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Anal hygiene or anal cleansing refers to hygienic practices that are performed on a person's
anus The anus (Latin, 'ring' or 'circle') is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, the residual semi-solid waste that remains after food digestion, which, d ...
, usually shortly after
defecation Defecation (or defaecation) 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. The act has a variety of names ranging ...
. Post-defecation cleansing is rarely discussed academically, partly due to the social taboo. The scientific objective of post-defecation cleansing is to prevent exposure to pathogens while socially it becomes a cultural norm. The process of post-defecation cleansing involves either rinsing the anus and inner part of the
buttocks The buttocks (singular: buttock) are two rounded portions of the exterior anatomy of most mammals, located on the posterior of the pelvic region. In humans, the buttocks are located between the lower back and the perineum. They are compose ...
with water or wiping the area with dry materials such as toilet paper. In water-based cleansing, either a hand is used for rubbing the area while rinsing it with the aid of running water or (in
bidet A bidet ( or ) is a bowl or receptacle designed to be sat on in order to wash one'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 ...
systems) pressurized water does the job. In either method subsequent hand sanitization is essential to achieve the ultimate objectives of post-defecation cleansing.


History

Ancient Greeks were known to use fragments of ceramic known as ''pessoi'' to perform anal cleansing. Roman anal cleansing was done with a sponge on a stick called a '' tersorium'' (). 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 for anal cleaning. 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. This became a breeding ground for bacteria, causing the spread of disease in the latrine. In ancient Japan, a wooden skewer known as ''
chuugi Shit stick means "a thin stake or stick used instead of toilet paper" for anal hygiene and was a historical item of material culture introduced through Chinese Buddhism and Japanese Buddhism. A well-known example is ''gānshǐjué''/''kanshikets ...
'' ("
shit stick Shit stick means "a thin stake or stick used instead of toilet paper" for anal hygiene and was a historical item of material culture introduced through Chinese Buddhism and Japanese Buddhism. A well-known example is ''gānshǐjué''/''kanshiketsu' ...
s") was used for cleaning after defecation. The use of toilet paper for post-defecation cleansing first started in China in the 2nd century BC.Needham, Volume 5, Part 1, 123. According to Charlier (2012) French novelist (and physician) François Rabelais had argued about the ineffectiveness of toilet paper in the 16th century. The first commercially available toilet paper was invented by Joseph Gayetty, a New York entrepreneur, in 1857 with the dawning of the second industrial revolution.


Cultural preferences

In predominantly
Catholic countries The Catholic Church is "the Catholic Communion of Churches, both Roman and Eastern, or Oriental, that are in full communion with the Bishop of Rome (the pope)." The church is also known by members as the People of God, the Body of Christ, th ...
,
Eastern Orthodox Eastern Orthodoxy, also known as Eastern Orthodox Christianity, is one of the three main branches of Chalcedonian Christianity, alongside Catholicism and Protestantism. Like the Pentarchy of the first millennium, the mainstream (or " canoni ...
, Hindu,
Buddhist Buddhism ( , ), also known as Buddha Dharma and Dharmavinaya (), is an Indian religion or philosophical tradition based on teachings attributed to the Buddha. It originated in northern India as a -movement in the 5th century BCE, and ...
and Muslim cultures, and in some Protestant countries such as
Finland Finland ( fi, Suomi ; sv, Finland ), officially the Republic of Finland (; ), is a Nordic country in Northern Europe. It shares land borders with Sweden to the northwest, Norway to the north, and Russia to the east, with the Gulf of Bo ...
, as well as in
Southeast Asia Southeast Asia, also spelled South East Asia and South-East Asia, and also known as Southeastern Asia, South-eastern Asia or SEA, is the geographical United Nations geoscheme for Asia#South-eastern Asia, south-eastern region of Asia, consistin ...
and
Southern Europe Southern Europe is the southern region of Europe. It is also known as Mediterranean Europe, as its geography is essentially marked by the Mediterranean Sea. Definitions of Southern Europe include some or all of these countries and regions: Alba ...
and
Latin America Latin America or * french: Amérique Latine, link=no * ht, Amerik Latin, link=no * pt, América Latina, link=no, name=a, sometimes referred to as LatAm is a large cultural region in the Americas where Romance languages — languages derived ...
, water is usually used for anal cleansing, using a jet ( bidet shower,
bidet A bidet ( or ) is a bowl or receptacle designed to be sat on in order to wash one'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 ...
) or vessel (
lota Lota may refer to: Places *Lota (crater), a crater on Mars *Lota, Chile, a city and commune in Chile *Lota, Punjab, village in Pakistan *Lota, Queensland, a suburb of Brisbane, Australia **Lota railway station, a station on the Cleveland line **Lo ...
, aftabeh), and a person's hand (in some places only the left hand is used). Cleaning with water is sometimes followed by drying the anal region and hand with a cloth towel or toilet paper. On the other hand, in some parts of
developing countries A developing country is a sovereign state with a lesser developed Industrial sector, industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is al ...
and during camping trips, materials such as vegetable matter (leaves), mudballs, snow (water), corncobs, and stones are sometimes used for anal cleansing. Having hygienic means for anal cleansing available at the
toilet A toilet is a piece of sanitary hardware that collects human urine and Human feces, feces, and sometimes toilet paper, usually for disposal. Flush toilets use water, while dry toilet, dry or non-flush toilets do not. They can be designed for ...
or site of defecation is important for overall
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
. The absence of proper materials in households can, under some circumstances, be correlated to the number of
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin ...
episodes per household. The history of anal hygiene, from ancient Rome and Greece to China and Japan, involves
sponges Sponges, the members of the phylum Porifera (; meaning 'pore bearer'), are a basal animal clade as a sister of the diploblasts. They are multicellular organisms that have bodies full of pores and channels allowing water to circulate throug ...
and sticks as well as water and paper. The inclusion of anal cleansing facilities is often overlooked when designing 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. Post-defecation facilities evolved with human civilization, thus, post-defecation cleansing. According to Fernando there are Sri Lankan archeological evidences of toilet use ranging from 936 AD at Pamsukulika monastery in Ritigala, sixth century Abhayagiri complex in Anuradhapura and at the Baddhasimapasada and the Alahana Pirivena hospital complex in Polonnaruwa to 12th century hospital toilet in Mihintale. These toilets were found to be with a complete system of plumbing and sewage with multistage treatment plants. According to Buddhism, toilet etiquettes (Wachchakutti Wattakkandaka in Pali language) were enumerated by Buddhas himself in Tripitaka (Three baskets), also known as Pali Canon, the earliest collection of Buddhist teachings.


Common methods


Water

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. There are flexible provisions for when water is scarce: stones or papers can be used for cleansing after defecation instead. In
Turkey Turkey ( tr, Türkiye ), officially the Republic of Türkiye ( tr, Türkiye Cumhuriyeti, links=no ), is a list of transcontinental countries, transcontinental country located mainly on the Anatolia, Anatolian Peninsula in Western Asia, with ...
, 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 A squat toilet (or squatting toilet) is a toilet used by squatting, rather than sitting. This means that the defecation posture used is to place one foot on each side of the toilet drain or hole and to squat over it. There are several types of sq ...
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). Another alternative resembles a miniature shower and is known as a "
health faucet A bidet shower —also known as a commode shower, toilet shower, bum 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 ...
", 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 The terms Muslim world and Islamic world commonly refer to the Islamic community, which is also known as the Ummah. This consists of all those who adhere to the religious beliefs and laws of Islam or to societies in which Islam is practiced. In ...
. In the
Indian subcontinent The Indian subcontinent is a physiographical region in Southern Asia. It is situated on the Indian Plate, projecting southwards into the Indian Ocean from the Himalayas. Geopolitically, it includes the countries of Bangladesh, Bhutan, India ...
, a
lota Lota may refer to: Places *Lota (crater), a crater on Mars *Lota, Chile, a city and commune in Chile *Lota, Punjab, village in Pakistan *Lota, Queensland, a suburb of Brisbane, Australia **Lota railway station, a station on the Cleveland line **Lo ...
vessel is often used to cleanse with water, though the shower or nozzle is common among new toilets.


Indian subcontinent

In India and the Indian subcontinent, over 95% of the population use water for cleansing the anal area after defecating. The cleaning of hands with soap/ liquid soap after this cleansing process is very important. In urban areas and newer settlements, bidet showers are widely used. Simpler toilet rooms or toilets in places without constant supply of running water generally use a
lota Lota may refer to: Places *Lota (crater), a crater on Mars *Lota, Chile, a city and commune in Chile *Lota, Punjab, village in Pakistan *Lota, Queensland, a suburb of Brisbane, Australia **Lota railway station, a station on the Cleveland line **Lo ...
or a mug along with buckets, and bails for storage of water and for the purpose of cleaning.


Southeast Asia

In Southeast Asian countries such as
Indonesia Indonesia, officially the Republic of Indonesia, is a country in Southeast Asia and Oceania between the Indian and Pacific oceans. It consists of over 17,000 islands, including Sumatra, Java, Sulawesi, and parts of Borneo and New Guine ...
, the
Philippines The Philippines (; fil, Pilipinas, links=no), officially the Republic of the Philippines ( fil, Republika ng Pilipinas, links=no), * bik, Republika kan Filipinas * ceb, Republika sa Pilipinas * cbk, República de Filipinas * hil, Republ ...
,
Thailand Thailand ( ), historically known as Siam () and officially the Kingdom of Thailand, is a country in Southeast Asia, located at the centre of the Indochinese Peninsula, spanning , with a population of almost 70 million. The country is b ...
,
Brunei Brunei ( , ), formally Brunei Darussalam ( ms, Negara Brunei Darussalam, Jawi alphabet, Jawi: , ), is a country located on the north coast of the island of Borneo in Southeast Asia. Apart from its South China Sea coast, it is completely sur ...
,
Malaysia Malaysia ( ; ) is a country in Southeast Asia. The federation, federal constitutional monarchy consists of States and federal territories of Malaysia, thirteen states and three federal territories, separated by the South China Sea into two r ...
, and
East Timor East Timor (), also known as Timor-Leste (), officially the Democratic Republic of Timor-Leste, is an island country in Southeast Asia. It comprises the eastern half of the island of Timor, the exclave of Oecusse on the island's north-we ...
, 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. 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 faucet A bidet shower —also known as a commode shower, toilet shower, bum 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 ...
s) connected to the plumbing in the absence of a built-in bidet. In
Vietnam Vietnam or Viet Nam ( vi, Việt Nam, ), officially the Socialist Republic of Vietnam,., group="n" is a country in Southeast Asia, at the eastern edge of mainland Southeast Asia, with an area of and population of 96 million, making it ...
, people often use a bidet shower. It is usually available both at general households and public places.


East Asia

The first "paperless" toilet seat was invented in Japan in 1980. A spray toilet seat, commonly known by Toto's trademark
Washlet is a registered trademark of the Japanese toilet company TOTO and is used for their line of cleansing toilet seats with water spray feature for genital and anal cleansing. The Washlet is an electronic bidet and commonplace on toilets in Japa ...
, 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 feminine 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.


Europe and the Americas

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. The
bidet A bidet ( or ) is a bowl or receptacle designed to be sat on in order to wash one'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 ...
is common in predominantly
Catholic countries The Catholic Church is "the Catholic Communion of Churches, both Roman and Eastern, or Oriental, that are in full communion with the Bishop of Rome (the pope)." The church is also known by members as the People of God, the Body of Christ, th ...
where water is considered essential for anal cleansing. Some people in
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a subcontinent of Eurasia and it is located enti ...
and the Americas use
bidet A bidet ( or ) is a bowl or receptacle designed to be sat on in order to wash one'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 ...
s for anal cleansing with water. Bidets are common bathroom fixtures in many
Western Western may refer to: Places *Western, Nebraska, a village in the US * Western, New York, a town in the US *Western Creek, Tasmania, a locality in Australia *Western Junction, Tasmania, a locality in Australia *Western world, countries that i ...
and Southern European countries and many
South American South America is a continent entirely in the Western Hemisphere and mostly in the Southern Hemisphere, with a relatively small portion in the Northern Hemisphere at the northern tip of the continent. It can also be described as the souther ...
countries,''Decreto ministeriale Sanità'', 5 July 1975, art. 7. while
bidet showers A bidet shower —also known as a commode shower, toilet shower, bum 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 ...
are more common in
Finland Finland ( fi, Suomi ; sv, Finland ), officially the Republic of Finland (; ), is a Nordic country in Northern Europe. It shares land borders with Sweden to the northwest, Norway to the north, and Russia to the east, with the Gulf of Bo ...
and
Greece Greece,, or , romanized: ', officially the Hellenic Republic, is a country in Southeast Europe. It is situated on the southern tip of the Balkans, and is located at the crossroads of Europe, Asia, and Africa. Greece shares land borders wit ...
. 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.


Toilet paper

In some cultures—such as many
Western countries The Western world, also known as the West, primarily refers to the various nations and states in the regions of Europe, North America, and Oceania.
—cleaning after defecation is generally done with
toilet paper Toilet paper (sometimes called toilet tissue or bathroom tissue) is a tissue paper product primarily used to clean the anus and surrounding anal region of feces after defecation, and to clean the perineal area and external genitalia of ...
only, until the person can bathe or
shower 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 ...
. Toilet paper is considered a very important household commodity in
Western culture image:Da Vinci Vitruve Luc Viatour.jpg, Leonardo da Vinci's ''Vitruvian Man''. Based on the correlations of ideal Body proportions, human proportions with geometry described by the ancient Roman architect Vitruvius in Book III of his treatise '' ...
, as illustrated by the
panic buying Panic buying (alternatively hyphenated as panic-buying; also known as panic purchasing) occurs when consumers buy unusually large amounts of a product in anticipation of, or after, a disaster or perceived disaster, or in anticipation of a large ...
of toilet paper in many Western countries during the
COVID-19 pandemic The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel virus was first identified ...
. 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). With
flush toilet A flush toilet (also known as a flushing toilet, water closet (WC) – see also toilet names) is a toilet that disposes of human waste (principally urine and feces) by using the force of water to ''flush'' it through a drainpipe to another loca ...
s, 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 Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term '' ...
may find it more difficult to keep the anal area clean using only toilet paper and may prefer washing with water as well. Although wiping from front to back minimizes the risk of contaminating the
urethra The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra c ...
, the directionality of wiping varies based on sex, personal preference, and culture. Some people wipe their anal region standing while others wipe theirs sitting.


Other methods and materials


Wet wipes and gel wipes

When cleaning babies' buttocks during diaper changes
wet wipe A wet wipe, also known as a wet towel or a moist towelette, disposable wipe, disinfecting wipe, or a baby wipe (in specific circumstances) is a small to medium-sized moistened piece of plastic or cloth that either comes folded and individuall ...
s are often used, in combination with water if available. As wet wipes are produced from plastic textiles made of polyester or
polypropylene Polypropylene (PP), also known as polypropene, is a thermoplastic polymer used in a wide variety of applications. It is produced via chain-growth polymerization from the monomer propylene. Polypropylene belongs to the group of polyolefins an ...
, they are notoriously bad for sewage systems as they do not decompose, although the wet wipe industry maintains they are biodegradable but not "flushable". 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 Gel wipe is a moisturizing gel applied to dry toilet paper for cleaning purposes, like personal hygiene, or to reduce skin irritation from diarrhea. It was developed in the 21st century as an environmentally sensitive alternative to wet wipes. ...
.


Prewipes

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., since abandoned.


Natural materials

Stones, leaves, corn cobs and similar natural materials may also be used for anal cleansing.


References

{{DEFAULTSORT:Anal Cleansing Defecation
Hygiene Hygiene is a series 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 refer ...