The best way to clean your bottom.

A colon/rectal surgeon's take on bidets and the shortage of toilet paper.

I am not sure why there is a run on toilet paper as a result of the present pandemic. It is not that this infection causes significant diarrhea. My thoughts on perineal hygiene in this age of toilet paper scarcity...

Using toilet paper to clean up after a bowel movement is really not the best way to do it. Imagine having a shower by just wiping down with dry tissue paper. In my humble opinion, I have to give credit to the bidet (pronounced Bee-day) as the best way of doing this. Essentially, using a bidet, one cleans with a jet of water, leaving the area free of fecal residue with it's objectionable odor and irritation from the waste products left on the skin by the fecal bacteria not removed and allowed to breed on this tender strip of skin. Women are more prone to urinary tract and vaginal infections as a result of not cleaning properly. Men leave malodorous skid marks on their underwear.

Toilet paper has only been available for the process since the late 1800s. Prior to this we used what we had available; in the the desert, our forefathers (and mothers) used sand (water being scarce); in most Eastern civilizations, water, used when a nearby stream flowed or a convenient well had been dug, leaves in forested climes, and more recently in the Appalachians and many mid-West states, corn cobs, were preferred. I have not heard of the Egyptians using papyrus or the Chinese making do with paper (which they actually invented before they did gun powder).

The simplest, low tech option is a plastic squeeze bottle with an angled tip that can be bought for a few dollars, filled with warm water and used repeatedly.  This method of perineal cleansing has been used effectively by mothers after natural childbirth.

Bidets are rare in North American culture, but are becoming increasingly popular. The ideal set up is to have a dedicated bidet installed beside one's commode. There are now ingenious alternatives being offered. A good option is one called “Clear Rear”, priced now at $80 (under $50 a few months ago). This easily attaches to your existing plumbing and offers a very satisfactory cleaning of the perineum with a strong jet of water. It can be installed in about 15 minutes using nothing but an adjustable wrench and a screwdriver.

The "bottom" line- Life will go on just fine without toilet paper!



Marcus M. Aquino, MD Marcus M. Aquino, MD Surgeon

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