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Implementation of a Defecation Posture Modification Device

Impact on Bowel Movement Patterns in Healthy Subjects

Modi, Rohan M., MD*; Hinton, Alice, PhD; Pinkhas, Daniel, DO*; Groce, Royce, MD, MS; Meyer, Marty M., MD; Balasubramanian, Gokulakrishnan, MD; Levine, Edward, MD; Stanich, Peter P., MD

doi: 10.1097/MCG.0000000000001143
Original Article: PDF Only

Goals: The goal of this study was to evaluate the influence of defecation postural modification devices (DPMDs) on normal bowel patterns.

Background: The introduction of DPMDs has brought increased awareness to bowel habits in western populations.

Materials and Methods: A prospective crossover study of volunteers was performed that included real-time collection of data regarding bowel movements (BMs) for 4 weeks (first 2 wk without DPMD and subsequent 2 wk with DPMD). Primary outcomes of interest included BM duration, straining, and bowel emptiness with and without DPMD use.

Results: In total, 52 participants (mean age, 29 y and 40.1% female) were recruited for this study. At baseline 15 subjects (28.8%) reported incomplete emptying, 23 subjects (44.2%) had increased straining, and 29 subjects (55.8%) noticed blood on their toilet paper in the past year. A total of 1119 BMs were recorded (735 without DPMD and 384 with DPMD). Utilizing the DPMD resulted in increased bowel emptiness (odds ratio, 3.64; 95% confidence interval (CI), 2.78-4.77) and reduced straining patterns (odds ratio, 0.23; 95% CI, 0.18-0.30). Moreover, without the DPMD, participants had an increase in BM duration (fold increase, 1.25; 95% CI, 1.17-1.33).

Conclusions: DPMDs positively influenced BM duration, straining patterns, and complete evacuation of bowels in this study.

*Department of Internal Medicine

Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Medical Center

Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH

The authors declare that they have nothing to disclose.

Address correspondence to: Rohan M. Modi, MD, Department of Internal Medicine, The Ohio State University Wexner Medical Center, 395 West 12th Avenue, 3rd Floor, Columbus, OH 43210 (e-mail:

Received June 14, 2018

Accepted September 17, 2018

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