Search our Database of Scientific Publications and Authors

I’m looking for a
    Primary constipation: an underlying mechanism.
    Med Hypotheses 1989 Feb;28(2):71-3
    Primary (simple) constipation is a consequence of habitual bowel elimination on common toilet seats. A considerable proportion of the population with normal bowel movement frequency has difficulty emptying their bowels, the principal cause of which is the obstructive nature of the recto-anal angle and its association with the sitting posture normally used in defecation. The only natural defecation posture for a human being is squatting. The alignment of the recto-anal angle associated with squatting permits smooth bowel elimination. This prevents excessive straining with the potential for resultant damage to the recto-anal region and, possibly, to the colon and other organs. There is no evidence that habitual bowel elimination at a given time each day contributes considerably to the final act of rectal emptying. The natural behavior to empty the bowels in response to a strong defecation reflex alleviates bowel emptying by means of the recto anal inhibitory reflex.

    Similar Publications

    Etiology and pathogenesis of diverticulosis coli: a new approach.
    Med Hypotheses 1988 May;26(1):17-20
    The paper describes a hypothesis as to the etiology and pathogenesis of diverticulosis coli. Colonic diverticulosis develops as a result of excessive straining at defecation due to habitual bowel emptying in a sitting posture, which is typical of Western man. The magnitude of straining during habitual bowel emptying in a sitting posture is at least three-fold more than in a squatting posture and upon urge. Read More
    Comparison of straining during defecation in three positions: results and implications for human health.
    Dig Dis Sci 2003 Jul;48(7):1201-5
    The aim of the study was to compare the straining forces applied when sitting or squatting during defecation. Twenty-eight apparently healthy volunteers (ages 17-66 years) with normal bowel function were asked to use a digital timer to record the net time needed for sensation of satisfactory emptying while defecating in three alternative positions: sitting on a standard-sized toilet seat (41-42 cm high), sitting on a lower toilet seat (31-32 cm high), and squatting. They were also asked to note their subjective impression of the intensity of the defecation effort. Read More
    Cardio-vascular events at defecation: are they unavoidable?
    Med Hypotheses 1990 Jul;32(3):231-3
    Cardio-vascular events at defecation are to a considerable degree the consequence of an unnatural (for a human being) seating defecation posture on a common toilet bowl or bed pan. The excessive straining expressed in intensively repeated Valsalva Maneuvers is needed for emptying the bowels in sitting position. The Valsalva Maneuver adversely affecting the cardio-vascular system is the causative factor of defecation syncope and death. Read More
    Study of the role of the second defecation reflex: anorectal excitatory reflex in the pathogenesis of constipation.
    J Am Coll Surg 2003 May;196(5):729-34
    Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt.
    Background: Previous studies have shown that anal distension caused rectal contraction, an action mediated through the anorectal excitatory reflex. Anal anesthetization aborted rectal contraction and rectal evacuation was induced by excessive straining. We investigated the hypothesis that inhibition or absence of the anorectal excitatory reflex could lead to constipation. Read More