Does a Toilet Footstool Actually Help?

Short answer: probably a little. Raising your feet puts you closer to a squat, which widens the angle your stool has to travel through and tends to mean less straining. The measurements behind that come from very small studies. It is a minor, cheap improvement rather than a fix, and a stack of books or an old step stool does the identical job for nothing.

I need to say something before the rest of this. There is a footstool linked at the bottom of this page and I earn a commission if you buy it. That is exactly why I would rather tell you to try the books first. If the books work, keep your money, and I would rather have you reading this site next year than have your click today.

Does a toilet footstool actually help hemorrhoids?

Not by acting on the hemorrhoids. Nothing about where your feet are does anything to a swollen vein.

What it may do is reduce straining, and straining is where the honest connection lives. Cleveland Clinic describes hemorrhoids and anal fissures as both commonly following straining too much to poop, with a fissure caused by the trauma of pushing hard stool through. NIDDK similarly lists straining and certain toilet habits among the causes of hemorrhoids.

So the chain is: less straining is good for you, and a footstool may give you less straining. That is two steps, and each one is worth stating separately, because the marketing tends to collapse them into “this fixes hemorrhoids.” It does not, and nobody has shown that it does.

What does the research actually show?

Less than the internet implies, and it is worth knowing what you are relying on.

The mechanism study everyone cites is Sakakibara and colleagues, 2010, which used videomanometry to measure the anorectal angle and abdominal pressure in three positions. Squatting produced a wider anorectal angle than normal sitting, roughly 126 degrees against 100, along with lower abdominal pressure and a straighter path out. That is a real, measured finding. It is also a study of six healthy volunteers. Six.

The outcome study is Modi and colleagues, 2019, published in the Journal of Clinical Gastroenterology. Fifty-two healthy participants recorded over a thousand bowel movements across four weeks, two weeks without a footstool device and two weeks with. Using it was associated with a better sense of complete emptying, less straining, and shorter time on the toilet. Two thirds of them said they planned to keep using it. Encouraging. Also self-reported diaries, no blinding possible, healthy volunteers rather than people with hemorrhoids or a fissure, and a design where knowing you are in the interesting phase can shape what you write down.

The most useful thing I found was a 2025 scoping review in BMC Public Health that looked across 42 studies of toilet posture. Its summary is that squatting may reduce strain and improve bowel evacuation, and that methodological limitations, including small sample sizes and inadequate control of confounders, prevent definitive conclusions.

That is the honest state of the evidence. Directionally positive, thin underneath.

Do I need to buy a special one?

No, and I want to be blunt about this because everything else on the internet will not be.

Cleveland Clinic’s self-care advice for anal fissures says to use a step stool to support your feet so your hips sit in a squatting position. A step stool. Not a brand, not a contoured product, not a specific height.

Anything that gets your knees above your hips does the job. A stack of books. An old step stool from the garage. An upturned crate. Two thick shoeboxes. A child’s plastic step. Try one of those for a week and see whether you notice anything. If you find you are using it every day and the shaped one is more comfortable, or the improvised version keeps sliding, or you want something that tucks under the bowl and does not make your bathroom look like a storage unit, then buy one. Those are all legitimate reasons. “It might fix my hemorrhoids” is not one.

How do you actually use it?

Feet flat, knees clearly above your hips. Lean forward slightly with your forearms on your thighs. Then breathe out and let it happen rather than bearing down hard.

The thing people get wrong is treating the stool as permission to push more efficiently. The whole point is to push less. If you are still straining with your feet up, the position is not the problem, the stool consistency is.

And keep it short. Get in, go, get out, leave the phone outside. Sitting on a toilet for twenty minutes reading your phone is its own risk factor and no amount of foot elevation cancels it.

Where does this rank against everything else?

Somewhere near the bottom of the list of things that mattered for me.

The order that makes sense is stool softness first, then not delaying when you feel the urge, then position. Fiber and water are what stop hard stool from re-tearing a fissure. If you sort out your posture while still passing hard stool, you have improved the angle at which you injure yourself.

My own recovery came from daily psyllium, real meals instead of skipped ones, and better hygiene. The footstool was a standard clinician recommendation I added on top, not the thing that turned it around, and I am not going to retroactively promote it into a starring role. If you want the piece that actually did the work, it is the fiber and the four-week timeline, and if you want the thing that helps most with pain right now, that is a warm sitz bath.

When is position not the problem at all?

If you are straining hard even when your stool is soft, or you feel blocked, or nothing moves despite the urge, then a footstool is not your answer. Cleveland Clinic lists obstructed defecation and anismus, also called dyssynergic defecation, as recognised conditions where the muscles do not coordinate properly. Those need assessment and sometimes biofeedback training, not a plastic step.

Same for anything on the red flags list. Bleeding, pain that has been running for weeks, a change in bowel habits that stuck around. A footstool is a comfort adjustment. It is not a reason to postpone being looked at, and I postponed for four years, which is the single thing I would take back. This is my experience next to published sources, not medical advice.

What to do tonight

Put two books under your feet. That is it. Cost you nothing, takes ten seconds.

Give it a week and pay attention to whether you are pushing less and getting out faster. If yes, you have learned something real about your own body, and you can then decide whether a purpose-built one is worth it to you. If nothing changes, you have saved yourself a purchase and you now know the problem is upstream, in what you are eating and drinking, which is where it usually is.