If you sit, you don't know squat: Western-commodes vs Indian style loos

In a South Bombay Breach Candy home studded with gizmos and gadgets, the installation of a new designer 'Indian style toilet' has led to much excitement.

"This is what we had in my maternal home in Chandigarh before I was married," reveals 58-year-old Surinder Khurana. "I'd found getting used to the commode very difficult and was often subject to taunts and barbs by the women at in-laws' home. Every time I wanted to use the loo, they'd all grin and remind me not to sit with legs up." In a sense, life has come full circle, since the family has changed one of the loos to an Indian one at considerable cost.

Ironically, it was not her, but her LSE (London School of Economics) returned son Harnam who necessitated the change. "Thanks to friends who did it, I'd got into the habit of reading in the loo in London and this continued here too," says Harnam who now handles the family transport business. "I'm very interested in the stock market and was reading two pink papers inside the loo." That was until he suffered rectal prolapse (rectal walls protruding out of the anus) in February. "It was embarrassing, miserable and painful as I went through surgical stapling," remembers Harnam, who began seeing a Yoga guru and was recommended the Indian loo. "Now I'm out in less than five minutes."

The Khuranas aren't alone. Many homes across the country are shifting to Indian toilets. Over the last few decades, bowel-related diseases like hemorrhoids, prolapse, constipation and irritable bowel syndrome have risen, especially with Western-influenced diets and lifestyles. It was increasingly borne out that the probability of such diseases was higher among Western toilet users.

Among them is septuagenarian SK Rajan, who lives in Hyderabad's tony Banjara Hills. The retired corporate honcho found a way to go Indian even though his wife has undergone knee replacement and can't squat. "We installed a semi-Indian toilet where you can both sit/squat."

Yoga and Ayurveda practitioners explain how squatting has been the most natural posture to finish one's daily 'business' from the cavemen and before. "Squatting is natural even to babies in the womb and children who aren't taught correct posture. This shows how it is the most natural posture," says Bal Krishna, Ayurvedacharya of Patanjali Yoga Peeth.

Others like Mumbai's leading Yoga guru Shameem Akhtar not only agree but emphasise how the squat position has been proven to facilitate the right peristalsis (movement of intestinal walls) needed to complete the act of excretion. "There are many yogic poses which replicate this: the goddess pose (Kaliasana), Utkatasana (squat pose), Druta Utkat Asana (dynamic squat pose)."

She says she recommends the Indian style toilet because it is a workout for the whole body, including the face, the whole back, legs, hips, and all the major joints. "While teaching Yoga, I'm often shocked to see how young Indians are unable to do the basic full-squat position. This comes from a lifestyle where the chair has replaced cross-legged seating on the ground that Indians/Asians are famous for, and of course, the Western toilet."

Akhtar says she prefers Indian toilets for the reasons listed. "The most immediate benefit is hygiene. Your hips/buttocks don't rest on the spot where others have sat! Your hips are off the rim of the toilet which, in a public one, can be a pure bacterial jungle, and make it really yucky, strewn with faeces or urine!"

And what does modern medicine have to say to this? Shortly before Christmas in 1978, then US president Jimmy Carter came down with a severe case of haemorrhoids. A few weeks later, Time magazine asked proctologist Michael Freilich to explain the president's ailment."We were not meant to sit on toilets," he said, "We were meant to squat in the field."

He's probably right, says Mumbai's leading gastroenterologist Dr Pravin Rathi. According to him, people control their defecation by contracting or releasing the anal sphincter. But the muscle cannot do this on its own. The body also relies on a bend between the rectum – where faeces builds up – and the anus – where faeces comes out. "When we're standing up, the extent of this bend, called the ano-rectal angle, is about 90 degrees, which puts upward pressure on the rectum and keeps faeces inside. In a squatting posture, the bend straightens out and defecation is easier," he explains and adds, "But to actually recommend one over the other will require more detailed studies."
If still in a dilemma whether to squat or not... the answer is staring at you. Squat!