The Anorectal Angle

At the core of the posture discussion is a muscle called the puborectalis. When seated upright at a standard toilet height (40–42 cm), this muscle maintains a kink in the rectum — an anorectal angle of approximately 100°. This kink is essential for continence, but it also means that elimination requires active effort to overcome.

When the knees are elevated above the hips — as in a squat or when using a footstool — the anorectal angle opens to approximately 126°, creating a straighter pathway. This is not opinion; it has been confirmed through defecography (X-ray imaging during evacuation) in multiple clinical studies.

Key Studies

Sikirov, 2003 — Digestive Diseases and Sciences: A study of 28 healthy volunteers compared three positions: sitting on a standard toilet, sitting on a low toilet, and squatting. Results showed that squatting led to significantly shorter evacuation times (average 51 seconds vs. 130 seconds sitting) and subjects reported a greater sense of complete emptying.

Sakakibara et al., 2010 — Lower Urinary Tract Symptoms: Using anorectal manometry and electromyography, researchers demonstrated that hip flexion beyond 60° relaxes the puborectalis muscle more effectively, reducing the need for straining.

Modi et al., 2019 — Journal of Clinical Gastroenterology: In a study of 52 participants using a posture-modification device, 90% reported reduced straining and 71% reported faster bowel movements. The authors concluded that "a simple posture modification device improves bowel function in a healthy population."

PMC Scoping Review, 2025: A comprehensive review across multiple databases found consistent evidence that squatting reduces straining, requires less abdominal pressure, and is associated with improved bowel evacuation compared to standard sitting.

Clinical Relevance

Chronic straining during defecation is a recognized risk factor for several conditions:

• Hemorrhoids — Straining increases venous pressure in the rectal area. Studies estimate that up to 50% of adults over 50 experience hemorrhoids, many linked to chronic straining.
• Pelvic floor dysfunction — Repeated downward pressure weakens the pelvic floor over time, contributing to conditions such as prolapse and incontinence.
• Diverticular disease — The increased intra-abdominal pressure from straining has been associated with the formation of diverticula in the colon wall.
• Constipation — The anorectal kink in the seated position makes complete evacuation more difficult, which can contribute to chronic constipation.

The Simple Solution

The clinical evidence consistently points to a straightforward intervention: elevating the feet during defecation to simulate a squat-like posture. This does not require replacing existing toilets — a well-designed footstool placed at the base is sufficient to achieve the biomechanical benefit. Releasy integrates this function into a product that already belongs in every bathroom.

Before the Pedestal: 10,000 Years of Squatting

For the vast majority of human history, people squatted. Archaeological evidence from Mesopotamia, the Indus Valley, and ancient Rome shows that early sanitation systems — remarkably sophisticated for their time — were all designed around the squat position. The Roman latrinae, ancient Greek facilities, and the elaborate drainage systems of Mohenjo-Daro (circa 2500 BCE) all accommodated this natural posture.

The human body evolved over millions of years to eliminate in this position. The modern pedestal toilet is, by comparison, an extremely recent invention.

The Victorian Pivot

The sitting toilet as we know it emerged in the late 18th century. Alexander Cumming patented the S-trap in 1775, and the design was refined throughout the 1800s. But the real turning point came during the Victorian era, when industrialization and urbanization created an urgent public health crisis.

The Great Stink of London in 1858 — when the Thames became an open sewer — accelerated the construction of modern sewage systems. The pedestal toilet became the standard, not because of any health advantage in posture, but because it connected efficiently to indoor plumbing and was considered more "civilized" by Victorian standards.

George Jennings' public flush toilets at the Great Exhibition of 1851 cemented the design in the public imagination. By the early 20th century, the raised, chair-height toilet had become the global symbol of modern sanitation — exported through colonialism and industrialization to much of the world.

A Design Decision, Not a Health Decision

It is important to note that the pedestal toilet was adopted for reasons of sanitation infrastructure, social convention, and manufacturing efficiency — not because anyone studied its effect on human physiology. The health implications of changing humanity's elimination posture were simply never considered.

It was not until the late 20th century that researchers began systematically studying the biomechanical differences between sitting and squatting. The findings have been consistent: the posture our infrastructure encourages is not the posture our bodies were designed for.

Correcting a 150-Year-Old Oversight

No one is suggesting we abandon modern plumbing. The flush toilet is one of the greatest public health achievements in history. But we can acknowledge that its standard height — designed for plumbing convenience, not anatomy — creates a biomechanical compromise. A simple elevation of the feet resolves this entirely, restoring the natural posture while keeping every benefit of modern sanitation.

Japan: Where Tradition Meets Innovation

Japan offers a fascinating case study. The traditional Japanese toilet — the washiki — is a squat-style fixture that was standard in homes, schools, and public facilities well into the late 20th century. Even today, squat toilets remain in many train stations, temples, and older buildings.

What makes Japan particularly interesting is that when Western-style toilets were introduced after World War II, adoption was slow. By 1977, sitting toilets finally outsold squat models — but the transition took decades, and many Japanese maintained a cultural preference for the squat position, associating it with cleanliness and health.

Japan then took the sitting toilet and reinvented it entirely — adding bidet functions, heated seats, and sophisticated hygiene features. But the underlying posture issue remained. Today, many Japanese homes and hotels offer both options, and there is a growing movement to recombine the ergonomic benefits of the squat with the comfort of modern fixtures.

South and Southeast Asia

Across India, Bangladesh, Thailand, Myanmar, and much of Southeast Asia, the squat toilet remains the norm — not due to a lack of development, but because of deeply held cultural practices around hygiene and health. In Ayurvedic medicine, the squatting posture has been recommended for digestive health for thousands of years.

India's experience with the Swachh Bharat (Clean India) mission, launched in 2014, is instructive. While the campaign focused on building toilet infrastructure, many implementations retained the squat design — recognizing both cultural preference and the practical health benefits of the posture.

The Middle East and North Africa

Throughout the Middle East, squat toilets are common in both public and private settings. Islamic hygiene practices (known as tahara) emphasize thorough cleaning and natural posture. Many modern Middle Eastern homes feature both sitting and squat-style facilities, giving residents the choice.

The Western Exception

When viewed globally, it is the Western sitting toilet — not the squat position — that is the exception. Roughly 1.2 billion people worldwide still use squat-style toilets as their primary fixture. The sitting posture is dominant primarily in Europe, North America, and Australia — regions where Victorian-era plumbing conventions set the standard.

This is not a question of developed versus developing. Singapore, Japan, South Korea, and the UAE — some of the world's most advanced economies — all maintain squat toilets alongside or integrated with modern fixtures.

Bridging the Gap

The insight from global toilet culture is clear: the human body benefits from a squatting posture during elimination, and most of the world has never stopped using it. The challenge in Western countries is not convincing people to squat on the floor — it is providing a discreet, elegant way to achieve the same biomechanical position within the existing bathroom environment.

This is precisely what Releasy was designed to do.

Why You'll Love It

Unlike bulky squatty potties that sit awkwardly beside your toilet, Releasy is a beautiful bathroom bin that hides its secret in plain sight.

• Replaces two products with one — saves space and money
• Stylish, minimal design that fits any bathroom aesthetic
• No embarrassing stool visible to guests — it's just a bin
• Ergonomically designed at the optimal height for the squat position
• Premium materials — easy to clean, built to last
• Available in colors that match modern bathrooms

Perfect For

• Anyone who values a clean, minimal bathroom
• Health-conscious individuals wanting better digestion
• Parents — great for kids learning proper toilet posture
• Expecting mothers dealing with pregnancy constipation
• Small apartments where space matters

Workplace Wellness, Reimagined

Companies invest in standing desks, ergonomic chairs, and meditation rooms. The bathroom — used several times per day — gets nothing. Until now.

• Employee wellness that works — digestive health affects productivity
• Bulk pricing for offices, hotels, co-working spaces
• Custom branding options available
• Replace existing bins with a dual-purpose upgrade — no extra space needed
• Conversation starter that shows your company thinks differently
• Ideal for hotels, Airbnbs, spas, and wellness centers

Industries We Serve

• Offices & co-working spaces
• Hotels & boutique accommodations
• Airbnb & short-term rental hosts
• Spas, wellness centers & clinics
• Restaurants & hospitality
• Gyms & fitness studios

Exclusive Distribution Offer for Hotels

Get in contact with us and we offer you a unique distribution channel. Be the only facility in your region that is served by us and stand out from your competitors. Health matters for your customers.