way you sit on the toilet every day may be working against your body — and a cheap footstool might fix it.

Quick Take

Squatting straightens the rectum by widening the anorectal angle to 100–110 degrees, making it easier to go without straining.
A 2019 clinical study tracked over 1,100 bowel movements and found people using a squat stool were far more likely to fully empty their bowels.
You don’t need a squat toilet — raising your knees above your hips on a standard toilet gives most of the same benefit.
The science is promising but not yet definitive; most studies used healthy volunteers, not people with chronic digestive problems.

Your Toilet Was Designed for Comfort, Not Biology

The modern sit-down toilet is only about 200 years old. For most of human history, people squatted to go. That matters because your body was built around that posture. When you sit upright on a standard toilet, a muscle called the puborectalis stays partially clenched. That muscle wraps around the lower rectum like a sling, creating a kink. That kink is the reason so many people strain. Squatting relaxes that muscle and straightens the path out.

When you squat, the anorectal angle — the bend between your rectum and the anal canal — opens up to roughly 100 to 110 degrees. ^[1] That straightening removes the kink and lets stool pass with far less effort. X-ray studies confirm this. Images taken during squatting show a noticeably straighter rectum and lower abdominal pressure compared to sitting upright. ^[4] The anatomy here is not in dispute. The debate is about how much that difference matters in real life.

What the Clinical Data Actually Shows

A 2019 study published in a peer-reviewed medical journal tracked 1,119 bowel movements across 52 healthy volunteers. ^[2] Participants used a footstool that raised their knees above their hips — mimicking a squat on a regular toilet. The results were clear. People using the stool were 3.64 times more likely to fully empty their bowels. They also strained significantly less, with straining odds dropping by 77 percent. Bowel movement time was shorter too. Those are meaningful numbers, not marketing copy.

The American Physical Therapy Association’s pelvic health division recommends the supported squat position for bowel movements. ^[11] Their guidance is simple: sit on the toilet, place both feet on a stool so your knees rise above your hips, lean slightly forward, and rest your elbows on your thighs. Relax your belly. Breathe. That’s it. No full squat required. No special equipment beyond a step stool or a stack of books.

Why Doctors Haven’t Made It Official Yet

Here’s the honest part. The science is real, but it has limits. The 2019 study used healthy volunteers, not people with chronic constipation or pelvic floor disorders. ^[2] A 2024 review of 42 studies on toilet postures found consistent support for squatting but also flagged small sample sizes and weak controls as problems. ^[1] The Indian Society of Gastroenterology called squatting “more physiological” and “ideal” — but also admitted the evidence of benefit is limited. Major clinical guidelines from groups like the American College of Gastroenterology simply don’t address posture at all, focusing instead on diet, fiber, and medication.

That silence from official bodies is frustrating, but it doesn’t mean squatting is wrong. It means the research hasn’t yet reached the scale and rigor that moves guidelines. A large, well-funded trial in patients with real digestive problems hasn’t been done. Until it is, the honest position is this: the anatomy makes sense, the available data points in one direction, and the only real downside is that a footstool costs twenty dollars. For older adults or people with knee or hip problems, a full squat can add joint stress, so the supported version on a regular toilet is the smarter option. ^[1]

The Simple Fix Most People Ignore

You don’t need a Squatty Potty brand product. Any stable footstool that raises your knees above your hips will do the job. The goal is a knee angle of about 35 degrees above hip level while leaning slightly forward. That position mimics a squat without putting stress on your joints. Relax your core, breathe slowly, and don’t force it. If nothing happens in a few minutes, get up and try later. Straining is the enemy — and the right posture is the simplest tool available to stop it.