Picture: Stefano Ferrario/Pixabay
Picture: Stefano Ferrario/Pixabay

Health experts weigh in on this bathroom debate: Bidets are big, but do you really need one?

By The Washington Post Time of article published Jan 11, 2022

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By Angela Haupt

Carrie Verrocchio has a theory: Once you go bidet, you never go back. She's so smitten with the toilet attachment that sprays water to clean your bum that her family had one installed in each of their four bathrooms - and they're shopping for a travel bidet, a water bottle-sized contraption to use when they're on the road.

Where to start on the appeal? "It's feeling clean all the time," says Verrocchio, 55, a motivational speaker

"You know how when you go to the bathroom, you have to wipe a zillion times with dry paper? You don't do that with the bidet. It literally just rinses it off, puts it in the toilet and you pat dry. I wish we'd done it years ago."

Nikki Webster, 47, a writer, similarly considers her bidets essential. "When you wipe, you're basically wiping what can be reached," she says. "When you spray, you get into every nook and cranny, which leaves you way cleaner."

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Indeed, health experts generally agree that bidets elevate the bathroom hygiene experience, at least when used properly.

What's less clear is whether they serve any medical purpose beyond that: While there's some indication that they could, for example, be helpful for those with haemorrhoids or mobility issues, research isn't conclusive, and there are concerns that bacteria could fester on the device; plus, users could be scalded if the water gets too hot.

Even if they're not a medical necessity, bidets exploded in popularity in the United States during the pandemic - and they've long been common in Europe and Asia.

These devices, which come in different styles, squirt water at your genital and anal areas after you use the toilet. Converts say they're far more hygienic than toilet paper, as well as more eco-friendly because you use less toilet paper.

"Remember when the pandemic first hit and there was a shortage of paper products?" Webster says. "At our house, no problem. We never stressed about searching for toilet paper - it wasn't even a concern." Over time, bidet aficionados also find them to be cost-effective.

The surge in use among Americans is a validating moment for James Lin, who launched the e-commerce site, Bidet King, in late 2009, after visiting his grandmother in Taiwan and getting acquainted with her bidet.

"It was one of those experiences where the glass shatters and you can't put it back together," he says. After a decade of diligently selling the devices, orders suddenly skyrocketed during the pandemic, when paper products became scarce.

Picture: Max Vakhtbovych/Pexels

"To say there was a spike is kind of putting it lightly," he says. "Sales increased by 20, 30 times over two to three weeks, to the point where you couldn't buy a bidet if you really wanted to. Everyone was out of stock." Inventory is now back to normal, he reports, though interest remains high.

As Lin puts it, those who discover the bidet "can't shut up about it - they tell their neighbours and friends and all that."

Here's a look at what health experts say about the pros and cons of bidets.

The pros

Washing instead of wiping is, in many ways, a no-brainer, says Evan Goldstein, an anal surgeon.

He regularly recommends bidets to his patients. "From a hygiene perspective, it just clearly makes sense," he says. "You're able to get rid of any extra residual that's there. The bidet has always been part and parcel to anal hygiene."

Less wiping. Goldstein says Americans tend to over-wipe: desperate to be clean, we rub toilet paper against ourselves, again and again, irritating the skin and sometimes even causing tiny cuts or bleeding.

While toilet paper can be abrasive, a bidet delivers a more soothing stream of water to sensitive areas. Wiping might not be entirely eliminated, though: Goldstein notes that it's still important to fully dry yourself after using the toilet - otherwise, excess moisture could lead to an infection.

He suggests using a little bit of toilet paper or a cloth towel to pat yourself dry; not wet wipes, which can vex the skin, especially if used consistently. (Some bidets have a built-in air dryer, but those models tend to be pricier.)

"The reality is that most people when they switch to a bidet, they're mad at themselves that they didn't use it earlier, and they consider it a game-changer," Goldstein says. "It's hygiene at its finest."

Good if you have problems with mobility. Bidets are often particularly helpful for people with mobility issues, including those with arthritis, morbid obesity or Parkinson's disease, says Christine Lee, a gastroenterologist at the Cleveland Clinic.

The device minimizes the need to use your wrist to get to difficult spots on your underside.

"If you can't quite reach - or if you have a spinal cord injury, and you have less sensation, so you're not quite sure where you're wiping - well, those kinds of things can decrease the quality of hygienic practices," she says. The bidet is a convenient way to guarantee thorough cleaning.

Plus, Lee says, some seniors with poor hand-eye coordination who aren't able to trim their nails accidentally cut themselves while wiping, leading to pain and infection. Indeed, a study published in Gerontologist found that bidets improved "comfort in toileting and cleanliness" among nursing home residents ages 75 and up.

Helpful if you have issues in that area. There's limited research on bidets, but a few studies suggest potential health benefits.

Using one might make sense for those with haemorrhoids and anal fissures since it reduces pressure in the rectum and is a relatively gentle experience. And people with pruritus ani, the technical term for the itchy anus, are often cautioned to avoid toilet paper, leading them to bidets.

"There have been clear anecdotal reports of people with haemorrhoids where the bidet helps," says John Swartzberg, a clinical professor emeritus at UC Berkeley's School of Public Health. But beyond those testaments and a pool of preliminary studies, there's "not a lot of science to support" the impassioned claims of bidet lovers, he says.

For example, some advocates believe bidets prevent urinary tract infections, but Swartzberg says there's no evidence of that.

The cons

Concern about bacteria. A bidet isn't a slam-dunk better toileting experience: Some research raises concerns. One large study, for example, indicated that regularly using a bidet altered the good bacteria in a woman's vagina. The study would "have to be repeated" for researchers to draw any conclusions, Swartzberg says.

Another study, involving a Japanese hospital, found that 254 out of 294 bidet nozzles were contaminated with infection-causing organisms such as Staphylococcus aureus and Enterococcus sp.

Maintenance and cleaning. That's a good reminder of one of the golden rules of bidet ownership: You need to regularly clean it. In many cases, running a damp cloth over the nozzle will suffice; it's typically best to avoid harsh chemicals, though that will vary depending on your specific model. "If you properly maintain it, as far as cleaning and upkeep, then it could be just as hygienic - if not more - than toilet paper," Lee says.

Potential scalding. It's also important to pay attention to your bidet's water pressure and temperature: If either is too high, you could experience scalding or otherwise agitate your bottom. Having a professional plumber install your bidet, and reading the user manual, can help you avoid such misfires, Lee says.

The bottom line

Do we all need a bidet? Swartzberg owns one, so he certainly understands the appeal. "We put one in when we remodelled about 10 years ago, and now there's a competition in the household for who gets to use that toilet," he says. But aside from cleanliness, there's no compelling medical reason to use one. "It's personal preference," he says. "People who like them tend to really like them. But from a medical standpoint, I don't think it's better or worse."

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