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

J Clin Gastroenterol. 2019 Mar;53(3):216-219. doi: 10.1097/MCG.0000000000001143.


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.

MeSH terms

  • Adult
  • Bathroom Equipment*
  • Cross-Over Studies
  • Defecation / physiology*
  • Equipment Design
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Posture
  • Prospective Studies