Is there a link between Hemorrhoids and the toilet seat of the so-called Modern West?
Instead of proffering my opinion on this most interesting question let me state some basic facts and leave that judgment to each interested subject to make his or her own mind.
Anatomy
Internal hemorrhoids or piles are symptomatic enlargement of the normal arteriovenous cushions at the anorectal junction. These vascular plexuses become congested and enlarged so that they may bleed and prolapse. They lie in the distribution of the superior rectal artery with a single left lateral and an anterior and posterior right branch with associated vein drainage to the portal system. The perianal external venous plexus drains systematically and may cause symptoms when rupture and congestion occur, leading to perianal haematoma, skin tags and may constitute the origin of fissure in ano.
The above description is unavoidable and I only quoted it verbatim to avoid any criticism from any seasoned General Practitioner or surgeon.
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| Angry Doctor who may or may not be mad at me personally. |
Let us take a look at nature, the animals and more specifically, our nearest ancestors, the primates - and examine how they defecate: They all squat down with their knees drawn up to their chest when ‘nature calls’. The so-called modern West aside, all human beings squat when they defecate and it is a very safe bet to conclude that applies to the majority of the six plus billion human that inhabit planet earth.
It is not much different when we ‘sit down’ on a toilet to defecate then sitting down on a chair at the dining table to eat. Think about this sentence for a minute. It implies that the grand design of the posture of human body is such that the passage of food from mouth to excreta follows the same angle which almost equates to a straight line of 180 degrees! Besides the very short passage from the esophagus to the stomach the passage of food from the stomach through the small intestine, large intestine, and now waste through the colon, rectum and anus is very tortuous and often complex.
Those of us who had grown up in the Middle East, lived or visited the Middle East as tourists would note that, despite modernity in style most homes still retain the option of what is called ‘Arabic Toilet’ involving squatting, and so called ‘Western style Toilet’ where one can sit and read the newspaper or send messages or emails whilst defecating. That is so assuming the 'defector' is not exerting him or herself and does not suffer from hemorrhoids, let alone bleeding or prolapsed hemorrhoids.
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| Arabic toilet |
The undeniable anatomical fact is that when we sit on a toilet, the lower end of the descending colon is bent, requiring expenditure of good effort and muscular exertion to evacuate the bowels. The strain caused by this effort can cause a clog or event burst capillaries that feed the anal sphincter causing the formation of hemorrhoids. When squatting as you would on an Arabic Toilet or in nature the colon aligns itself naturally with the rectum and anus which opens up completely and almost effortlessly in the squatting posture when the knees are drawn up to the chest. I would argue that the older style toilet has greater benefit to the reduction of hemorrhoids than the modern day design.
Needless to say one can still defecate squatting on a comfortable toilet. How? Simply raise the seat and stand up on the rim and squat down slowly until the knees are pressed against the chest. Just be careful not to hit your head on the ceiling and make sure you have good balance when you squat on the rim making sure the toilet roll is within level reach. Yes, I actually wrote that.
For completeness I should make a mention that the exertion involved in childbirth is often a cause for a woman developing hemorrhoids. That's a scene that's never made it to the modern day rom com movies.
One must also take note and make mention of the fact that modern technology and smart mobile, so called i-phones, had made awareness of conditions such as hemorrhoids, soft stools and the importance of high fiber diet readily accessible. But despite this easy accessibility, it is highly questionable whether the pressure of modern day living had allowed people to chew their food more leading to them actually digesting their food in a sensible manner. It's interesting how many people I have heard having actual conversations with friends whilst in the restrooms. This exchnaging of turds with friends is becoming more and more common, baffling as it is the world is literally at our fingertips on these devices, I just cant help but question the standard of acceptable restroom antics.
I think the modern day bathrooms should have the option of both toilets for individuals to decide for themselves, it may, arguably so, ease the pressure of a shitty day. Yes. I actually wrote that.
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