HOW TO POOP WHEN CONSTIPATED ON THE TOILET | 5 GUIDELINES
Reviewed by: Horia Marculescu, MD
First. Keep your knees higher than your hips to increase the anorectal angle and straighten the anorectal canal.
Second. Create pressure inside the intestine and contract your abdomen.
Third. Gently strain the rectum and push when you feel the stool is ready to evacuate.
After learning all the techniques, you will be able to prepare your body and understand how stool evacuation works. You will be able to know when it is time to step away from the toilet. And when not to strain.
1. LIFT YOUR FEET
If you are constipated and feel the need to poop then, it is time to position your bottom on the toilet bowl.
The position you sit on the toilet bowl is essential to have smooth stool evacuation.
It is also true when you learn how to relieve constipation on the toilet in the long-term.
Good posture requires to lower your body on the toilet seat with the knees higher than the hips.
You can achieve this posture by lifting your feet and keep them like that on the tip of the foot. You can also put a footstool under your feet to have less effort on your toes and heels.
The purpose of keeping the knees higher than the hips like that is to increase the anorectal angle.
Increasing the anorectal angle will relax
- the puborectalis muscles
- the internal / external sphincter.
It is a bit challenging and demanding because it takes some muscle effort on your feet if you don’t have a footstool.
Lift your feet on the tip of the toes
This technique is excellent if you do not have a footstool at your disposal.
While you sit on the toilet, try to lift your heels. But keep the soles of your feet on the ground.
Raise your feet until your heels are at a 45-degree angle with the ground floor.
Now do the following:
- Keep the feet for 1-3 minutes like that
- Pause and let the feet touch the ground
- Relax the ankles
- Try again for 1-3 minutes
- Repeat for 3-4 times
If you are used to having an effort on your feet, you can continue to keep the knees like that for 3-5 minutes.
This exercise is more demanding if you lift your feet, and they stay in the air. There is no balance, and it will require lots of effort on your hips.
This thing does not help much.
Lift your feet with a footstool
The easiest way to lift your feet while sitting on the toilet is to put a footstool.
There are many stands (ex: squatty potty) designed for raising the feet with different heights. Some of them can modify height and size.
Here is how to poop when constipated on the toiled with a footstool under your feet.
- Position yourself on the toilet
- Drag the footstool near the toilet bowl
- Put the stoles of your feet on it
- Let the bodyweight on the toilet bowl and support
You can put the support before you sit on the toilet.
In this way, climb the 1.5-2 inches height and after this, lower your body and sit on the toilet.
Your knees should be at the same level of height with the abdomen.
Now stay in this position for 1-5 minutes until your anorectal angle increases. It may take longer.
After this period, your body should feel a slight relaxing feeling. Also, the sphincter relaxes as soon as your feet raise their height.
You will feel relief when the stool reaches the rectum to evacuate.
Lifting your feet helps to increase the anorectal angle. This thig prepares the anorectal canal for the stool to evacuate. View this guideline as preparation before pooping when you suffer from constipation.
What do the experts say?
A study called The Psychology of Human defecation compared the time and sense of satisfactory rectal emptying in three postures. 
The three postures were
- sitting on a standard Western commode
- sitting on the same commode by placing the soles of the feet on a 10 cm footstool
- sitting in squatting posture
...it was found that evacuation was quickest and afforded a more complete sense of bowel emptying in the squatting posture and was most difﬁcult on the standard Western type commode.
The U.S. National Library of Medicine presents a helpful Guide to Good Posture. 
The guidelines promote the long-term use of excellent body posture. The body posture can be sitting on the feet or sitting on a chair.
It also mentions the fact that poor posture is bad for our health.
Poor posture can be bad for your health. Slouching or slumping over can Make it harder to digest your food.
Here is another body posture guide, focused on sitting up straight, presented by the NIH News in Health newsletter. 
Posture is not only about how well you sit, but how well you move and go about your daily life.[back to top]
2. CREATE PRESSURE INSIDE
Don’t strain the rectum immediately. Before pooping, we need to create pressure inside the intestines.
Here is how to how to poop when constipated on the toilet with pressure.
We can create pressure by contracting the abdomen slowly. Do this thing slowly and gently.
We use pressure to create gas and expand the intestinal muscles. Gas tends to move towards evacuation. So does the stool.
First of all, you need to have a relaxed position, so your body does not feel the tension.
The second thing you need to do is to:
- slowly contract the abdomen muscles
- slowly simulate as if you were pooping
- take a pause
- repeat these steps every half of the minute.
This repetition should not take more than 3-5 minutes.
Focus on the abdominal muscles only. This thing means the upper part of the abdomen. Try not to strain the rectum yet.
The rectum area is underneath the abdomen, so try to avoid it for now.
First, simulate, then poop
If you find yourself stuck on the toilet with constipation, you should consider simulating pooping gently at first, rather than straining hard the rectum.
Simulating pooping will make your brain to send signals to the nervous system.
The nervous system will try to relax the body and contract the muscles around the intestines. Also, the sphincter will get signals to relax and to prepare the stool for evacuation.
In 5-10 minutes, you should be able to poop. It can happen faster.
If this thing does not happen, repeat the steps above until the sphincter relaxes completely. If you follow all the steps and practice them often, your body will memorize them.
In this way, it will be easier for the large intestine and the rectum to prepare stool evacuation.
What do the experts say?
The thesis called Investigation of alternative approaches for ecologically responsible and culturally friendly composting toilet (The Ohio State University) presents a study about The Proper Posture for Defecation. (pdf) 
The study involved the presentation of
- the anatomy of the colon, the anus, the rectum
- the benefits of the squatting posture
- the unfavorable parts of the unnatural position for defecation, including pressure in the abdomen.
Studies have proven that sitting down for defecation is against the natural position for elimination and therefore is causing great health issues.
People have to strain if they sit down during defecation. Secondly, the valve separating the small intestine and the colon tightly close, resulting in lower pressure in the abdomen and substances in the colon getting backed up.
This thing is the reason why it is essential to increase the anorectal angle first by raising your feet and then contracting the abdomen.
In this way, the anorectal canal will have a clear path for the stool to evacuate.
Another study: The importance of a high rectal pressure on strain in constipated patients: implications for biofeedback therapy published on the NIH website. 
The study wanted to show the benefit of biofeedback and the implications of rectal pressure on strain on patients with chronic constipation.
We have identified a subgroup of patients with dyssynergic symptom... …who were characterized by a high straining rectal pressure. Although these patients displayed some physiological differences to the patients with lower straining rectal pressure, they suffer similarly. Importantly, we have shown that these patients can respond favorably to anorectal BF. [back to top]
3. GENTLY STRAIN THE RECTUM
Now it is time to poop
Here is how to poop when constipated on the toilet after creating pressure inside the intestines.
After you feel there is enough pressure inside the intestines and the stool is ready to evacuate, do the following:
- Strain the rectum area slowly
- Strain the rectum for 1-2 minutes
- Strain it a bit harder when you feel the stool is in near the rectum
- Push the rectum gently until it evacuates
- Take a pause
You have to feel the stool is in the rectum area. If nothing happens the first time, take a short pause, and repeat it.
You should be able to poop smoothly.
Force the intestines to evacuate the stool by pushing the air out slowly. It has to come naturally because the pressure will push the gas and the fecal matter out.
Take a deep breath and push
If nothing happens and you feel the stool is ready to evacuate, try to force it a bit.
Let the air go and take a deep breath. Fill the lungs as much as you can. Do this thing gently at first, so the stool inside the large intestine prepares to evacuate.
Contract the rectum gently, so it has time to relax. This thing also helps with the final evacuation.
Now strain harder and evacuate the stool. Release the air and push the rectum down harder.
What we want to achieve with this technique is to: force the evacuation if the stool is hard and dry. This thing also helps intestinal motility because it puts the intestines to work. Contract the rectum and the abdomen once every minute until you feel the stool will evacuate.
What do the experts say?
The Harvard Health Publishing website published an article called Chronic Constipation a Strain for Men in which it presents straining as a way to increase pressure to aid defecation. 
Usually, this physical effort comes when we sit on the Western toilet.
At the same time, the muscles of the lower colon have to contract to propel the stool outward, and voluntary contractions of the abdominal muscles ("straining") increase pressure to aid the process.
This thing happens because the colon stores a large amount of fecal material. And when it fills up, the body gives signals to the rectum and the internal sphincter to unlock the kink.
In this way, the stool can naturally evacuate. [back to top]
4. RELAX THE SPHINCTER
Relax the internal and external sphincter to better understand how to poop when constipated on the toilet.
If you went through steps 1, 2, 3, and you did not poop smoothly, then it is time to step away from the toilet.
This thing means that: the puborectalis muscles and the sphincter are not ready yet. It could also mean that the stool is ready to evacuate, but it is dry.
Dry stools can stick like glue to the intestinal walls. If there is a large quantity of dry stool sitting in the rectum, there won’t be any stool evacuation. To relax the internal and external sphincter, you have to squat outside the toilet.
Focus on the sphincter
The anal sphincter relaxes when you squat. This thing means that the anorectal angle will increase, making a clear path in the anorectal canal.
The role of this guide is to relax the sphincter and the muscles around the hips.
Squat as follows
- Squat for 1-5 minutes outside the toilet
- Take a pause
- Squat again for 1-5 minutes
- Take a pause
It usually takes 5-10 for the sphincter to relax. In this time, the brain tells the rectum to prepare for stool evacuation.
It might take longer than 10 minutes to poop if you ate lots of bread, meat, eggs, and cheese. The interval of 5-10 minutes is enough to relax the sphincter.
If you suffer from severe or chronic constipation, then it might take longer at first. But do not worry. This way of preparing to poop works in the long-term. You need to be patient and wait. Also, do not force yourself.
Don’t push too much
If nothing happens after you squat, then it is time to take a pause and relax your body.
It may be the case that your bottom muscles and hips are too tensed and numb.
Who suffers from sourness?
- People who stay long periods at a desk
- People who drive for more than five hours
- People who stay in bed with their smartphone all day long
A little bit of physical activity may improve the intestinal motility. It is essential to take a walk or do some light exercises before pooping.
What do the experts say?
A study called Comparison of Straining During Defecation in Three Positions: Results and Implications for Human Health compares the straining forces applied when having stool evacuation. 
The study involves sitting in the usual way on the toilet and squatting.
In conclusion, the present study confirmed that sensation of satisfactory bowel emptying in sitting defecation posture necessitates excessive expulsive effort compared to the squatting posture.
Another study about the rectum: The anal canal and rectum: Their varying relationship and its effect on anal continence. The study concludes that increasing the anorectal angel makes pooping easier. 
This straightening effect results in lessening the resistance at the anorectal junction and increased ease of defecation.
Also, another study called Influence of Body Position on Defecation in Humans confirms the same thing. 
The results of the present study suggest that the greater the hip flexion achieved by squatting, the straighter the rectoanal canal will be, and accordingly, less strain will be required for defecation. [back to top]
5. OTHER WAYS TO POOP
Two other techniques can stimulate stool evacuation when sitting on the toilet. When you sit on the toilet seat waiting to poop, you can’t move much. So, we have to get some internal stimulus.
Why is it important to learn how to poop when constipated on the toilet with stimulus?
Sometimes, it can give us a kick start when we suffer from constipation, and we feel the need to poop.
Here are two simple techniques that stimulate the abdomen and the bottom.
Listen to loud music
Listening to music on the toilet is an excellent technique to stimulate the intestines.
Put your headphones on and play your favorite tracks for 5-10 minutes.
Music is great to
- Relax the body
- Create tension in the abdomen
- To make the pelvic area move
Relaxing music is excellent for those of us who stay in stressed and noisy environments. This type of music relaxes the brain and the nervous system.
Loud music that has a 100-130 beats per minute rhythm is better for creating episodes of tension in the abdomen.
Low-frequency loud music affects the pelvic area. It puts the rectum and the large intestines to work.
As an example: when you go to a rock concert. You hear the loud drums and the bass hitting the body. They involuntary contract your abdomen.
Drink hot tea
If you want to avoid doing physical exercises, you can drink a cup of hot tea.
Hot liquids, in general, stimulate the intestines. They create pressure and gas.
If you drink more, the intestines will get larger and larger. In this way, you make the intestines push the stool towards evacuation.
Fruit juice can create eve more gas and has laxative effects. [back to top]
6. A WORD OF CAUTION
These guidelines show you how to poop when constipated on the toilet with simple techniques.
If you rarely feel the need to poop when you sit on the toilet, then you should consider visiting a doctor.
There could be other physical causes that influence the way you poop. The position you sit on the chair before going to the toilet is also vital. If you feel severe pain for longer than one month, it is time to visit a doctor.
For example, if your body is tired and you sat all day at your desk studying, it is highly un-probable that you will have smooth defecation.
Also, do no force yourself when you strain. Too much straining can lead to hemorrhoids and other rectal complications.
Prevention is the secret when dealing with constipation in the long-term.
What do the experts say?
In a study called Squatting for the Prevention of Haemorrhoids? the author mentions that straining too much is a potential cause for hemorrhoids. 
According to this explanation, straining during defaecation, brought on by constipation or holding one's breath, is a primary factor in causing haemorrhoids. [back to top]
What is essential when you learn how to poop when constipated on the toilet?
To keep in mind to relax the anal sphincter and straighten the anorectal canal.
A clear path in the anorectal canal makes the poop evacuate smoothly.
To create pressure inside the intestines and contract the abdomen.
Also, to gently strain the rectum and push when the stool is ready to evacuate. [back to top]
- Best Position to Poop In When Constipated
- Best way to sit on toilet when constipated
- Stuck on toilet with constipation
- What to do when constipated on the toilet
About the author
My name is Sebastian D., and I am the senior editor of constipationguide.com. With the help of my mentor, Dr. Horia Marculescu, I decided to create a practical guide to constipation relief.. read more