Influence of body posture on defecation: a prospective study of “The Thinker” position

Takano, Shota; Sands, Dana R.

doi:10.1007/s10151-015-1402-6

Cited by 43 publications

(25 citation statements)

References 14 publications

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“…Rectal emptying during squatting is facilitated by anorectal angle straightening, resulting in higher rectal pressure and lower anal pressures with possible levator ani relaxation 8. Previous studies have documented that squatting improved the angle of the anorectal canal, reduced strain, increased sensation of adequate bowel emptying, and decreased time associated with defecation when compared with sitting 1,4,9.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Defecation Posture Modification Device

Modi¹,

Hinton

Pinkhas³

et al. 2019

Journal of Clinical Gastroenterology

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Goals: The goal of this study was to evaluate the influence of defecation postural modification devices (DPMDs) on normal bowel patterns. Background: The introduction of DPMDs has brought increased awareness to bowel habits in western populations. Materials and Methods: A prospective crossover study of volunteers was performed that included real-time collection of data regarding bowel movements (BMs) for 4 weeks (first 2 wk without DPMD and subsequent 2 wk with DPMD). Primary outcomes of interest included BM duration, straining, and bowel emptiness with and without DPMD use. Results: In total, 52 participants (mean age, 29 y and 40.1% female) were recruited for this study. At baseline 15 subjects (28.8%) reported incomplete emptying, 23 subjects (44.2%) had increased straining, and 29 subjects (55.8%) noticed blood on their toilet paper in the past year. A total of 1119 BMs were recorded (735 without DPMD and 384 with DPMD). Utilizing the DPMD resulted in increased bowel emptiness (odds ratio, 3.64; 95% confidence interval (CI), 2.78-4.77) and reduced straining patterns (odds ratio, 0.23; 95% CI, 0.18-0.30). Moreover, without the DPMD, participants had an increase in BM duration (fold increase, 1.25; 95% CI, 1.17-1.33). Conclusions: DPMDs positively influenced BM duration, straining patterns, and complete evacuation of bowels in this study.

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Section: Discussionmentioning

confidence: 99%

Implementation of a Defecation Posture Modification Device

Modi¹,

Hinton

Pinkhas³

et al. 2019

Journal of Clinical Gastroenterology

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“…However the actual situation remains to be unclear. "The Thinker" position seems to be a more efficient method for defecation than the sitting position [18]. "The Thinker" position is the position used on a Japanese-style toilet.…”

Section: Introductionmentioning

confidence: 99%

Questionnaire Survey of Bowel Habit in Japanese Medical Personnel

Maeda

Koide

Katsuno

et al. 2021

J Anus Rectum Colon

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Objectives: This study aims to clarify the bowel habit, change of bowel movement throughout the cycle of menstruation, and toilet use in Japanese medical personnel. Methods: A questionnaire survey was completed by Japanese medical personnel after listening to lectures on bowel disorders. Constipation was defined according to Rome III criteria, whereas diarrhea was defined as Bristol stool form scale type 6 and 7. Results: In total, 463 persons (mean age, 35.6 years, range 20-91, male/female/no answer: 132/324/7) have completed the questionnaire. Constipation was significantly more often observed in females (male/female: 3%/31%, p > 0.001, Chi-squared test), while diarrhea was noted to be less in females (male/female: 1%/7%). Constipation was observed in 20% of participants in their 20s, and the constipation rate was observed to gradually increase with age. It was observed in 45% of participants in their 70s or older. Bowel movement changed to constipation around menstruation in 18% of females and changed to diarrhea in 43% of females. Constipation often occurred before menstruation and diarrhea during menstruation. Only 2% of participants used a Japanese-style toilet, and 5% of participants claimed that they were unable to pass a stool on a Japanese-style toilet. Conclusions: Constipation was significantly more frequent in females and increased with age among female Japanese medical personnel. Change of bowel movement occurred in 61% of females around menstruation. Five percent of participants were unable to pass stools on a Japanese-style toilet.

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“…Rectal emptying during squatting is facilitated by anorectal angle straightening, resulting in higher rectal pressure and lower anal pressures with possible levator ani relaxation. 8 Previous studies have documented that squatting improved the angle of the anorectal canal, reduced strain, increased sensation of adequate bowel emptying, and decreased time associated with defecation when compared with sitting. 1,4,9 Our study suggests that by emulating characteristics of squatting, DPMDs can provide similar benefits to patients.…”

Section: Discussionmentioning

confidence: 98%

Implementation of a Defecation Posture Modification Device: Impact on Bowel Movement Patterns in Healthy Subjects

Modi

Pinkhas

Hinton

et al. 2017

American Journal of Gastroenterology

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Goals:The goal of this study was to evaluate the influence of defecation postural modification devices (DPMDs) on normal bowel patterns.Background: The introduction of DPMDs has brought increased awareness to bowel habits in western populations. Materials and Methods:A prospective crossover study of volunteers was performed that included real-time collection of data regarding bowel movements (BMs) for 4 weeks (first 2 wk without DPMD and subsequent 2 wk with DPMD). Primary outcomes of interest included BM duration, straining, and bowel emptiness with and without DPMD use.Results: In total, 52 participants (mean age, 29 y and 40.1% female) were recruited for this study. At baseline 15 subjects (28.8%) reported incomplete emptying, 23 subjects (44.2%) had increased straining, and 29 subjects (55.8%) noticed blood on their toilet paper in the past year. A total of 1119 BMs were recorded (735 without DPMD and 384 with DPMD). Utilizing the DPMD resulted in increased bowel emptiness (odds ratio, 3.64; 95% confidence interval (CI), 2.78-4.77) and reduced straining patterns (odds ratio, 0.23; 95% CI, 0.18-0.30). Moreover, without the DPMD, participants had an increase in BM duration (fold increase, 1.25; 95% CI, 1.17-1.33).Conclusions: DPMDs positively influenced BM duration, straining patterns, and complete evacuation of bowels in this study.

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Influence of body posture on defecation: a prospective study of “The Thinker” position

Abstract: "The Thinker" position seems to be a more efficient method for defecation than the sitting position. This technique may be helpful when retraining patients with constipation.

Cited by 43 publications

References 14 publications

Implementation of a Defecation Posture Modification Device

Implementation of a Defecation Posture Modification Device

Questionnaire Survey of Bowel Habit in Japanese Medical Personnel

Implementation of a Defecation Posture Modification Device: Impact on Bowel Movement Patterns in Healthy Subjects

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