Can a small plastic stool really change what happens in the bathroom? Toilet footstools have become a common bathroom accessory, sold with plenty of confident claims. The idea is simple: raise your knees, mimic a squat, and things move more easily.
The research is more mixed than the marketing. Here are the questions people ask most, with what the studies found.
Why would posture matter at all?
Muscles at the end of the bowel hold the rectum at an angle, which helps with continence. When you sit upright, that angle stays relatively bent. The theory is that squatting straightens it, so stool can pass with less pushing.
A small Japanese study tested this with X-ray video in six healthy volunteers. When they squatted, the angle at the rectum during a bowel movement was wider, 126 degrees compared with 100 degrees when sitting normally, and resting abdominal pressure was lower. But sitting with the hips only partly flexed didn't widen the angle, which measured 99 degrees (Sakakibara et al., 2010).
Does squatting make bowel movements easier?
In one study, it did. Twenty-eight healthy volunteers aged 17 to 66 timed six bowel movements each in three positions: on a standard toilet, on a lower toilet and squatting. They also rated how hard they had to push. Squatting sharply reduced both the time needed to feel empty and the sense of straining, compared with either sitting position (Sikirov, 2003).
That study was small and relied on self-timing, so it's a starting point rather than strong proof. But it fits the basic idea.
What about a footstool specifically?
A footstool isn't a full squat. It puts you somewhere in between, and that's where the evidence splits.
The encouraging study. At Ohio State University, 52 healthy volunteers with an average age of 29 logged every bowel movement for four weeks: two weeks without a footstool-style device, then two weeks with one. Across 1,119 bowel movements, using the device was linked to a greater feeling of complete emptying and less straining. Without it, bowel movements took longer (Modi et al., 2019).
The less encouraging study. An Australian team tested 41 people referred for constipation, 93% of them women, with an average age of 52. Each tried to expel a small balloon from the rectum, a standard test of how well the bowel empties, with no footstool, a 7-inch stool and a 9-inch stool in random order. The footstools clearly changed their posture. But they didn't change how long it took to expel the balloon, and people didn't find it easier or more comfortable (Trieu et al., 2023).
These studies measured different things in different people. The first involved young, healthy adults who knew they were using a device, with no comparison group running at the same time. The second used a lab test in mostly midlife women with constipation. Neither settles the question.
