Your rectum doesn't run straight down. A U-shaped sling called the puborectalis loops around it and holds it bent forward — that kink is what keeps you continent the rest of the day ¹. When you go, the sling relaxes only partway, and how much depends on your hip angle. Bend past 90°, which is what a footstool buys you, and the canal swings toward a straight line: about 90° sitting, around 130° in a full squat ². Straighter path, less force to clear it, less pressure on the venous cushions that become hemorrhoids when they're chronically squeezed ³.

The trial data is small but points one way. In a squat, mean time on the toilet fell from about 130 seconds to 51, and self-rated straining dropped by more than half ². Two weeks with a seven-inch stool at home: across a thousand recorded bowel movements, 90% came with less straining and 71% went faster, and two-thirds of people kept the stool afterward ⁴. What the trials can't tell you is whether it prevents hemorrhoids a decade out; nobody has run that study, so the long game rides on the anatomy.

The whole intervention is one purchase and a position you hold.

Within a week you spend less time in there and push with less force, and the nagging am I done? fades — when you're done, you know ⁴. A month in, if you get occasional hemorrhoid flares, they come back less often; the bad-fiber weeks still happen but the floor doesn't drop as far. A year in, the change goes quiet: you stop noticing how long bowel movements take because they don't take long.