Using toilet paper is grosser than you think. Here's a better idea.
Q: I feel like I'm using the wrong toilet paper or what I'm using is too harsh on my skin. How should I be wiping after using the bathroom?
A: Instead of wiping with toilet paper, try using a bidet.
Bidets are gentle and hygienic. In fact, a 2022 study found that the hands of people who use bidets have profoundly fewer microbes than those who wipe.
Researchers asked 32 nursing students in Japan to wear clean medical gloves when they used the bathroom to poop and subsequently examined those gloves to see what bacteria grew. People who wiped with toilet paper had an average of nearly 40,000 different viable bacteria attached to their gloves afterward.
The bacteria on the gloves of bidet users were reduced by almost 10-fold.
The study was small, and more rigorous research is needed on the effects of using bidets compared with toilet paper. But as someone who's on #teambidet, I've seen what a difference they can make in my patients' lives.
I recommend them all the time for my patients with loose stools, like in irritable bowel syndrome, who find constant wiping makes their skin raw. Bidets are also excellent for anyone who might struggle with balance or coordination reaching back to wipe and especially fantastic for people with hemorrhoids, anal fissures or those who are recovering postpartum.
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The benefits of using a bidet
Bidets are not just better for your wallet (think of how much toilet paper your family breezes through each month), but they're better for the environment too. While you do waste one-eighth of a gallon of water per use with a bidet, your waste from toilet paper plummets. It takes about 1.5 pounds of wood and more than six gallons of water to produce just a single roll of toilet paper.
I get it though: It can be hard to get over the weirdness of trying a new thing in an area where you don't try new things often. But once you experience that level of freshness, it becomes so intuitive that it's hard to go back to just plain wiping.
There is a bit of a learning curve when it comes to adjusting the water pressure and getting into all the nooks and crannies. And unless you've got a fancy bidet with a dryer, you'll need to dab the area dry with a sheet of toilet paper or a clean towel.
To start using a bidet, you don't have to buy a whole new toilet. Toilet seat attachments can cost around $50. You'll need to measure your toilet and think about the nearest outlet as you're making your purchasing decisions.
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What kind of toilet paper should I buy?
Can't get into the idea of a bidet? You can still give your rear end the tender loving care it deserves by investing in a toilet paper that is two-ply or higher.
Toilet paper sold in the United States is often made from trees sourced from Canada's boreal forest. Ply refers to the number of layers per sheet: One ply is a single layer of tissue while two-ply is two layers glued together.
Those in favor of one-ply paper argue that it's better for the environment as it's more easily dissolvable and kills fewer trees. But one-ply is thinner and rougher on the skin, and people may bunch up an especially thick wad when confronted with one-ply.
And a note on "flushable wipes": I do recommend them in certain situations like for people with hemorrhoids or doing a bowel prep for a screening colonoscopy. But plush as they are, they're probably not actually flushable - and should be discarded in the trash instead.
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How to wipe after you pee
Men commonly don't wipe at all after urination. It probably isn't harmful to their health - there have been no studies proving as much.
Girls and women often learn to wipe front to back after urination or defecation. The idea behind this is that women have shorter urethras (the tube leading to the bladder) than men and that wiping back to front could give fecal bacteria a greater chance of making their way to the urethra, where they have a small distance to travel before causing a urinary tract infection.
Getting a urinary tract infection does not imply to anyone that you simply must've "wiped incorrectly" - there are lots of associations with urinary tract infections at play and that entire area isn't exactly sterile. But wiping back to front is one risk factor that is worth mitigating.
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How to wipe after you poop
Wiping can be harsh and abrasive to the delicate skin around your anus. While everyone's poop is different - and that is perfectly normal - if you are someone who has more frequent softer stools, there's a chance you're wiping a lot.
So allow me to introduce you to the power of dabbing, my friends: Instead of wiping, gently pat any excess away onto the tissue to avoid irritating the skin or aggravating pesky hemorrhoids.
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Before flushing, close the toilet lid
You might be thinking the next step is to adjust your breeches and flush away. But what about the toilet lid?
One study from 2012 found that the bacteria C. difficile spread nearly 12-fold more during flushing when the lid was up compared with when the lid was down.
Even if it's your home bathroom, you probably don't want aerosolized particles from the toilet landing on your toothbrush.
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What I want my patients to know
Now that you've touched the wipes, the lid and the flush, wash your hands afterward. I'm sorry this has to be said, but you're not exempt if you used your foot to flush, as some do in a public restroom - your hand still has bacteria on it. Diseases can spread when fecal pathogens make their way into our mouths, so washing your hands thoroughly is 20 extra seconds well-spent.
Trisha Pasricha is an instructor of medicine at Harvard Medical School.
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