Raising your knees above your hips, whether by squatting or using a footstool on a standard toilet, is the single most effective position change for relieving constipation. This works because it straightens the path stool travels through your lower bowel, reducing the effort needed to go. But the way you sit is only part of the picture. Leaning forward, lying on your left side, and certain movements can all help get things moving.
Why Squatting Works Better Than Sitting
Your body has a built-in kink in the pathway between your rectum and the outside world. A sling-shaped muscle wraps around the lower rectum and pulls it forward, creating a bend called the anorectal angle. When you sit upright on a standard toilet, that angle sits around 80 to 90 degrees, which partially pinches off the passage and makes your muscles work harder to push stool through.
When you squat, your thighs press up toward your abdomen, the sling muscle relaxes, and the anorectal angle opens to roughly 100 to 110 degrees. That straightens the rectum into more of a direct chute. Stool passes with less straining, less time, and less discomfort. This is the core principle behind every positional fix for constipation: get your knees higher than your hips to mimic a squat.
How to Modify a Standard Toilet
Most people aren’t switching to a squat toilet. The practical solution is a footstool (sometimes called a “squatty potty”) placed in front of your toilet. You rest your feet on it so your knees rise above hip level, approximating a squat while you stay comfortably seated. In a four-week study at Ohio State University, 71 percent of participants had faster bowel movements after adding a toilet stool, and 90 percent reported less straining.
You don’t need a branded product. A sturdy step stool, a stack of books, or an upturned storage bin all work. Aim for a height that brings your knees noticeably above your hips. For most adults, something in the 7- to 9-inch range does the job, though taller people may need more height.
Lean Forward With Elbows on Knees
Once your feet are elevated, lean your torso forward and rest your elbows on your knees. This isn’t just about comfort. The weight of your upper body pressing against your thighs applies gentle external pressure on your colon, giving it an extra mechanical squeeze. Researchers have specifically recommended this forward-leaning posture for people who struggle with constipation, as it combines the benefits of the widened anorectal angle with added abdominal compression. Keep your spine relatively straight rather than hunching over, and breathe slowly rather than holding your breath and bearing down.
Lying on Your Left Side
If you’re not on the toilet yet but feel bloated or backed up, lying on your left side can encourage stool to move in the right direction. Your large intestine follows a specific path: it travels up the right side of your abdomen, crosses beneath your ribs, and descends down the left side before reaching the rectum. That final descending section sits along your left flank. When you lie on your left side, gravity pulls the contents of that descending colon downward toward the rectum, helping things progress naturally.
This position is especially useful first thing in the morning or after a meal, when your colon is already more active. Try drawing your knees gently toward your chest while on your left side to further relax the abdominal muscles and reduce any cramping.
Abdominal Self-Massage
You can manually encourage stool along the path of your colon with a simple massage technique. The key is direction: always move clockwise, which follows the natural route of your large intestine.
- Start low on your right side, near your right hip bone. Using one or both hands, press firmly and slide upward toward your ribs.
- Cross the top of your abdomen from right to left, just below the rib cage.
- Slide down the left side toward your left hip bone.
Think of it like squeezing toothpaste through a tube. Use firm, steady pressure and continue for about two minutes. You can repeat this two or three times in a session. Adding gentle vibration, where you place one hand over the other and make small shaking movements while pressing down, can help loosen things further. This works well while lying on your back with knees bent, or even while sitting.
Movement and Stretching That Help
Physical movement stimulates the rhythmic contractions that push stool through your intestines. You don’t need an intense workout. A 10- to 15-minute walk, especially after eating, is one of the simplest and most effective things you can do for sluggish digestion.
Certain yoga-style stretches target the abdomen more directly. Twisting and hip-opening positions compress and release the digestive organs, which can help break up gas and encourage movement through the colon. A few that are particularly useful:
- Knees to chest (wind-relieving pose): Lie on your back, draw both knees toward your chest, and hold them with your hands. Rock gently side to side. This compresses the ascending and descending colon and helps release trapped gas.
- Cat/cow: On your hands and knees, alternate between arching your back (belly dropping, head up) and rounding your back (belly drawing in, head down). The rhythmic flexion massages your abdominal organs. Do this for 10 or more breaths.
- Deep squat (malasana): Stand with feet wide apart, then lower into a deep squat with your knees tracking over your toes. This opens the hips and mimics the squatting position that straightens the anorectal angle. Hold for several slow breaths. If your heels lift, place a rolled towel under them.
- Happy baby: Lie on your back, draw your knees wide toward your armpits, and hold the outsides of your feet. Keep your tailbone on the ground and breathe deeply for five or more breaths. This opens the pelvic floor and relaxes tension in the lower abdomen.
Deep, slow breathing during any of these positions matters more than you might expect. Slow exhales activate the part of your nervous system responsible for “rest and digest” functions, which directly supports intestinal motility. Stress and tension do the opposite, tightening the pelvic floor and slowing gut movement.
Putting It All Together
The most effective approach combines several of these strategies in sequence. When you feel the urge to go, or at a consistent time each day (morning is ideal, since your colon is most active after waking and after eating), try this order: do a few minutes of gentle movement or stretching, perform a clockwise abdominal massage for two minutes, then sit on the toilet with your feet elevated on a stool, lean forward with elbows on your knees, and breathe slowly. Avoid straining or holding your breath, which actually tightens the pelvic floor and works against you.
When Position Changes Aren’t Enough
Positional adjustments help with the mechanics of evacuation, but they won’t resolve every cause of constipation. If you’re also not drinking enough water, eating very little fiber, or taking medications that slow the gut (certain pain relievers, antacids, or antidepressants are common culprits), those underlying factors need attention too.
Certain symptoms signal that constipation has a cause that positioning alone won’t fix: blood in your stool, unintended weight loss of 10 pounds or more, constipation that starts suddenly in someone over 50, or a family history of colon cancer. Any of these warrant prompt medical evaluation rather than continued home management.