This is a topic I’d never run across online until recently. In the anal hygeine department, it looks like the Europeans and Japanese—with their bidets—are ahead of us in North America.
To keep your backside happy, Goldstein [a rectal surgeon] recommended using a patting motion rather than a wiping motion and being as gentle as possible. Ideally, he added, you should use a bidet to clean yourself and then pat the excess water dry with a bit of toilet paper if need be.
Asbury [a dermatologist] is an advocate of the standalone or add-on toilet accessory that squirts a spray of water between your cheeks to flush out residual fecal matter. While bidets are common in Europe and Japan, the West has been slower to adopt this superior method of post-poop clean-up; others might be wary of tapping into existing home plumbing to supply fresh water, even though DIY installation is quite easy. For those patients, Asbury has developed an alternative method.
TRY PAPER TOWELS AND WATER
“What I tell people to use is Viva, a really soft, thick paper towel made by Kleenex,” he says. “You get a squirt bottle and you leave it near the toilet and moisten the paper towel.” Regular toilet paper is usually too flimsy to stand up to a soaking, while normal paper towels are too harsh for rectal purposes. Viva is apparently just right. (And no, Asbury is not a brand ambassador, nor does Kleenex endorse this alternative use.)
This advice does come with a major caveat: Viva wipes are not flushable and might very well clog your pipes if you try to send them down the drain.
When it comes to wiping, less is more and not just because it keeps you from replacing the toilet paper roll every other day. “Overwiping can irritate the perianal skin and lead to small abrasions that trigger inflammation and itching,” Sheth [a gastroenterologist] says. One or two wipes are all it takes, he says. If you need to wipe more than that you may not have completely emptied your system or you could be constipated (in which case, up your fiber and water intake like you would to prevent hemorrhoids). If you still require more than a few wipes, consider switching to wet toilet paper or unscented baby wipes. “Moist wipes decrease the friction of wiping and cause less irritation,” Sheth says.
The first two links recommend against baby wipes.
Many people cannot bear the thought of a dirty anus and they go to great lengths to keep their anus spotlessly clean using large amounts of toilet paper and vigorously washing the area, especially after defaecation. Unfortunately this breaks down the fragile anal skin and then this usually effective barrier to bacteria lets in microbes to the surrounding tissues. This is very irritating to local nerves and people then get in to a viscious cycle because they get itchy, feeling the need to clean the anus even more, which breaks down the anal skin barrier even further. Therefore it is ironically and usually the cleanest people that end up in my specialist bowel surgery clinic rather than the dirtiest!
The first thing to do is to break the vicious cycle and I recommend that people tone down their anal cleaning routine. Fingernails and abrasive materials such as rough toilet paper should be kept away from the anus. Non-scented baby wipes or luxury toilet tissue are usually the kindest and most effective ways of wiping the bottom after opening the bowels. Running water is the best way to wash the anal surfaces.
Often people think that they must keep on wiping their bottom with toilet paper until they do not see any more brown smears on the toilet paper but this can cause significant damage. Instead people should stop wiping when the brown smears have lessened but before they rub their fragile anal skin raw.
All of this provides a mixed view on the ideal material for wiping. Water is very good, because it’s gentle and won’t cause tears, but you want to stay away from residual moistness. Toilet paper isn’t bad, because it easily soaks up any moisture, but it also can be a little rough, which is bad. The ideal method would probably be a water bath followed by careful, gentle, and immediate drying, whether that’s with toilet paper or a jet of warm air.
For a history of anal hygeine and a tour of various cultures, visit Toilet Guru.
Steve Parker, M.D.