Choosing Between Sitting and Squatting Toilets: How Toilet Posture Affects Your Gut and Health

When it comes to something as routine as using the toilet, we often don’t give much thought to how we do it. But the posture we adopt—whether sitting or squatting—can have a surprising impact on digestive health and even influence other aspects of physical well-being.

In India, both squatting and sitting toilets are common, with a noticeable shift in recent decades toward Western-style sitting toilets, especially in urban areas. However, medical research and traditional practices suggest that squatting, as used in older Indian toilet systems, may be better aligned with how our bodies naturally function during bowel movements.

Posture and Digestion: Why Squatting Might Be Better

The main difference between sitting and squatting toilets comes down to posture. Squatting helps straighten the anorectal angle—the natural bend between the rectum and the anus—making it easier to pass stool without excessive straining. This position relaxes a muscle called the puborectalis, which normally acts as a kind of brake on the rectum.

Sitting toilets, in contrast, keep this muscle slightly tense because of the 90-degree angle they create between the torso and thighs. This makes defecation more effortful and, over time, can contribute to issues like constipation, haemorrhoids, or incomplete evacuation.

People who regularly use squatting toilets often report faster, smoother bowel movements with less need to strain. This suggests that squatting supports a more efficient digestive process.

Health Benefits of Squatting Toilets in Everyday Life

In addition to smoother bowel movements, squatting toilets can help reduce pressure in the colon. This matters because constant straining during defecation has been linked to the development of haemorrhoids and, in some cases, pelvic floor problems.

Women, in particular, may benefit from squatting, as the position encourages more complete bladder emptying, which can lower the risk of urinary tract infections (UTIs). Also, since squatting toilets require less direct skin contact with surfaces, they are often considered more hygienic in public or shared settings.

Another important factor is water usage. Traditional squatting toilets generally use less water per flush, making them a more sustainable option in a country like India where water scarcity is a continuing concern.

Potential Risks: When Squatting Might Not Be Safe

While squatting has clear digestive benefits, it’s not without potential risks—especially for people with certain health conditions or physical limitations.

One study, led by Chakrabarti and colleagues and published in The National Medical Journal of India, found that squatting could cause temporary spikes in blood pressure. Hypertensive individuals experienced increases of 14 mmHg in systolic and 9 mmHg in diastolic pressure while squatting. Alarmingly, the study also noted that about 36% of stroke cases occurred while people were squatting to use the toilet.

There are also orthopedic concerns. Elderly individuals, people with arthritis, or anyone with limited mobility may find it difficult or painful to squat. For these groups, the risk of falls, joint strain, or tendon injuries makes squatting an unsafe choice.

How Sanitation Programs Shaped Toilet Use in India

Over the last decade, government sanitation programs—particularly the Swachh Bharat Mission—have significantly improved toilet access across India. Millions of new toilets have been built, and open defecation rates have dropped sharply.

However, these new toilets, especially in urban settings, have leaned heavily toward sitting models. This reflects aspirations around modernization and lifestyle rather than scientific understanding of health benefits.

So far, public messaging around sanitation has focused mainly on cleanliness and access, which are essential, but the discussion on toilet posture and health has been largely absent. Including this perspective in future awareness campaigns could make these efforts more holistic and medically sound.

Modern Adaptations: Getting the Best of Both Worlds

If you prefer sitting toilets but still want the digestive benefits of squatting, there are simple solutions. Footstools—popularized globally by products like the “Squatty Potty”—can help recreate the squatting angle even on a sitting toilet. Raising the knees slightly changes the anorectal angle, easing bowel movements.

Some newer toilet models can convert between sitting and squatting positions or include built-in footrests. For older adults or people with heart conditions, sitting toilets remain the safer option but can still be adapted for better gut health with minor adjustments.

Cultural Habits and Changing Preferences

Toilet habits are not just about comfort—they’re closely tied to cultural upbringing. Older generations in India are generally more accustomed to squatting, while younger people often view sitting toilets as a modern convenience.

Behavioral studies in India show that toilet choices often follow social trends. In many villages, people adopted toilets more readily when they saw their neighbours doing the same. This ripple effect also influences whether squat or sit toilets are chosen. Bridging traditional practices with modern needs doesn’t mean choosing one over the other—it means making informed decisions that balance health and comfort.

Whether you use a sitting toilet or a squatting one, knowing how posture affects your body can make a real difference. Squatting may support better digestion and help prevent common bowel issues, but it’s not ideal for everyone, particularly those with cardiovascular or mobility concerns. By understanding the pros and cons of both systems—and using adaptive tools when needed—we can create toilet habits that promote overall well-being without compromising safety or comfort.

Disclaimer: This article is for general informational purposes only. It should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your doctor or a qualified healthcare provider for personalized guidance.