The best way to sit on the toilet is with your knees raised above your hips and your upper body leaning slightly forward. This position mimics a squat, which straightens the path between your colon and rectum so stool passes with less effort. Most people can achieve this simply by placing a small stool under their feet.
Why Standard Sitting Makes Things Harder
When you sit on a standard toilet with your feet flat on the floor, your thighs form roughly a 90-degree angle with your torso. In this position, a sling-shaped muscle called the puborectalis wraps around your rectum and keeps it kinked, like a bent garden hose. That kink exists for good reason: it’s what keeps you continent throughout the day. But when it’s time to go, you want that kink to release.
Sitting upright doesn’t fully relax that muscle. The rectum stays partially bent, which means you need more force to push stool through. This increases pressure inside the rectal veins and makes straining more likely. Over time, that repeated pressure contributes to hemorrhoids, and it can worsen constipation by making evacuation feel incomplete.
The Position That Works Best
A supported squat, sometimes called “the Thinker” position, is what pelvic health specialists recommend. Here’s how to set it up:
- Place a footstool in front of the toilet. Rest both feet on it, hip-width apart, so your knees rise above hip level.
- Lean forward slightly. Rest your elbows on your knees or your forearms on your thighs.
- Relax your belly and pelvic floor. Let your abdomen expand rather than bracing or bearing down.
This position does two things at once. Raising your knees increases the angle of hip flexion, which relaxes the puborectalis muscle and straightens the rectum. Leaning forward compresses your abdomen gently against your thighs, adding natural pressure that helps move stool downward without forceful straining. Together, these changes reduce the effort needed and help your bowel empty more completely.
A clinical study of 52 people found that using a toilet stool improved bowel movement duration, reduced straining, and led to more complete evacuation. If you don’t have a stool handy, the American Physical Therapy Association’s pelvic health division suggests simply sitting forward comfortably, which captures some of the same benefit.
Choosing the Right Stool Height
Toilet stools typically come in two heights: 7 inches and 9 inches. The right one depends on your body and your toilet.
A 7-inch stool works for most people and fits standard toilets that measure 14 to 16 inches from the top of the bowl to the floor. If you’re tall, a 7-inch stool is also the better starting point because a higher stool can push your knees uncomfortably high. A 9-inch stool is better for shorter people, those who are flexible, or anyone with a “comfort height” toilet (the taller models that measure above 16.5 inches from bowl to floor). Those taller toilets sit higher off the ground, so you need a taller stool to get your knees above your hips.
To check your toilet height, lift the seat and measure from the top of the bowl rim straight down to the floor. Anything above 16.5 inches means you likely need the 9-inch option.
How Long You Should Stay on the Toilet
Five minutes is the maximum recommended time for a single bathroom visit, according to Cleveland Clinic gastroenterologists. If nothing has happened by then, get up and try again later. Sitting longer doesn’t help and actively increases your risk of problems.
Prolonged sitting puts sustained pressure on rectal veins, which have to push blood upward against gravity. The longer you sit, the more those veins swell. Straining compounds the effect by increasing pressure even further. This is the primary mechanical pathway to hemorrhoids, and it’s largely avoidable.
Why Your Phone Matters More Than You Think
A study of 125 adults undergoing screening colonoscopies found that people who used smartphones on the toilet had a 46% higher risk of hemorrhoids compared to those who didn’t. The connection isn’t the phone itself. It’s the time. About 37% of phone users reported spending more than five minutes per bathroom visit, compared to just 7% of people who left their phone outside.
Scrolling extends your toilet time without you noticing. You finish your bowel movement but stay seated, and the pressure on rectal tissue continues. The researchers found this association held even after adjusting for age, exercise habits, and fiber intake. Leaving your phone outside the bathroom is one of the simplest things you can do for your rectal health.
What to Avoid
Sitting bolt upright with your feet flat on the floor is the least effective position. It keeps the rectum bent and forces you to strain harder. Leaning backward is even worse, as it increases the kink angle further.
Bearing down hard is another common mistake. Forceful straining spikes intra-abdominal pressure and pushes blood into the rectal veins. If you’re in the right position with your knees elevated and your torso tilted forward, you shouldn’t need much effort. A gentle push or even just relaxing the pelvic floor should be enough. If it’s not, the issue is more likely dietary (not enough fiber or water) than postural, and adjusting what you eat will do more than adjusting how you sit.