Skip to main content
Top
Published in: Techniques in Coloproctology 2/2016

01-02-2016 | Original Article

Influence of body posture on defecation: a prospective study of “The Thinker” position

Authors: S. Takano, D. R. Sands

Published in: Techniques in Coloproctology | Issue 2/2016

Login to get access

Abstract

Purpose

We hypothesized that bending the upper body into what we have termed “The Thinker” position facilitates defecation. This study aimed to assess the influence of “The Thinker” position on defecation.

Methods

This is the prospective single-group study. Patients who could not evacuate the paste in normal sitting position on cinedefecography between January and June 2013 were enrolled in this study. Cinedefecography was first performed in the sitting position; if the patient was unable to evacuate the paste, images were obtained in “The Thinker” position. Patients who were able to evacuate the paste were excluded from the study. Anorectal angle (ARA), perineal plane distance (PPD), and puborectalis length (PRL) during straining in both positions were measured from the radiographs.

Results

Twenty-two patients unable to evacuate the barium paste underwent cinedefecography in “The Thinker” position. Seventeen patients were female, average age of 56 (range 22–76) years. “The Thinker” position had significantly wider ARA than the sitting position (113° vs. 134°, respectively; p = 0.03), larger PPD (7.1 vs. 9.3 cm, respectively; p = 0.02), and longer PRL (12.9 vs. 15.2 cm, respectively; p = 0.005) during straining. Eleven patients could evacuate completely in “The Thinker” position.

Conclusion

“The Thinker” position seems to be a more efficient method for defecation than the sitting position. This technique may be helpful when retraining patients with constipation.
Literature
1.
go back to reference Sikirov D (2003) Comparison of straining during defecation in three positions: results and implications for human health. Dig Dis Sci 48:1201–1205PubMedCrossRef Sikirov D (2003) Comparison of straining during defecation in three positions: results and implications for human health. Dig Dis Sci 48:1201–1205PubMedCrossRef
2.
go back to reference Rad S (2002) Impact of ethnic habit on defecographic measurements. Arch Iran Med 5:115–117 Rad S (2002) Impact of ethnic habit on defecographic measurements. Arch Iran Med 5:115–117
3.
go back to reference Tsuchino M, Yamashita K, Boda T et al (2008) A study of the relationship between continence function and defecatory posture. J Jpn Soc Stoma Cont Rehabil 24:34–38 Tsuchino M, Yamashita K, Boda T et al (2008) A study of the relationship between continence function and defecatory posture. J Jpn Soc Stoma Cont Rehabil 24:34–38
4.
go back to reference Drossman DA (2006) The functional gastrointestinal disorders and the Rome III process. Gastroenterology 130:1377–1390PubMedCrossRef Drossman DA (2006) The functional gastrointestinal disorders and the Rome III process. Gastroenterology 130:1377–1390PubMedCrossRef
5.
go back to reference Jorge JM, Wexner SD, Marchetti F, Rosato GO, Sullivan ML, Jagelman DG (1992) How reliable are currently available methods of measuring the anorectal angle? Dis Colon Rectum 35:332–338PubMedCrossRef Jorge JM, Wexner SD, Marchetti F, Rosato GO, Sullivan ML, Jagelman DG (1992) How reliable are currently available methods of measuring the anorectal angle? Dis Colon Rectum 35:332–338PubMedCrossRef
6.
go back to reference Felt-Bersma RJ, Luth WJ, Janssen JJ, Meuwissen SG (1990) Defecography in patients with anorectal disorders. Which findings are clinically relevant? Dis Colon Rectum 33:277–284PubMedCrossRef Felt-Bersma RJ, Luth WJ, Janssen JJ, Meuwissen SG (1990) Defecography in patients with anorectal disorders. Which findings are clinically relevant? Dis Colon Rectum 33:277–284PubMedCrossRef
7.
go back to reference Jorge JM, Ger GC, Gonzalez Wexmer SD (1994) Patient position during cinedefecography. Influence on perineal descent and other measurements. Dis Colon Rectum 37:927–931PubMedCrossRef Jorge JM, Ger GC, Gonzalez Wexmer SD (1994) Patient position during cinedefecography. Influence on perineal descent and other measurements. Dis Colon Rectum 37:927–931PubMedCrossRef
8.
go back to reference Jorge JM, Wexner SD, Ehrenpreis ED, Nogueras JJ, Jagelman DG (1993) Does perineal descent correlate with pudendal neuropathy? Dis Colon Rectum 36:475–483PubMedCrossRef Jorge JM, Wexner SD, Ehrenpreis ED, Nogueras JJ, Jagelman DG (1993) Does perineal descent correlate with pudendal neuropathy? Dis Colon Rectum 36:475–483PubMedCrossRef
9.
go back to reference Habib FI, Corazziari E, Viscardi Badiali D, Torsoli A (1992) Role of body position, gender, and age on pelvic floor location and mobility. Dig Dis Sci 37:500–505PubMedCrossRef Habib FI, Corazziari E, Viscardi Badiali D, Torsoli A (1992) Role of body position, gender, and age on pelvic floor location and mobility. Dig Dis Sci 37:500–505PubMedCrossRef
10.
go back to reference Haubruch W (1985) Constipation. In: Berk J (ed) Bockus gastroenterology, 4th edn, Saunders, Philadelphia, p 111 Haubruch W (1985) Constipation. In: Berk J (ed) Bockus gastroenterology, 4th edn, Saunders, Philadelphia, p 111
12.
go back to reference Singer C (1958) History of technology. The industrial revolution, Oxford, pp 507–508 Singer C (1958) History of technology. The industrial revolution, Oxford, pp 507–508
13.
go back to reference Tagart RE (1966) The anal canal and rectum: their varying relationship and its effect on anal continence. Dis Colon Rectum 9:449–452PubMedCrossRef Tagart RE (1966) The anal canal and rectum: their varying relationship and its effect on anal continence. Dis Colon Rectum 9:449–452PubMedCrossRef
14.
go back to reference Altomare DF, Rinaldi M, Veglia A, Guglielmi A, Sallustio PL, Tripoli G (2001) Contribution of posture to the maintenance of anal continence. Int J Colorectal Dis 16:51–54PubMedCrossRef Altomare DF, Rinaldi M, Veglia A, Guglielmi A, Sallustio PL, Tripoli G (2001) Contribution of posture to the maintenance of anal continence. Int J Colorectal Dis 16:51–54PubMedCrossRef
15.
go back to reference Rao SS, Kavlock R, Rao S (2006) Influence of body position and stool characteristics on defecation in humans. Am J Gastroenterol 101:2790–2796PubMedCrossRef Rao SS, Kavlock R, Rao S (2006) Influence of body position and stool characteristics on defecation in humans. Am J Gastroenterol 101:2790–2796PubMedCrossRef
16.
go back to reference Martelli H, Devroede G, Arhan P, Duguay C (1978) Mechanisms of idiopathic constipation: outlet obstruction. Gastroenterology 75:623–631PubMed Martelli H, Devroede G, Arhan P, Duguay C (1978) Mechanisms of idiopathic constipation: outlet obstruction. Gastroenterology 75:623–631PubMed
17.
go back to reference Parks A (1975) Anorectal incontinence. Proc R Soc Med 68:21–30 Parks A (1975) Anorectal incontinence. Proc R Soc Med 68:21–30
18.
19.
go back to reference Preston D (1983) Neuropathology of stow-transit constipation. Gut 24:997A Preston D (1983) Neuropathology of stow-transit constipation. Gut 24:997A
20.
go back to reference Swash M (1988) Pelvic floor outlet and sphincter disorders. Ital J Gastroenterol 20:344–347 Swash M (1988) Pelvic floor outlet and sphincter disorders. Ital J Gastroenterol 20:344–347
21.
go back to reference Alves-Ferreira PC, Gurland B, Zutshi M, Hull T (2012) Perineal descent does not imply a more severe clinical disorder. Colorectal Dis 14:1372–1379PubMedCrossRef Alves-Ferreira PC, Gurland B, Zutshi M, Hull T (2012) Perineal descent does not imply a more severe clinical disorder. Colorectal Dis 14:1372–1379PubMedCrossRef
Metadata
Title
Influence of body posture on defecation: a prospective study of “The Thinker” position
Authors
S. Takano
D. R. Sands
Publication date
01-02-2016
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue 2/2016
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-015-1402-6

Other articles of this Issue 2/2016

Techniques in Coloproctology 2/2016 Go to the issue