How To Train Your Body To Have The Perfect Poo

Illustrated by Xinyue Song.
Welcome to Bathroom Break, Refinery29’s series all about poop and the complicated relationship we have with our bowels. To see the rest of the articles, click here.
Everyone has a toilet horror story. A filthy portaloo on a hot day at an ice cream festival; the exact moment you realised you were lactose intolerant. A bus stop bathroom in Colombia with no loo roll and a door you had to hold closed with your foot. A slippery-floored squat toilet behind a curtain in a restaurant on holiday. The bleakest five minutes of your life in the downstairs loo of a new boyfriend’s family home as his mum shouts through the door: "It won’t flush, darling, but don’t worry!" You know, just to throw out random hypothetical situations that definitely didn’t happen to me. 
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Then there’s the story from 2017, of the Bristol student who couldn’t flush the loo in her date’s house so tried to throw the result of her bathroom visit out into the garden – only to miss and then get trapped while trying to rescue the offending item, which had fallen between two panes of glass. Her chivalrous date took a photo of the firefighters breaking the window to free her and the story went viral. 
How, and where, you poo can have an impact on the rest of your day: a terrible experience can leave you feeling disgusting for hours or, in the case of the bus stop bathroom, days. Women are disproportionally affected by bathroom anxiety, says Dr Anton Emmanuel, a professor in neuro-gastroenterology at University College London. "It’s interesting, there is data from other countries and other cultures saying men are as affected as women, but in Western culture and certainly from data in the UK and North America, in terms of who presents to doctors, it’s much more a female than a male problem. Some people have a real toilet phobia and they’re terrified of making a noise in a public bathroom or [in the office bathroom, in front of] their co-workers."
All this is to say that there can be a lot of negativity when it comes to pooing. Why, then, isn't there more talk about how to have a good poo, the kind that leaves you feeling satisfied and content?
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All the experts I spoke to agreed that when it comes to having an optimum poo, position is important and you’re probably doing it wrong. "This is a controversial subject," warns Dr Lisa Das, a consultant gastroenterologist at One Welbeck Digestive Health and The London Clinic, when we speak. "The ‘defecating’ or ‘squatting’ position is practised commonly in the Middle East, Africa and Asia, and studies have shown that this improves the angle of the anorectal canal, reduces straining at stool, increases the sensation of complete bowel emptying and decreases the time in the toilet when compared with sitting. This position allows the knees to be higher than the hips, forming almost a 45 degree angle with the knees.
"The Western adoption of the commode toilet means we are using the ‘sitting position’ where the knees and hips form a 90 degree angle." Interestingly, she says that this has led to a quarter of the 'healthy' Western population experiencing 'difficult bowel evacuation'.
There’s an easy enough way to solve this problem and you've probably seen the memes about it. The Squatty Potty – essentially a little plastic stool that wraps around the toilet base – brings your knees up to the correct angle, costs $24.99 (£19) and was invented in 2010 by Judy Edwards. After the stool (the plastic one) appeared on US reality show Shark Tank (think Dragons' Den, only 70% more intense) in 2015, it turned over $1m (£775k) overnight and around $33m (£25.5m) since. Celeb fans include Howard Stern, Breaking Bad’s Bryan Cranston and Sally Field, and the 2015 advert – where a unicorn poops rainbow ice cream, which is then served to children – has been viewed 38m times on YouTube.
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"Using a Squatty Potty is always more beneficial and makes pooping much quicker and easier," Judy tells Refinery29. "But gut health is also an important part of that as well. I take a very good and strong probiotic every day and that, along with the Squatty Potty, has made a big difference in my life. If your gut is healthy, it usually finds a daily schedule and that helps. I still find it difficult to poop at someone else’s home or in a public restroom, though – not sure that will ever change for me!"
If you’re worried about using the office toilet, or want to avoid public toilets, you can actually retrain your body to ‘go’ at a different time of day, says Professor Emmanuel. "Your bowel is a creature of habit," he says. "Generally you have the most natural contractions when you wake up and after a meal. When you wake up in the morning and have a coffee, that can propel things forward. Pace around, have a black coffee – whatever works for you – and the more regularly you do that, your body will fall into that pattern."
The key is to get into a regular routine – as the saying goes, no one likes surprises. "Research has shown that people who suffer from constipation have higher psychological disorders such as anxiety, depression and pain disorders in comparison to those who have healthy bowel movements," says Carey Boothe, a colon hydrotherapist and nutritional therapist at Feel Good Balham. "Mood states have been linked with the composition of the microbiome in the gut. If your gut is unhappy, it is likely to affect your overall wellbeing, both physically and mentally. Serotonin is a well-known brain neurotransmitter and it is estimated that 90% of the body's serotonin is made in the digestive tract. More and more studies show that certain bacteria in the gut are important for the production of this neurotransmitter."
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We haven’t always been as private as we are now around bathroom habits. Romans treated going to the communal toilet as a social event, making deals, swapping news, catching up with friends – a bit like a pre-pandemic nightclub bathroom, only with less lip gloss getting passed around, and more defecating. 
In medieval England, you’d squat and do your business in a pot in any room of the house, before throwing it out into the street. Or, if you were posh, you had a garderobe: a seat with a hole in it, positioned over a river. Elizabeth I, whose godson Sir John Harrington actually invented the first flushing loo in 1592 (Thomas Crapper would popularise it 300 years later), would just walk behind a curtain with her ladies-in-waiting and sit on her velvet-covered commode. It wasn’t until 1848 that the government decided it was better if we made the toilet a separate room and every new house had to have a water closet, which directed waste into London's newly built sewer system. 
Really, it was the prudish Victorians who kicked off women’s toilet anxiety. In the early 1900s, public toilets were only for men, leaving women unable to leave home without a plan as to where they’d relieve themselves. Sound familiar, anyone who tried to go on a walk in lockdown? It was only after campaigns by the Ladies' Sanitary Association that women’s toilets in ‘female spaces’ (department stores, basically) arrived. Even then, they weren’t specifically toilets – they were powder rooms with couches (to lie on in case of feeling faint) and mirrors for reapplying makeup, somewhere for women to retire to and regroup their weak feminine energy. The first women’s public toilet was opened in Camden in 1898 after a campaign by playwright George Bernard Shaw but the Victorians simply didn’t want to think about women going for a poo, and that shame seems to have surrounded women ever since – even in 2020. 
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"Now, women are far more conditioned to believe that bodily functions are private, and that losing control is shameful," says Dr Das. "Our gender is intimately connected to the perception of our excretion. Women are more ‘disgusted’ by bodily waste, more concerned about concealing toilet smells and sounds while visiting toilets, and more likely to wash their hands afterwards compared with men. Additionally, the sense of privacy is especially important to women. Some women only feel comfortable and private at home, while others actively avoid any public toilets."
Which brings us to the final, very important factor in the perfect bathroom experience: fainting couches. No! Atmosphere. We’ve all walked into a toilet, decided it has cursed energy (all train loos have bad vibes) and concluded that we can wait. According to a survey of my friends via WhatsApp – so extremely scientific – the correct loo atmosphere is all about three things: familiarity (one friend refused to use the toilets at their school and sixth form, for seven years, and would only go at home), security (thank you to all my friends who took this as an opportunity to tell me to get a lock for my bathroom door. It’s a small flat! If I can’t see you, you’re in the toilet!) and ventilation to eliminate smell anxiety. As a wise friend puts it: "Outside of your own home, the ideal is one of those loo cubicles that’s actually a room, with a window. Second best: a cubicle with a window. The worst is a middle cubicle with people queuing outside." One friend admitted that she had such bad office toilet anxiety, she’d go back to her flat nearby to use the loo. Which is a bit extreme, but fine. Only, when she moved out, she kept the key and would sneak back into the flat during work hours. Can you imagine how tense it was, hoping the new tenants wouldn’t come home early to find a stranger using their bathroom like a reverse Goldilocks? (She would like to point out that she "bleached it every time", just in case that’s the part of this story that worries you.)
So that’s the answer. Although everybody is different, the perfect bathroom experience essentially comes down to five things: a squatting position, good gut health, a window, feeling like you’re in control, and a lock on the door. One that, preferably, only you have the key to. 

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