The Best Way to Wipe Your Butt, According to the Experts

iStock
iStock

Curtis Asbury, MD sees it all the time. A patient comes in with blotchy, red, irritated rectum and insists they’re not doing anything unusual. Peering into their sore bottom, Asbury nods solemnly, then delivers news most people never expect to hear.

“You’re not wiping correctly,” he says.

A dermatologist practicing in Selbyville, Delaware, Asbury has seen an uptick in the number of people coming in expressing dissatisfaction with their rectal hygiene. Whether it’s due to misguided parental instruction during toilet training or wiping on sheer instinct, some of us are simply not maintaining one of the most potentially dirty crevices of our body. And the consequences can be irritating.

“It’s called perianal dermatitis,” Asbury tells Mental Floss, describing the kind of topical irritation that afflicts people who are wiping poorly, infrequently, or overzealously. In an attempt to clean their rear end, some people scrub so violently that the American Society of Colon and Rectal Surgeons has given a name to the resulting tenderness: Polished Anus Syndrome, or PAS.

Fortunately, the key to avoiding PAS and other rectal misadventures is relatively easy. Here are some pro tips for a clean butt.

GIVE UP WET WIPES

For starters, Asbury recommends that people stop using the pre-moistened cloths, which are heavily marketed to promote a sparkling cavity. Use of the wipes has been associated with allergic reactions to methylisothiazolinone, a preservative used to inhibit bacterial growth while products are on store shelves. “Even the all-natural ones can cause problems,” he says, since any kind of chemical present in the wipes isn’t usually rinsed off right away.

Does that mean you should reach for dry toilet paper instead? Not quite. “It’s healthier, certainly, to clean your body with water," Asbury says. "Nobody takes a dry piece of paper, rubs it over their skin, and thinks they’re clean.” Even the Greco-Romans (332 BCE–395 CE) knew this, as one historical account from the philosopher Seneca revealed that they used a damp sponge affixed to a stick as a post-toiletry practice. Of course, some ancient cultures also wiped with pebbles and clam shells, among other poor ideas, so perhaps we should stick with contemporary advice.

INVEST IN A BIDET

A bidet sprays water out of a toilet
iStock

Asbury 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 Asbury recommends the technique, he advises people to throw used towels in the trash. If you find that idea appalling, and provided your butt is not already red from bad wiping strategy, lightly moistening a wad of durable toilet paper should do the job.

DRY THOROUGHLY BUT GENTLY

Once you’ve wiped enough to see clean paper, take a dry square and mop up any excess moisture. Whether it’s wet wipes or bidets, some people don’t bother with this step, but “it would be weird not to dry,” Asbury says. Occasionally, moisture can lead to intertrigo, which is irritation in skin folds, or a fungal infection.

You also want to have a soft touch. “I see people scrubbing hard,” Asbury says. “That just makes the problem worse.” Excessive wiping can lead to micro-tears in the anal tissue, causing bleeding and discomfort.

WIPE IN THE RIGHT DIRECTION

Make sure to go from front to back, pushing waste away from the groin. This has traditionally been advised for women to keep poop away from the vaginal canal and prevent urinary tract infections. While Asbury hasn't found specific studies to back up this advice, he still believes it's likely more hygienic. There’s also something to be said for sitting while wiping, since ergonomically, it may keep your perianal area open. But if you’re uncomfortable reaching into the toilet to wipe, standing should suffice.

Assuming you’ve done all that and you’re still feeling discomfort, Asbury warns it might be something else. “If you’re not feeling clean, there could be issues with your sphincter,” he says. Weakened muscles can cause leakage. But generally, it’s dry-wipers who have trouble getting everything they need to get. For the hard-to-clean, Asbury advises that they make the switch to a bidet.

“It’s cold at first,” he says. “But you get used to it.”

A Generic EpiPen Coming in Early 2019 Could Save You Money

Brand-name EpiPens at a Congressional hearing on the escalating cost of the drug in 2016
Brand-name EpiPens at a Congressional hearing on the escalating cost of the drug in 2016
Alex Wong/Getty Images

For an incredibly common, life-saving medication, EpiPens (epinephrine auto-injectors) are surprisingly difficult for many consumers to get ahold of. Their cost has skyrocketed in recent years from less than $100 for a pack of two to more than $600. They’ve gotten so expensive that some EMTs have resorted to using syringes to manually administer epinephrine rather than purchasing the standard auto-injectors, which are almost exclusively made by the pharmaceutical company Mylan. Generic options have been slow to come to market, but according to Business Insider, a recently approved EpiPen rival is coming in the first few months of 2019, and it could save consumers a significant chunk of change.

The drug’s developers have had an unusually hard time getting the new EpiPen alternative, called Symjepi, onto store shelves. The drug was approved in 2017, but the company, Adamis Pharmaceuticals, had trouble finding investors. Now, Novartis, the Swiss-based pharmaceutical giant that manufactures drugs like Ritalin, is releasing the drug through its Sandoz division (perhaps most famous for it role in discovering LSD in the 1930s).

Symjepi will cost $250 out-of-pocket for a pack of two doses. That’s 16.6 percent less than the Mylan-authorized generic EpiPen or Teva’s generic EpiPen, which both sell for $300. It differs a bit from its rivals, though, in that it’s a pre-filled, single-dose syringe rather than a spring-loaded auto-injector. Auto-injectors are plastic, pen-like devices that keep the needle shielded until the moment of injection, and are specifically designed to help make it easier for untrained (even squeamish) people to use in an emergency. With this version, patients will need to remove a needle cap and inject the needle. Just like the EpiPen, though, it’s designed to be injected in the upper thigh, through clothing if necessary.

If you have health insurance, the difference in cost may not matter as much for you as a consumer, depending on your plan. (I personally picked up a two-pack of Mylan-authorized generic Epipens at CVS recently for $0, using a manufacturer’s Epipen coupon to knock down what would have been a $10 copay.) But it will matter considerably for those with high-deductible plans and to insurers, which, when faced with high costs, eventually pass those costs on to the consumer either through higher co-pays or higher premiums. It also affects agencies that buy EpiPens for emergency use, like local fire departments. And since EpiPens expire after just a year, the costs add up.

However, there’s currently a shortage of EpiPens on the market, according to the FDA, making it more important than ever to have other epinephrine drugs available to those at risk for serious allergic reactions.

[h/t Business Insider]

Brain-Eating Amoeba Kills Seattle Woman Who Used Tap Water in Her Neti Pot

CDC/Dr. Govinda S. Visvesvara, Wikimedia Commons // Public domain
CDC/Dr. Govinda S. Visvesvara, Wikimedia Commons // Public domain

If you use a neti pot to clear out your sinuses, there's one important rule you should always follow: Don't fill it with tap water. Doing so could land you a sinus infection, or worse, a potentially fatal disease caused by a brain-eating amoeba. Although the latter scenario is exceptionally rare, a 69-year-old woman in Seattle died from doing just that, The Seattle Times reports. Experts are also warning that these infections could become more common as temperatures in the northern hemisphere continue to rise.

Physicians at Seattle's Swedish Medical Center initially thought the woman had a brain tumor. She was brought into the emergency room following a seizure, and a CT scan of her brain seemed to reveal a tumor-like mass. The only other known symptom she had was a red sore on her nose, which was previously misdiagnosed as rosacea. When surgeons operated on her the following day, they noticed that "a section of her brain about the size of a golf ball was bloody mush," neurosurgeon Dr. Charles Cobbs told The Seattle Times. "There were these amoeba[e] all over the place just eating brain cells. We didn't have any clue what was going on, but when we got the actual tissue we could see it was the amoeba."

She died a month later of an infection called granulomatous amoebic encephalitis (GAE), according to a recent case report published in the International Journal of Infectious Diseases. The disease is caused by a single-celled amoeba called Balamuthia mandrillaris, and it's extremely deadly. Of the 109 cases between 1974 and 2016, 90 percent were fatal.

According to the FDA, some bacteria and amoebae in tap water are safe to swallow because acid in the stomach kills them. However, when they enter the nasal cavity, they can stay alive for long periods of time and travel up to the brain, where they start eating their way through tissue and cells. Another brain-eating amoeba called Naegleria fowleri can cause a similar disease, except it acts faster and can cause death in just a few days. Although it's also rare, it's usually found in warm freshwater, and infections start by getting contaminated water up one's nose while swimming or by using a nose irrigation device filled with tap water.

Dr. Cynthia Maree, an infectious disease doctor at the Swedish Medical Center, said the changing environment could facilitate the spread of these infections. "I think we are going to see a lot more infections that we see south (move) north, as we have a warming of our environment," Maree says. Researchers say these amoebae are still little-understood. Future studies would need to be conducted to learn more about the risk factors involved.

[h/t The Seattle Times]

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