Toilet paper or water – what the butt really needs

Anyone who grows up in Germany usually only knows a kind of toilet hygiene: toilet paper. But many vacationers experience a surprise when traveling. In Thailand or Turkey, a small hand shower suddenly dangles next to the toilet, in Japan the ceramic bowl begins to spray at the push of a button-and quite a few wonder what to do with it.

In fact, bideting showers and shower toilets in numerous countries have long been the norm. They are considered more hygienic and environmentally friendly than dry wiping with paper. What choice is better from a scientific and medical point of view?

Toilet paper in its current perforated form on a role has been used in western countries since the late 19th century as the standard for cleaning after the toilet. However, studies show that it is not necessarily the most thorough method – at least not alone. For example, a study published in 2021 in the journal “Journal of Water & Health” showed that the combination of toilet paper and shower toilet significantly reduces the microbial contamination of the hands after the stool compared to the sole use of paper.

Such a shower toilet-also called Washlet-is a toilet with an integrated water nozzle in the seating area, which uses a warm water jet to clean the intimate area after the toilet. It is particularly common in Japan and South Korea. In many countries of southern and Southeast Asia, as well as the Middle East and North Africa, bidet-hand broken, also known as Bumguns, are the norm next to the toilet. And in Italy, Portugal, Spain, France and some South American countries, it is common to have a bidet in addition to the toilet for water cleaning.

In contrast, the majority of toilet paper is used, especially in the USA, Canada, Great Britain, Australia, Scandinavia and in Germany, the average Germans are said to consume 134 roles per year. Not the best method for Rose George: For her book “The Big Necessity: Adventures in the World of Human Waste”, the British author dealt with a wide variety of aspects of human excretions and has been convinced since then that toilet paper removed it, but not completely. Overall, water cleaning is more effective: you would not take a shower with a dry towel, according to your conclusion.

George says, says George, says George. Dermatologist Silas Soemantri confirms: “It is true that aggressive wiping with dry toilet paper can lead to microtraumatic injuries that can favor anal fissures and make hemorrhoids worse.” The mechanical irritation can cause small cracks in sensitive skin, which in turn favors inflammation, says soemantri, the member of the professional association of German dermatologists (BVDD).

The doctor recommends a gentle cleaning, preferably with water or moist, unparroted toilet paper: “This measure helps to protect the skin and prevent further irritation.”

Scientific studies, especially on the subject of bideting, draw a contradictory picture. Various analyzes came to the conclusion that the hot water nozzles of bidets and similar devices can contain a wide range of bacteria. Others, on the other hand, describe that water remove pathogens more thoroughly in the intimate area.

In 2021, an article in the “Journal of the Anus, Rectum and Colon” warned that excessive bidet use could lead to itching in the anal area and stool incontinence. There were also occasionally reported on increased vaginal infections in women.

Other studies suggested that water cleaning could be advantageous for people with hemorrhoids – at least if the water jet was not too strong.

Dermatologist SOEMANTRI also advises people who tend to hemorrhoids or other anal complaints to pay attention to gentle cleaning. “From a dermatological point of view, water cleaning usually offers the most thorough and skin -friendly way to clean the genital area because it minimizes irritation through mechanical influence.”

The water should be lukewarm and the water pressure should be moderately adjusted to avoid irritation. Moist toilet paper is the second choice and can be an acceptable alternative if it is unpareted and gently formulated. Soemantri emphasizes: “Normal dry toilet paper should only be used in situations without any other option, since it can irritate the skin through the friction and lead to wounds.”

The dermatologist has another tip: “It is a recommendation to add normal toilet paper for cleaning, which means that the skin can be gently and yet thoroughly cleaned. However, it is essential to dab down dryly.”

When it comes to whether paper or water, there is also the environmental aspect: Shower toilets, bidets and bidet-hand broken water require water for cleaning-but probably less than is necessary for the production of toilet paper.

If small children have to go to the toilet, things have to go quickly. In Höxter, the problem of missing toilets is now being combated with an unusual solution.