I recently became a contributing medical expert for the lifestyle website Lifehacker.com. My input was used on a recent article about what evidence there is on wiping your rear. Below is a more in depth, referenced look at the subject:
Medical Evidence on Wiping Your Bum
All of us do it: using your anus is (almost) as inevitable as dying. However, not all of us clean our rears in the same manner. The question is: have the billions spent on medical research found the healthiest way to wipe our bum?
And the short answer is… No. Not really. The long answer is that, obviously, there is not much money for research into butt wiping. All the studies quoted below share one thing in common: they are small, and thus not very reliable.
What evidence we do have shows that the paper you use can make a difference, with some people having reactions to moist wipes1, and recycled paper proving more irritant to those already with skin irritation around the anus2. There is no evidence that wiping causes haemorrhoids, although abrasive paper can make them worse3.
One well known claim is that wiping from front-to-back rather than back-to-front is healthier, especially in women, as it stops germ laden poo going into the cleaner urinary tract and causing a Urinary Tract Infection (UTI). It makes sense, but the scientific research is pretty patchy. If we look over the last decade, there were three key studies specifically commenting on wiping
- One study of wiping after passing urine, showed a small increase in infection when wiping back-to-front.4
- However, another study on college age women with UTIs showed that there was no increase5.
- A final one looking at how frequently women had a second or third UTI also showed no increase6.)).
If we look at the related topics of alternatives to wiping: Japanese toilets often contain a water jet and blow dryer that cleans the anus for you. Apparently, some Japanese doctors are now claiming to be seeing cases of “Washlet Syndrome”, where cleaning that is too effective leads to problems such as weak sphincter muscles, dry skin and anal sores7. However, I was unable to track down a documented case study, though this may be more down to my inadequate Japanese than anything else.
Worldwide, whilst most of us in the West sit down to go to the loo, there is some more, again patchy, evidence that points to squat toilets being the healthier option8. Across the world, anal conditions such as haemorrhoids and colon cancer are less common, a statistic attributed to the high fibre diet that most of the third world eat910.
Finally, an honourable mention for one researcher, who has selflessly experimented with various alternatives for wiping, including dried corncob, rocks, newspaper, leaves and vinegar on a sponge11. Whilst his experimental methods leave much to be desired, it’s an entertaining read!
In conclusion: eat a diet high in fibre, then poo in a squatting position, and finish up by wiping front to back with soft, non moist, non recycled toilet paper. Or don’t, and you’ll probably still be fine.
- “Contact allergy to moist toilet paper” by de Groot et al. – Contact Dermatitis 1991;Volume 24, Issue 2:135–136 [↩]
- “Tolerance to Different Toilet Paper Preparations: Toxicological and Allergological Aspects” by Blecher et al. – Dermatology 1995;191:299-304 [↩]
- “What causes hemorrhoids? A new theory of etiology” by Graham-Stewart – Diseases of the Colon & Rectum 1963;6:5:333-344 [↩]
- “Association between urinary tract infection and postmicturition wiping habit” by Persad et al. – Acta Obstetricia et Gynecologica Scandinavica 2006;85:11:1395-1396 [↩]
- “Urinary Tract Infection in the Adult Female: Pathophysiology, Evaluation, and Treatment” by Heisler et al. – Journal of Pelvic Medicine & Surgery 2008;1:1-14 [↩]
- “Risk Factors for Second Urinary Tract Infection among College Women” by Foxman et al. – American Journal of Epidemiology 2000;151(12):1194-1205 [↩]
- Washlet Syndrome on Wikipedia – http://en.wikipedia.org/wiki/Toilets_in_Japan#Washlet_Syndrome : Last accessed 2/6/11 [↩]
- “Squatting for the Prevention of Haemorrhoids?” by Martin et al. – Townsend Letter for Doctors & Patients 1996;159:66-70 [↩]
- “Office evaluation and treatment of hemorrhoids” by Alonso-Coello et al. – The Journal of Family Practice 2003;52:5:366-374 [↩]
- “Effect of dietary fibre on stools and transit-times, and its role in the causation of disease” by Burkitt et al. – The Lancet 1972;300:7792:1408-1411 [↩]
- Techniques of Wiping – http://www.poopreport.com/Techniques/Content/Wiping/wipingbc.html : Last accessed 2/6/11 [↩]