Anal hygiene

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Anal hygiene [1] refers to practices (anal cleansing) [2] that are performed on the anus to maintain personal hygiene, usually immediately or shortly after defecation. Anal cleansing may also occur while showering or bathing. Post-defecation cleansing is rarely discussed academically, [2] partly due to the social taboo surrounding it. The scientific objective of post-defecation cleansing is to prevent exposure to pathogens. [2]

Contents

The process of post-defecation cleansing involves washing the anus and inner part of the buttocks with water. Water-based cleansing typically involves either the use of running water from a handheld vessel and a hand for washing or the use of pressurized water through a jet device, such as a bidet. In either method, subsequent hand sanitization is essential [2] to achieve the ultimate objectives of post-defecation cleansing.

History

Anal cleansing instruments known as chugi from the Nara period (710 to 784) in Japan. The modern rolls in the background are for size comparison. Nara period toilet paper.jpg
Anal cleansing instruments known as chūgi from the Nara period (710 to 784) in Japan. The modern rolls in the background are for size comparison.

Materials

The ancient Greeks were known to use fragments of ceramic, known as pessoi (πεσσοί), to perform anal cleansing. [3]

The ancient Romans used a tersorium (Greek : xylospongium), consisting of a sponge on a wooden stick. The stick would be soaked in a water channel in front of a toilet, and then stuck through the hole built into the front of the toilet [4] for anal cleaning. [5] [6] The tersorium was shared by people using public latrines. To clean the sponge, they washed it in a bucket with water and salt or vinegar. However, this became a breeding ground for bacteria, causing the spread of disease in the latrine.[ citation needed ]

In ancient Japan, wooden skewers known as chuugi ("shit sticks") were used for post-defecation cleaning.[ citation needed ]

The use of toilet paper first started in ancient China around the 2nd century BC. [1] [7] According to Charlier (2012), French physician François Rabelais had argued about the ineffectiveness of toilet paper in the 16th century. [1] The first commercially available toilet paper was invented by American entrepreneur Joseph Gayetty in 1857, with the dawning of the Second Industrial Revolution. [8]

Facilities

Post-defecation facilities evolved with human civilization, and thus, so did post-defecation cleansing. According to Fernando, [9] there is archeological evidence of toilet use in medieval Sri Lanka, ranging from the 6th-century Abhayagiri Complex in Anuradhapura; the 10th-century Pamsukulika Monastery in Ritigala, and the Baddhasimapasada and the Alahana Pirivena hospital complex in Polonnaruwa; to the 12th-century hospital toilet in Mihintale.[ citation needed ] These toilets were found to be with a complete system of plumbing and sewage with multi-stage treatment plants. According to Buddhism, toilet etiquettes (Wachchakutti Wattakkandaka in Pali language) were enumerated by Buddha himself in Tripitaka, the earliest collection of Buddhist teachings.[ citation needed ]

Common methods

Washing

In countries that have predominantly Catholic, [10] Eastern Orthodox, [11] Hindu, Buddhist, [12] or Islamic cultural traditions, water is usually used for anal cleansing. It is also practiced in some Protestant cultures, such as that of Finland. [13] The cleaning process is typically done through either a pressurized device (e.g., a bidet or a bidet shower) or a non-pressurized vessel (e.g., a lota or an aftabeh) alongside a person's hand; many cultures assert that only the left hand is to be used for this task. Washing is sometimes followed by drying the cleaned areas with a cloth towel.

Wiping

In some parts of the developing world and in other areas where water may not always be usable, such as during camping trips, materials such as vegetable matter (leaves), mudballs, snow, corncobs, and stones are sometimes used for anal cleansing. [14] [15] Having hygienic means for anal cleansing available at the toilet or site of defecation is important for overall public health. The absence of proper materials in households can, under some circumstances, be correlated to the number of diarrhea episodes per household. [16] The history of anal hygiene, from the Greco-Roman world to ancient China and ancient Japan, involves the widespread use of sponges and sticks as well as water and paper.

The inclusion of anal cleansing facilities is often overlooked in the design of public or shared toilets in developing countries. In most cases, materials for anal cleansing are not made available within those facilities. Ensuring safe disposal of anal cleansing materials is often overlooked, which can lead to unhygienic debris inside or surrounding public toilets that contributes to the spread of diseases. [17]

Cultural preferences

Water

Top view of a bidet Bidet top.jpg
Top view of a bidet
A bidet shower or "health faucet" Bidee shower.jpg
A bidet shower or "health faucet"

Water with soap cleansing is a reliable and hygienic way of removing fecal remnants.

Muslim societies

The use of water in Muslim countries is due in part to Islamic toilet etiquette which encourages washing after all instances of defecation.[ citation needed ] There are flexible provisions for when water is scarce: stones or papers can be used for cleansing after defecation instead.[ citation needed ]

In Turkey, all Western-style toilets have a small nozzle on the centre rear of the toilet rim aiming at the anus. This nozzle is called taharet musluğu and it is controlled by a small tap placed within hand's reach near the toilet. It is used to wash the anus after wiping and drying with toilet paper. Squat toilets in Turkey do not have this kind of nozzle (a small bucket of water from a hand's reach tap or a bidet shower is used instead).[ citation needed ]

Another alternative resembles a miniature shower and is known as a "health faucet", bidet shower, or "bum gun". It is commonly found to the right of the toilet where it is easy to reach. These are commonly used in the Muslim world. In the Indian subcontinent, a lota vessel is often used to cleanse with water, though the shower or nozzle is common among new toilets.[ citation needed ]

Christian societies

The use of water in many Christian countries is due in part to the biblical toilet etiquette which encourages washing after all instances of defecation. [18] The bidet is common in predominantly Catholic countries where water is considered essential for anal cleansing. [19] [20]

Some people in Europe and the Americas use bidets for anal cleansing with water. Bidets are common bathroom fixtures in many Western and Southern European countries and many South American countries, [21] [22] [23] while bidet showers are more common in Finland [24] and Greece. The availability of bidets varies widely within this group of countries. Furthermore, even where bidets exist, they may have other uses than for anal washing. In Italy, the installation of bidets in every household and hotel became mandatory by law on July 5, 1975. [22]

East Asia

A Japanese toilet with integrated bidet spraying water for cleaning. The water jet is used to wash the anus and buttocks after defecation. JapaneseToiletBidet.jpg
A Japanese toilet with integrated bidet spraying water for cleaning. The water jet is used to wash the anus and buttocks after defecation.

The first "paperless" toilet seat was invented in Japan in 1980. A spray toilet seat, commonly known by Toto's trademark Washlet, is typically a combination of seat warmer, bidet and drier, controlled by an electronic panel or remote control next to the toilet seat. A nozzle placed at rear of the toilet bowl aims a water jet to the anus and serves the purpose of cleaning. Many models have a separate "bidet" function aimed towards the front for vaginal cleansing. The spray toilet seat is common only in Western-style toilets, and is not incorporated in traditional style squat toilets. Some modern Japanese bidet toilets, especially in hotels and public areas, are labeled with pictograms to avoid language problems, and most newer models have a sensor that will refuse to activate the bidet unless someone is sitting on the toilet.

A modern bidet of the traditional type, available in many southern European and South American countries Bidet weiss.jpg
A modern bidet of the traditional type, available in many southern European and South American countries

Southeast Asia

In Southeast Asian countries such as Indonesia, the Philippines, [26] Thailand, Brunei, Malaysia, and East Timor, [27] house bathrooms usually have a medium size wide plastic dipper (called gayung in Indonesia, tabo in the Philippines, ขัน (khan) in Thai) or large cup, which is also used in bathing. In Thailand, the "bum gun" is ubiquitous. [28] Some health faucets are metal sets attached to the bowl of the water closet, with the opening pointed at the anus. Toilets in public establishments mainly provide toilet paper for free or dispensed, though the dipper (often a cut up plastic bottle or small jug) is occasionally encountered in some establishments. Owing to its ethnic diversity, restrooms in Malaysia often feature a combination of anal cleansing methods where most public restrooms in cities offer toilet paper as well as a built in bidet or a small hand-held bidet shower (health faucets) connected to the plumbing in the absence of a built-in bidet.

In Vietnam, people often use a bidet shower. [29] [28] It is usually available both at general households and public places.

Toilet paper

Western world and Sub-Saharan Africa

A roll of toilet paper Toiletpapier (Gobran111).jpg
A roll of toilet paper

In some cultures—such as many Western countries—cleaning after defecation is generally done with toilet paper only, until the person can bathe or shower. Toilet paper is considered a very important household commodity in Western culture, as illustrated by the panic buying of toilet paper in many Western countries during the COVID-19 pandemic. [30] [31]

In some parts of the world, especially before toilet paper was available or affordable, the use of newspaper, telephone directory pages, or other paper products was common. In North America, the widely distributed Sears Roebuck catalog was also a popular choice until it began to be printed on glossy paper (at which point some people wrote to the company to complain). [32] [33] With flush toilets, using newspaper as toilet paper is likely to cause blockages.

This practice continues today in parts of Africa; while rolls of toilet paper are readily available, they can be fairly expensive, prompting poorer members of the community to use newspapers.

People suffering from hemorrhoids may find it more difficult to keep the anal area clean using only toilet paper and may prefer washing with water as well. [34]

Although wiping from front to back minimizes the risk of contaminating the urethra, the directionality of wiping varies based on sex, personal preference, and culture.

Some people wipe their anal region standing while others wipe theirs sitting. [35]

Other methods and materials

Wet wipes and gel wipes

When cleaning babies' buttocks during diaper changes wet wipes are often used, in combination with water if available. As wet wipes are produced from plastic textiles made of polyester or polypropylene, they are notoriously bad for sewage systems as they do not decompose, although the wet wipe industry maintains they are biodegradable but not "flushable". [36] [37] [38]

A product of the 21st century, special foams, sprays and gels can be combined with dry toilet paper as alternatives to wet wipes. A moisturizing gel can be applied to toilet paper for personal hygiene or to reduce skin irritation from diarrhea. This product is called gel wipe. [39]

Pre-wipes

Novel pre-wipes and methods are disclosed for assisting in the cleaning of skin in the anal area. The pre-wipes comprise an anti-adherent formulation and are wiped across the anal region of a user prior to defecation to introduce a film of the anti-adherent formulation onto the anal region. This film reduces the amount of fecal material that is retained in the anal region after defecation and reduces the amount of cleanup required. This reduced amount of cleanup results in cleaner, healthier skin. [40]

Natural materials

Stones, leaves, corn cobs and similar natural materials may also be used for anal cleansing. [41] : 162 

Related Research Articles

<span class="mw-page-title-main">Toilet paper</span> Tissue paper for cleaning after defecation or urination

Toilet paper is a tissue paper product primarily used to clean the anus and surrounding region of feces, and to clean the external genitalia and perineal area of urine.

<span class="mw-page-title-main">Defecation</span> Expulsion of feces from the digestive tract

Defecation follows digestion, and is a necessary process by which organisms eliminate a solid, semisolid, or liquid waste material known as feces from the digestive tract via the anus or cloaca. The act has a variety of names ranging from the common, like pooping or crapping, to the technical, e.g. bowel movement, to the obscene (shitting), to the euphemistic, to the juvenile. The topic, usually avoided in polite company, can become the basis for some potty humor.

<span class="mw-page-title-main">Hygiene</span> Practices performed to preserve health

Hygiene is a set of practices performed to preserve health. According to the World Health Organization (WHO), "Hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases." Personal hygiene refers to maintaining the body's cleanliness. Hygiene activities can be grouped into the following: home and everyday hygiene, personal hygiene, medical hygiene, sleep hygiene, and food hygiene. Home and every day hygiene includes hand washing, respiratory hygiene, food hygiene at home, hygiene in the kitchen, hygiene in the bathroom, laundry hygiene,and medical hygiene at home.And also environmental hygiene in the society to prevent all kinds of bacterias from penetrating into our homes.

<span class="mw-page-title-main">Washing</span> Method of cleaning

Washing is a method of cleaning, usually with water and soap or detergent. Regularly washing and then rinsing both body and clothing is an essential part of good hygiene and health.

<span class="mw-page-title-main">Bidet</span> Plumbing fixture or type of sink intended for washing the genitalia and anus of the human body

A bidet is a bowl or receptacle designed to be sat upon in order to wash a person's genitalia, perineum, inner buttocks, and anus. The modern variety has a plumbed-in water supply and a drainage opening, and is thus a plumbing fixture subject to local hygiene regulations. The bidet is designed to promote personal hygiene and is used after defecation, and before and after sexual intercourse. It can also be used to wash feet, with or without filling it up with water. Some people even use bidets to bathe babies or pets. In several European countries, a bidet is now required by law to be present in every bathroom containing a toilet bowl. It was originally located in the bedroom, near the chamber-pot and the marital bed, but in modern times is located near the toilet bowl in the bathroom. Fixtures that combine a toilet seat with a washing facility include the electronic bidet.

<span class="mw-page-title-main">Hand washing</span> Act of cleaning ones hands

Hand washing, also known as hand hygiene, is the act of cleaning one's hands with soap or handwash and water to remove viruses/bacteria/microorganisms, dirt, grease, and other harmful or unwanted substances stuck to the hands. Drying of the washed hands is part of the process as wet and moist hands are more easily recontaminated. If soap and water are unavailable, hand sanitizer that is at least 60% (v/v) alcohol in water can be used as long as hands are not visibly excessively dirty or greasy. Hand hygiene is central to preventing the spread of infectious diseases in home and everyday life settings.

<span class="mw-page-title-main">Shower</span> Place in which a person bathes under a spray of water

A shower is a place in which a person bathes under a spray of typically warm or hot water. Indoors, there is a drain in the floor. Most showers have temperature, spray pressure and adjustable showerhead nozzle. The simplest showers have a swivelling nozzle aiming down on the user, while more complex showers have a showerhead connected to a hose that has a mounting bracket. This allows the showerer to hold the showerhead by hand to spray the water onto different parts of their body. A shower can be installed in a small shower stall or bathtub with a plastic shower curtain or door. Showering is common due to the efficiency of using it compared with a bathtub. Its use in hygiene is, therefore, common practice.

<span class="mw-page-title-main">Squat toilet</span> Toilet used by squatting

A squat toilet is a toilet used by squatting, rather than sitting. This means that the posture for defecation and for female urination is to place one foot on each side of the toilet drain or hole and to squat over it. There are several types of squat toilets, but they all consist essentially of a toilet pan or bowl at floor level. Such a toilet pan is also called a "squatting pan". A squat toilet may use a water seal and therefore be a flush toilet, or it can be without a water seal and therefore be a dry toilet. The term "squat" refers only to the expected defecation posture and not any other aspects of toilet technology, such as whether it is water flushed or not.

<span class="mw-page-title-main">Toilets in Japan</span>

Toilets in Japan are sometimes designed more elaborately than toilets commonly seen in other developed nations. European toilets occasionally have a separate bidet whilst Japan combines an electronic bidet with the toilet. The current state of the art for Western-style toilets in Japan is the bidet toilet, which as of March 2016 is installed in 81% of Japanese households. In Japan, these bidets are commonly called washlets, a brand name of Toto Ltd., and they may include many advanced features rarely seen outside of Asia. The basic feature set commonly found on washlets consists of anal hygiene, bidet washing, seat warming, and deodorization.

<span class="mw-page-title-main">Washlet</span> Toilet by the Japanese company Toto

Washlet is a Japanese line of cleansing toilet seats manufactured and sold by the company Toto. The electronic bidet features a water spray element for genital and anal cleansing. and commonly appears on toilets all over Japan. The device was released in June 1980 and as of January 2022, Toto has sold more than 60 million units.

<span class="mw-page-title-main">Wet wipe</span> Small moistened piece of paper or cloth

A wet wipe, also known as a wet towel, wet one, moist towelette, disposable wipe, disinfecting wipe, or a baby wipe is a small to medium-sized moistened piece of plastic or cloth that either comes folded and individually wrapped for convenience or, in the case of dispensers, as a large roll with individual wipes that can be torn off. Wet wipes are used for cleaning purposes like personal hygiene and household cleaning; each is a separate product depending on the chemicals added and medical or office cleaning wipes are not intended for skin hygiene.

<span class="mw-page-title-main">Anal plug</span> Medical device sometimes used to treat fecal incontinence

An anal plug is a medical device that is often used to treat fecal incontinence, the accidental passing of bowel moments, by physically blocking involuntary loss of fecal material. Fecal material such as feces are solid remains of food that does not get digested in the small intestines; rather, it is broken down by bacteria in the large intestine. Anal plugs vary in design and composition, but they are typically single-use, intra-anal, disposable devices made out of soft materials to contain fecal material and prevent it from leaking out of the rectum. The idea of an anal insert for fecal incontinence was first evaluated in a study of 10 participants with three different designs of anal inserts.

Personal care products are consumer products which are applied on various external parts of the body such as skin, hair, nails, lips, external genital and anal areas, as well as teeth and mucous membrane of the oral cavity, in order to make them clean, protect them from harmful germs and keep them in good condition. They promote personal hygiene and overall health, well-being and appearance of those body parts. Toiletries form a narrower category of personal care products which are used for basic hygiene and cleanliness as a part of a daily routine. Cosmetic products, in contrast, are used for personal grooming and beautification. Pharmaceutical products are not considered personal care products.

<span class="mw-page-title-main">Toilet</span> Piece of hardware for the collection or disposal of human excreta

A toilet is a piece of sanitary hardware that collects human urine and feces, and sometimes toilet paper, usually for disposal. Flush toilets use water, while dry or non-flush toilets do not. They can be designed for a sitting position popular in Europe and North America with a toilet seat, with additional considerations for those with disabilities, or for a squatting posture more popular in Asia, known as a squat toilet. In urban areas, flush toilets are usually connected to a sewer system; in isolated areas, to a septic tank. The waste is known as blackwater and the combined effluent, including other sources, is sewage. Dry toilets are connected to a pit, removable container, composting chamber, or other storage and treatment device, including urine diversion with a urine-diverting toilet.

<span class="mw-page-title-main">Bidet shower</span> Hand-held triggered nozzle

A bidet shower—also known as a handheld bidet, commode shower, toilet shower, health faucet, bum shower, jet spray, hand shower, Muslim shower, shatafa or bum gun—is a hand-held triggered nozzle that is placed near the toilet and delivers a spray of water used for anal cleansing and cleaning of the genitals after using the toilet for defecation and urination. The device is similar to that of a kitchen sink sprayer.

<span class="mw-page-title-main">Toilet (room)</span> Room for privately accessing a toilet, and often handwashing sink

A toilet is a small room used for privately accessing the sanitation fixture (toilet) for urination and defecation. Toilet rooms often include a sink (basin) with soap/handwash for handwashing, as this is important for personal hygiene. These rooms are typically referred to in North America as half-bathrooms in a private residence.

<span class="mw-page-title-main">Xylospongium</span> Ancient Roman implement for anal hygiene

The xylospongium or tersorium, also known as a "sponge on a stick", was a utensil found in ancient Roman latrines, consisting of a wooden stick with a sea sponge fixed at one end.

<span class="mw-page-title-main">Electronic bidet</span> Nozzle attached to an existing toilet, or a part of the toilet itself

An electronic bidet is a seat attached to an existing toilet or a part of the toilet itself, with a nozzle to squirt a jet of warm water for cleaning the anus and female genitals, electrically powered and with electronic controls. It replaces the conventional bidet, a separate plumbing fixture not attached to a toilet. Some bidets of this type have one adjustable nozzle on the side rim for anus and genital areas, or two nozzles on the back rim, a shorter "family nozzle" for washing the area around the anus, and a longer "bidet nozzle" for women to wash their vulva.

<span class="mw-page-title-main">Tabo (hygiene)</span> Traditional cleaning tool in the Philippines, Indonesia, Cambodia, East Timor, Malaysia, and Brunei

The tabò is the traditional hygiene tool primarily for cleansing, bathing, and cleaning the floor of the bathroom in the Philippines, Indonesia, East Timor, Malaysia, Vietnam and Brunei. Tabò is the Filipino name, while gayung and cebok are the equivalent terms used in Indonesia, Brunei, Malaysia, and East Timor. Its Vietnamese name is thau tắm or chậu nước. The tabò could most commonly be in found rural areas though it is also widely used in cities. The word may be related to the word cebok in Indonesia and Malaysia, which describes the process of cleansing oneself using a tabò in a mandi.

<span class="mw-page-title-main">Intelligent toilet</span> Toilet with built-in technology for hygiene, comfort and health

An intelligent toilet or smart toilet is a bathroom plumbing fixture or type of electronic bidet toilet which incorporates traditional bidet cleansing, with the added enhancement of modern SMART home technology.

References

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