POOP: Are you pooping properly?

Defecation or 'pooping' is the term given for the act of expelling poop from the digestive system through the anus. It is a complex activity that requires coordinated participation from the digestive system, the nervous system as well as the muscle and skeletal system.

The frequency of pooping within a 24-hour period varies depending on your age and the diet, but most people tend to poop 1 to 3 times daily.

Pooping is necessary to expel undigested portions of food and metabolic waste products from the body in the form of stool. Stool also contains bacteria and cellular debris from the digestive tract.

The large intestine is responsible for propelling poop towards the rectum and beginning the urge to defecate. The external anal sphincter and the puborectalis muscle relax to allow the poop to pass out of the rectum.

Valsalva maneuver and abdominal muscle contracts to increase intra-abdominal pressure and expel poop more rapidly. Sensitive nerves of the rectum are responsible for the sensation of rectal fullness and the urge to defecate.

How does Pooping happen?

Powerful rhythmic movements in the gut move intestinal contents into the rectum. Once the rectum fills up, it activates mechanical receptors in the wall of the rectum causing awareness of the need to poop.

As the poop reaches the rectum, a small amount is allowed to pass through to the anal canal by an involuntary relaxation of the internal anal sphincter. This action is known as 'anal sampling', which is the process of determining if the content are of the gaseous, solid, or liquid form.

At this time, if pooping is not socially acceptable or convenient, the rectal wall relaxes, and the need to defecate subsides temporarily. If it is a proper time to defecate, the person generally either sits or squats depending on their environment.

Contraction of the abdominal muscles and performing the Valsalva maneuver while simultaneously relaxing the external anal sphincter and puborectalis muscle will expel poop from the body due to the pressure gradient generated between the rectum and anal canal. After fecal expulsion, the closing reflex occurs, which involves the external anal sphincter regaining its tone to maintain continence at rest.

Squatting or sitting?

Squatting has been the natural pooping position for humans since time immemorial.

Studies have evidently reported that squatting improved the angle of the anorectal canal, reduced strain, increased sensation of adequate bowel emptying, and decreased time associated with pooping when compared with sitting.

Rectal emptying during squatting is facilitated by anorectal angle straightening, resulting in higher rectal pressure and lower anal pressures with possible relaxation of an anal muscle known as levator ani which facilitates smooth pooping.

Haemorrhoids, digestive diseases and even constipation are common in countries where people generally sit on some kind of chair to pass their stool this is because sitting puts too much pressure on the end of the gut during pooping.

Read about Haemorrhoids here.

To beat the modern challenges of pooping while sitting, scientists have introduced defecation postural modification devices (DPMDs) to replicate the alignment achieved with squatting while using a toilet. DPMDs may offer a simple treatment option for a common diagnosis such as constipation.

DPMDS: Defecation Postural Modification Devices