title: Primary constipation: an underlying mechanism.
abstract: Primary (simple) constipation is a consequence of habitual bowel elimination on common toilet seats. A considerable proportion of the population with normal bowel movement frequency has difficulty emptying their bowels, the principal cause of which is the obstructive nature of the recto-anal angle and its association with the sitting posture normally used in defecation. The only natural defecation posture for a human being is squatting. The alignment of the recto-anal angle associated with squatting permits smooth bowel elimination. This prevents excessive straining with the potential for resultant damage to the recto-anal region and, possibly, to the colon and other organs. There is no evidence that habitual bowel elimination at a given time each day contributes considerably to the final act of rectal emptying. The natural behavior to empty the bowels in response to a strong defecation reflex alleviates bowel emptying by means of the recto anal inhibitory reflex.
authors.forename: B A
authors.initials: BA
authors.lastname: Sikirov
mesh_terms: D003248:Constipation / Q000209:etiology* / Q000628:therapy; D005769:Gastrointestinal Motility; D006801:Humans; D011187:Posture; D014038:Toilet Facilities