Sitting vs Squatting

A common question from my patients is why would you ever choose going into GI?! Well to be very honest, I believe that the field choose me. I was born in Detroit in the 1980s, but a number of my childhood summers were spent in India visiting family. One of my most vivid travel memories was taking a train from Mumbai to Ahmedabad, an 8-hour endeavor. I was 9 years old at the time and remember needing to have a bowel movement. I was taken to the restroom, where I was surprised to find no toilet and instead needing to squat on a moving train. The mission was a success, but needless to say it was a different bathroom experience!

Toilets were not as common 30 years ago throughout India, and the concept was squatting was something I had become accustomed when visiting. Even as a kid I found that when I squatted, I had a more formed bowel movement without significant straining. Outside of the bathroom differences, I also had be careful with only drinking bottled water as I came to find out on a few occasions that tap water in India can result in traveler’s diarrhea. These were my own subtle introductions to GI – long before I ever dreamed of helping others with similar issues.

As I grew older my trips to India became less frequent and every time I went back as an adult, I noticed how fast India was catching up to the West. Long gone was the need for squatting and in most homes the toilet had become the norm. Ironically, I started seeing more adaption of Eastern practices here such as the introduction of turmeric to help with common ailments, yoga studios at every corner, and a greater emphasis on plant-based options that is common in many Indian diets.

Fast forward a few more years when I was an Internal Medicine resident at Ohio State. A night I will never forget was when I saw Squatty Potty being pitched on Shark Tank. This was a simple stool (either 7-9 inches in height) placed in front of the toilet that reduces the straining required to have a bowel movement and closely aligned with squatting. Imagine my shock to see a family from Utah implementing something that was so common only 30 years ago in India. It took me all of 5 minutes to get on Amazon and order one for myself. Within a week I found myself having better bowel movements and I was telling all my friends about this product – something only a budding Gastroenterologist would do!

I loved it so much that I reached out to the company and asked to develop a research study to assess the benefits of Squatty Potty. There were no publications to demonstrate the effectiveness and I thought it would be a unique study. Over the next 12 months, I was able to collect data from 52 participants and recorded data from over 1110 bowel movements. We found that patients had reduced time on the toilet, decreased straining, and increased emptiness (here is the actual article if you wanted more info: Modi et al JCG 2019). The publication picked up quite a bit of traction – there were articles about it in Times, Forbes, NYTimes, etc and I even had an opportunity to talk about my study at national conferences. I have been lucky enough to maintain a relationship with Squatty Potty and am on their Medical Advisory Counsel as well.

Nowadays, I am busy with my clinical practice here in Columbus, Ohio at Gastro Office. My biggest passion is to provide patients with the knowledge and tools to have better gut health. I now can talk to people about all sorts of GI issues – including trouble with emptying their bowels or increased straining on the toilet, which is a prefect segway into talking about a simple stool that may help alleviate their issues without the need of chronic laxative therapy. Who knows – maybe even if you don’t have issues going to the bathroom, you will also become a Squatty Potty believer!

Rohan Modi, MD Rohan Modi, MD, Gastroenterologist. Joins the team of expert providers at Gastro Office, serving patients throughout Hilliard, Ohio. He provides expert care in the field of gastroenterology and is dedicated to improving his patients' digestive tract health that includes but is not limited to the esophagus, stomach, small/large intestines, gallbladder, and liver.

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