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

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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
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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.”

12 Facts About Diabetes Mellitus

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iStock/mthipsorn

Thirty million Americans—about 9 percent of the country's population—are living with diabetes mellitus, or simply diabetes. This chronic condition is characterized by sustained high blood sugar levels. In many patients, symptoms can be managed with insulin injections and lifestyle changes, but in others, the complications can be deadly. Here's what you need to know about diabetes mellitus.

1. There are three types of diabetes.

In healthy people, the pancreas produces enough of the hormone insulin to metabolize sugars into glucose and move the glucose into cells, where it's used for energy.

But people with type 2 diabetes—the most common form of the disease, accounting for about 95 percent of cases—either can't produce enough insulin to transport the sugars, or their cells have become insulin-resistant. The result is a buildup of glucose in the blood (a.k.a. high blood sugar or hyperglycemia). Type 2 diabetes typically develops in adults.

Type 1 diabetes, also known as juvenile diabetes, makes up the remaining 5 percent of chronic cases and most often develops in children and young adults. With this condition, the initial problem isn’t blood sugar levels, but insulin production: The pancreas can’t make enough insulin to process even normal amounts of glucose. The sugar builds up as a result, leading to dangerous concentrations in the bloodstream.

The third form, gestational diabetes, only afflicts pregnant people who weren’t diabetic before their pregnancy. The mother's blood glucose levels usually spike around the 24th week of pregnancy, but with a healthy diet, exercise, and insulin shots in some cases, diabetes symptoms usually can be managed. Blood sugar levels tend to return to normal in patients following their pregnancies.

2. The mellitus in diabetes mellitus means "honey sweet."

Around 3000 years ago, ancient Egyptians described a condition with diabetes-like symptoms, though it wasn't called diabetes yet. It took a few hundred years before the Greek physician Araetus of Cappodocia came up with the name diabetes based on the Greek word for "passing through" (as in passing a lot of urine, a common diabetes symptom). English doctor Thomas Willis tacked on the word mellitus, meaning "honey sweet," in 1675, building on previous physicians' observations that diabetic patients had sweet urine. Finally, in 1776, another English physician named Matthew Dobson confirmed that both the blood and urine of diabetes patients were made sweeter by high levels of glucose in their blood.

3. The cause of one type of diabetes is well understood; the other, not so much.

A person’s lifestyle is a key predictor of developing type 2 diabetes. Factors like being overweight or obese, consuming a high-calorie diet, smoking, and seldom exercising contribute to the risk. Foods and drinks that are high in sugar—soda, candy, ice cream, dessert— may contribute to hyperglycemia, but any food that’s high in calories, even if it's not sweet, can raise blood sugar levels.

In contrast to these well-established factors, medical experts aren’t entirely sure what causes type 1 diabetes. We do know that type 1 is an autoimmune disease that develops when the body attacks and damages insulin-producing cells in the pancreas. Some scientists think that environmental factors, like viruses, may trigger this immune response.

4. Family history also plays a role in diabetes risk.

If a parent or sibling has type 2 diabetes, you are predisposed to developing pre-diabetes and type 2 diabetes. Lifestyle habits explain some of these incidences, since family members may share similar diets and exercise habits. Genetics also play a role, but just because one close relative has diabetes does not mean you're destined to. Research conducted on identical twins, which share identical genes, showed that the pairs have discordant risk. Among twins in which one has type 1 diabetes, the other has only a 50 percent chance of developing it; for type 2, the risk for the second twin is 75 percent at most.

5. Racial minorities are at a higher risk for developing diabetes.

Many racial minority groups in the U.S. have a higher chance of developing type 2 diabetes. Black Americans, Latino Americans, Native Americans, Pacific Islanders, and some groups of Asian Americans are more likely to have pre-diabetes and type 2 diabetes than white Americans. This can be partly explained by the fact that some of these groups also have higher rates of obesity, which is one of the primary risk factors of type 2 diabetes. Socioeconomics may also play a role: One study shows that people with diabetes living in poverty are less likely to visit diabetes clinics and receive proper testing than their middle-income counterparts. According to another study, diabetic people without health insurance have higher blood sugar, blood pressure, and cholesterol rates than insured diabetics. Genetics, on the other hand, don’t appear to contribute to these trends.

6. Diabetes is one of the world's deadliest diseases.

With proper management, people with diabetes can live long, comfortable lives. But if the disease isn’t treated, it can have dire consequences. Diabetics make up the majority of people who develop chronic kidney disease, have adult-onset blindness, and need lower-limb amputations. In the most serious cases, diabetes leads to death. The condition is one of the deadliest diseases in the world, killing more people than breast cancer and AIDS combined.

7. Millions of Americans are pre-diabetic.

According to the CDC, 84 million adults living in the U.S. are pre-diabetic: Their blood sugar is higher than what’s considered safe, but hasn't yet reached diabetic level. In pre-diabetic patients, blood glucose levels after eight hours of fasting fall between 100 and 125 milligrams per deciliter, and diabetic levels are anything above that. People with pre-diabetes are not just at a greater risk for type 2 diabetes, but also for heart disease and stroke. Fortunately, people who are diagnosed with pre-diabetes can take steps to eat a healthier diet, increase physical activity, and test their blood glucose level several times a day to control the condition. In some cases, doctors will prescribe drugs like metformin that make the body more receptive to the insulin it produces.

8. After climbing for decades, rates of diabetes incidence are declining.

In the U.S., the rate of new diagnoses skyrocketed 382 percent between 1988 and 2014. Globally, 108 million people had diabetes in 1980, but by 2014 that number was 422 million.

But thanks to nationwide education and prevention efforts, the trend has reversed in the U.S., according to the CDC. Since peaking in 2009, the number of new diabetes cases in America has dropped by 35 percent. In that same timeframe, the number of people living with diagnosed diabetes in the U.S. has plateaued, suggesting people with the condition are living longer.

9. The first successful treatment for type 1 diabetes occurred in 1922.

Prior to the 20th century, type 1 diabetes was usually fatal. Diabetic ketoacidosis—a toxic buildup of chemicals called ketones, which arise when the body can no longer use glucose and instead breaks down other tissues for energy—killed most patients within a year or two of diagnosis. In searching for way to save children with juvenile (type 1) diabetes, Canadian physician Frederick Banting and medical student Charles Best built on the work of earlier researchers, who had demonstrated that removing the pancreas from a dog immediately caused diabetes symptoms in the animal. Banting and Best extracted insulin from dog pancreases in University of Toronto professor J.J.R. Macleod's lab. After injecting the insulin back into dogs whose pancreases had been removed, they realized the hormone regulated blood sugar levels. On January 11, 1922, they administered insulin to a human patient, and further refined the extract to reduce side effects. In 1923, Banting and Macleod received the Nobel Prize in Medicine for their work.

10. A pioneering physicist discovered the difference between type and and type 1 diabetes.

In the 1950s, physicist Rosalyn Yalow and her research partner Solomon Berson developed a method for measuring minute amounts of substances in blood. Inspired by Yalow's husband's struggle with diabetes, Yalow focused her research on insulin. Their "radioimmunoassay" technology revealed that some diabetes patients were still able to produce their own insulin, leading them to create two separate categories for the disease: “insulin-dependent” (type 1) and “non-insulin-dependent” (type 2). Prior to that discovery in 1959, there was no distinction between the two types. In 1977, Yalow won the 1977 Nobel Prize in Medicine for the radioimmunoassay, one of only 12 female Nobel laureates in medicine.

11. Making one insulin dose once required tons of pig parts.

Insulin is relatively easy to make today. Most of what's used in injections comes from a special non-disease-producing laboratory strain of E. coli bacteria that's been genetically modified to produce insulin, but that wasn't always the case. Until about 40 years ago, 2 tons of pig pancreases were required to produce just 8 ounces of pure insulin. The pig parts were typically recycled from pork farms.

12. A quarter of diabetes patients don’t know they have it.

The symptoms of type 2 diabetes can develop for years before patients think to ask their doctor about them. These include frequent urination, unexplained thirst, numbness in the extremities, dry skin, blurry vision, fatigue, and sores that are slow to heal—signs that may not be a cause for concern on their own, but together can indicate a more serious problem. Patients with type 1 diabetes may also experience nausea, vomiting, and stomach pain.

While serious, the symptoms of diabetes are sometimes easy to overlook. That’s why 25 percent of people with the illness, 7.2 million in the U.S., are undiagnosed. And that number doesn’t even cover the majority of people with pre-diabetes who aren’t aware they’re on their way to becoming diabetic.

There Are 2373 Squirrels in New York's Central Park, Census Finds

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iStock/maximkabb

Central Park in New York City is home to starlings, raccoons, and exotic zoo animals, but perhaps the most visible fauna in the area are the eastern gray squirrels. Thanks to a team of citizen scientists, we now know exactly how many of the rodents occupy the space—approximately 2373 of them, according to a census reported by Smithsonian.

In October 2018, a group called the Squirrel Census—with help from the Explorers Club, the NYU Department of Environmental Studies, Macaulay Honors College, the Central Park Conservancy, and the New York City Department of Parks & Recreation—organized a squirrel survey across all 840 acres of Central Park. For 11 days, more than 300 volunteers staked out their sections of the park twice a day—at dawn and dusk when the crepuscular animals are most active—and noted each squirrel they spotted. They also recorded how the squirrels looked, vocalized, behaved, and reacted to humans.

The research was analyzed and presented at an Explorers Club event in New York City on June 20. All the non-peer-reviewed findings—which includes a printed report, an audio report on a vinyl 45, 37 pages of data, collectible squirrel cards, and large maps of the park and the squirrel locations—are available to purchase for $75 from the Squirrel Census website.

This isn't the first time a massive census has been conducted of a public park's squirrel population. In 2011, the Squirrel Census launched with its first survey of Atlanta's Inman Park. They've conducted satellite squirrel counts at other parks, but Central Park is just the second park the organization has investigated in person.

[h/t Smithsonian]

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