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Are bidet-type toilets a health hazard?

39 Comments

"The warm-water bidet type toilet seat originated in the United States, but up to the present these have not caught on at all in Europe or the U.S." says Mitsuharu Ogino, an OB-GYN physician at the Center Hospital of the National Center for Global Health and Medicine in Shinjuku. 

Ogino continues: "It's been pointed out the toilets carry a risk of spreading infectious diseases, because of sanitation issues related to the nozzle and warm water." 

The question posed to Dr Ogino, in conjunction with an article in Shukan Gendai (Feb 27-Mar.6),  asks why Washlets, TOTO's proprietary brand that's become the generic name for such devices, have taken Japan by storm, while achieving scant success elsewhere. 

A survey by the prime minister's office found that in 2020, 80.2% of Japan's households had installed such toilets, an explosive increase over the 14.2% households with Washlets in 1992. 

By contrast, less than 10% of U.S. households were found to have adopted such toilets as of last year. In China, the figure was around 5% in 2019. 

Dr Ogino believes the popularization of bidet-type toilets here reveals ignorance among  Japanese over their potential dangers. 

Kahoru Kusama, a proctologist based in Azabu, Tokyo, explains why.

"Over washing the anus risks removing the sebum, which lubricates the surface. There have been reports of problems caused by over drying of peripheral areas," says Kusama. 

According to Koichiro Fujita, professor emeritus at Tokyo Medical and Dental University, our skin surface generally maintains a slightly acidic pH of between 4.5 to 6.0. The use of bidets can remove skin flora, raising pH to a neutral 7.0 or slightly above into alkaline. This leaves the body vulnerable to dermatitis and possibly invasion of staphylococcus aureus bacteria. 

The transition process to become pH neutral or alkaline generally takes 10 hours, so two or more warm-water washes in the course of a single day may be enough to prevent the skin from returning to its mildly acidic state. 

The aforementioned Dr Ogino says he's aware of numerous reports of people complaining of chronic cases of rectal bleeding or hemorrhoids. 

Sixty-five-year-old Yuji Kawata (a pseudonym), who installed a Washlet after developing hemorrhoids, tells Shukan Gendai, "The warm water wash felt good after elimination, and I used it frequently. Afterwards I would feel the need to go again; but when I sat down, nothing would come out. From overuse I developed rectal bleeding." 

Dr Kusama warns that Washlet users troubled by less serious discomforts may disregard warning signs of colon or intestinal cancer. 

"In many cases, by the time they realize the problem, the cancer has already reached an advanced stage," she says. 

A London-based journalist tells the magazine bidet-type toilets are seldom found in British or American homes. 

"Many Europeans and Americans don't regard them as sanitary and fear risking infections from them. I don't see the likelihood of further adoption." 

Shukan Gendai also approached the big three manufacturers of bidet-type toilets -- TOTO, LIXIL and Panasonic -- which control about 90% of the market. The makers referred him to the Japan Sanitary Equipment Industry Association, whose spokesperson stated, "Concerning water emitted from the toilet nozzle or present in the toilet tank, we have conducted microbiological surveys, which have confirmed the water to be safe. 

"Our association is not aware of risks incurred through use of the warm water bidet toilets."  

The aforementioned Dr Fujita disagrees. 

"People's excessive concerns over cleanliness have become a bad influence," he says. "It should be obvious that subjecting either the anus and vagina to direct jets of warm water can create problems. We can't overlook the point that it kills off skin flora. As far as the human body is concerned, such devices are unnatural."

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39 Comments
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Using warm water to clean one's body is unnatural?

13 ( +15 / -2 )

We use a washlet toilet.

11 ( +12 / -1 )

I could see a problem if the orifice was made wide open, but I don’t think people would do that.

7 ( +7 / -0 )

What ?

Bidet is a french word.

Bidet doesn’t originated in United States but in France at the beginning of the XVI century.

4 ( +7 / -3 )

Newpresident,

I read the first sentence to mean the Warm-Water bidet was invented in the US, not the bidet itself.

bidet-type toilets here reveals ignorance among Japanese over their potential dangers. 

Quite an insult on science education in Japan, isn’t it, considering how few use them in the rest of the world.

Zichi,

Doesn’t a bidet cause you to use more toilet paper (for drying off purposes)?

1 ( +4 / -3 )

@borscht...mea culpa :)

1 ( +1 / -0 )

"Over washing the anus risks removing the sebum, which lubricates the surface. There have been reports of problems caused by over drying of peripheral areas," says Kusama. 

Surely toilet paper does the same thing.

10 ( +12 / -2 )

I remember as a kid seeing an old fashioned bidet at a rich friend's home. I didn't know what to make of it, it was like a toilet but yet like a wash basin. Perhaps these would be less harsh on the @nus, although you would have to use your fingers. The jets from modern e-bidets can sometimes really make you jump!

2 ( +4 / -2 )

Most bidet and oshiri devices have an air dryer too if you spend more.

I recently spent ¥420,000 on renovating the toilet and sentakubeya and it was worth it. I tell the seat cover to lift and flush and it listens to me. I do turn the power off when friends come over as we do not want them using our bidet water squirted cleaner. Yuckers!

-6 ( +1 / -7 )

Rarely use such except when nature suddenly calls when I'm out and I need a more extensive clean up - lol.

However, the 2 toilets in my house are both analog and I have no desire to update.

Of course all folks are free to choose whatever system to clean their private parts, but I've always been a bit suss about a device (nozzle) that sits in an atmosphere heavy with micro-critters, probably contaminating it, and then sprays through that "air" directly to one or two cavities.

The sense of reluctance by other countries citizens to indulge is understandable and reminds me a little of a survey years back on why heated toilet seats were not esp big in Australia. The #1 reason was "The warm seat gave the feeling someone has just been sitting on it".

3 ( +6 / -3 )

Remember that compared to the Japanese average body size, most others in the world are two to three times larger. Because of that, they can easily break delicate electronic sensors in modern Japan toilet seats, plus their bottoms are very much compressed. The spray water would most likely splatter everywhere and be of no use for front nor rear areas.

-15 ( +1 / -16 )

I leave bidets well alone, but I would've thought that if bidets were a serious health hazard then pretty much the entire population of France would be suffering from bum-related illnesses.

4 ( +5 / -1 )

Been using a washlet for years now, can’t say I’ve come across any of the problems raised in this article.

Much more pleasant than trying to clean up with dry paper.

11 ( +12 / -1 )

I also have a portable bidet, a hand-held contraption which you fill with water. The jet's not that strong but it sprays water. As Cleo says, dry paper just won't do the job.

And as Captain Kirk says, I just don't like the Klingons.

11 ( +11 / -0 )

Anything can be harmful to the human body if used incorrectly, or to excess.......toothbrushes, hand soap, q-tips, can all be used excessively.

10 ( +10 / -0 )

No.

2 ( +2 / -0 )

I've been using them for 20 years. And, as others here have mentioned, I have never had any of the issues the doctor in the article mentions.

On the rare occasions when I use a toilet without one, I don't feel clean afterwards. I'd rather hold it in until I get home, when possible, than use a non-washlet toilet.

4 ( +7 / -3 )

Most - if not all - muslim countries have a little shower for this purpose posted on the right side of the toilet (the left hand is used to clean the bottom). But it's with cold water.

4 ( +4 / -0 )

Since they require power for 24 hours a day, Washlets increase power consumption and are a drain on energy resources. I'm not sure what percent household electric bills increase by having them, but if 80% of the people in Japan -- plus in hotels, public buildings, hospitals, etc. -- are using them, that must be a considerable amount. I am more concerned with their impact on the environment than what they might or might not do to the human body.

-4 ( +3 / -7 )

They don't use power 24 hours a day. The unit is actually the seat that has bidets and heater seats. WE only use the heater during the winter months. The average max is about 600 watts. Japanese consume less power than half of that used by Americans, Canadians, and others. Using less toilet paper which requires power to manufacture and produce. Better for the oceans.

6 ( +7 / -1 )

Doesn’t a bidet cause you to use more toilet paper (for drying off purposes)?

You use much less paper than you would wiping only with paper. Have you used a bidet? The spray is narrow and directed. It doesn't make your whole backside wet. Our momma in Shanghai has one. I like it. I was really wishing I had one in the US early in the pandemic when tp was sold out in all the stores.

3 ( +4 / -1 )

Remember that compared to the Japanese average body size, most others in the world are two to three times larger. Because of that, they can easily break delicate electronic sensors in modern Japan toilet seats, plus their bottoms are very much compressed. The spray water would most likely splatter everywhere and be of no use for front nor rear areas.

Oh good grief! We bought one for our momma in Shanghai and it works just fine on a wide variety of body sizes. It is operated by controls on the side of the seat using little soft touch buttons. There are no sensors in the seat. Though her seat is heated you have to turn that feature on and leave it on. Momma's water and heat controls are electronic but some cheaper models have a simple faucet valve to control water use. Cold water only, though in the summer here even the cold water is plenty warm. If you shop on line you find many dozen models are available with and without heat.

6 ( +6 / -0 )

So if you shower twice a day and soap and clean that area wouldn't it have the same effect of removing the skin flora raising the PH level? As someone said above, if used too much or incorrectly anything can do damage. But I think this is far better than wiping and wiping using lots of tp and never really getting completely clean down there.

6 ( +6 / -0 )

I read somewhere that Kimberley Clark developed flushable wet wipes in the 1970s that they found to be superior to regular toilet paper, but couldn't sell the product because Americans were too embarrassed to talk about having a poo. This stopped them getting a buzz going and winning acceptance of the product.

In the UK building regs are quite strict about putting electrical outlets in the bathroom. I don't think you can put one right next to the toilet, as washlets have in Japan.

I don't know about other countries, but I doubt the lack of washlets in the UK has very much to do with sanitary concerns. Having a shower above a bathtub is still very common in the UK, so it is hardly a world leader when it comes to bathrooms.

7 ( +8 / -1 )

It has value to investigate problems and search for the possible causes, but immediately assuming that any observed problem relates to one single cause its not valid.

Professionals that worry about negative effects on the health should put in order a properly controlled survey to see if the problems they observe are actually related or not with using bidets and go from there. That is what has been done to identify known causes of problems like diet or infections.

5 ( +7 / -2 )

In the UK building regs are quite strict about putting electrical outlets in the bathroom. I don't think you can put one right next to the toilet, as washlets have in Japan.

In the US, any outlets within a certain distance to water, such as in bathrooms and kitchens, are required to have GFP circuits. (Ground Fault Protection). This prevents accidental electrocution.

I don't know about other countries, but I doubt the lack of washlets in the UK has very much to do with sanitary concerns. Having a shower above a bathtub is still very common in the UK, so it is hardly a world leader when it comes to bathrooms.

The bath/shower model is generally the same in the US, as well, except for some higher-end homes with a separate shower stall. (Think of a phone booth with a shower head.) But, the ofuro "room" with tub and shower in a large water-tight room, able to freely splash water everywhere is extremely rare.

The lack of popularity of these devices in the US is mainly because people find them "weird" and "foreign", not because of infrastructure or regulations. They tend to be more popular among the more educated, higher income, and better-travelled people, as well as foreigners living in the US.

Google has them in all the restrooms in all of their many campuses and buildings. I imagine other tech companies have followed their lead.

3 ( +3 / -0 )

I read somewhere that Kimberley Clark developed flushable wet wipes in the 1970s that they found to be superior to regular toilet paper, but couldn't sell the product because Americans were too embarrassed to talk about having a poo.

I don't doubt it. In the US, toilet paper is advertised and marketed with the name "bathroom tissue", so as not to offend, even though everybody calls it toilet paper, anyway.

2 ( +3 / -1 )

Only if you drink from it

2 ( +2 / -0 )

Bidet is a french word.

Yes

Bidet doesn’t originated in United States but in France at the beginning of the XVI century.

The early origin of the Bidet didn't, but the modern version did.

In 1928, in the United States, John Harvey Kellogg applied for a patent on an "anal douche". In his application, he used the term to describe a system comparable to what today might be called a bidet nozzle, which can be attached to a toilet to perform anal cleansing with water.

In 1965, the American Bidet Company featured an adjustable spray nozzle and warm water option, seeking to make the bidet a household item. The fixture was expensive, and required floor space to install; it was eventually discontinued without a replacement model.

1 ( +2 / -1 )

The Romans had their version of a bidet. Communal sponge on a stick.

The xylospongium or tersorium, also known as sponge on a stick, was a hygienic utensil used by ancient Romans to wipe their anus after defecating, consisting of a wooden stick

4 ( +4 / -0 )

There are many, many countries in the world where people wash their rear ends instead of using toilet paper:

https://therestroomkit.com/travel-toilet-paper/

As far as I know they don't have a problem with it.

4 ( +4 / -0 )

I say bring back "proper" toilet paper in a box. Izal was the brand name. None of this soft double quilted nonsense. For those who have never experienced a real British outdoor toilet in the 1960's.. Izal has all the softness and delicacy of 600 grit sandpaper.

Character building!

For those who didn't experience a realt outdoor toilet in the 1960s

-1 ( +1 / -2 )

So many men commenting here...Are you all sure to know what a bidet is usually meant for? ROFL

-3 ( +0 / -3 )

Sven Asai

So many men commenting here...Are you all sure to know what a bidet is usually meant for? ROFL

You are mistaken. On the Japanese Washlet toilet, not actually called a bidet. There are two settings, two buttons, one for the front area, and one for the rear area. There is also a button for setting the pressure. On some there is also a dryer button.

Washlet (ウォシュレット, Woshuretto) Trademark of Toto.

1 ( +2 / -1 )

My personal toilet history is born in a house with a WC at the bottom of the yard with ripped up news print. To Japanese Washlet.

2 ( +3 / -1 )

We have washlets at my workplace, and people like to adjust the settings to their particular preference.

I have occasionally hit the BUM button to be shocked by a jet of water at full force. Not to be recommended first thing on a weekday morning.

1 ( +1 / -0 )

As a long time sufferer of hemorrhoids, bidets are a god-send (especially compared to the dry & irritating paper alternative). Since living in Japan, i've never looked back, and when overseas always grateful when i remember to carry wet wipes.

Based on a helpful poll I saw in the https://rhoidrage.select.id/ community, theres unanimous conviction it's greatly net-positive.

I sympathize for Sixty-five-year-old Yuji Kawata, but if he started using a washlet due to hemorrhoids, then the latter is almost certainly responsible for the bleeding, not the washlet. After all, how can you overuse a bidet without also overusing (sitting for a long time & likely straining) the toilet?

Consider your hands & face - It simply doesn't make any common sense that cleaning with warm water would be worse than the unsanitary practice of wiping with dry paper.

1 ( +1 / -0 )

I partially grew up in the Middle East and they have a little hole in the toilet where the water shoots out. I have a washlet in my mansion. I always have and always will use a washlet.

Much more pleasant than trying to clean up with dry paper.

As Cleo says, dry paper just won't do the job.

And as Captain Kirk says, I just don't like the Klingons.

Hats off to Cleo, Pukey and Captain Kink. I couldn't agree with the 3 of you more!

0 ( +0 / -0 )

BobbyMar. 2 11:05 am JST

As a long time sufferer of hemorrhoids, bidets are a god-send (especially compared to the dry & irritating paper alternative). Since living in Japan, i've never looked back, and when overseas always grateful when i remember to carry wet wipes.

Why aren't hemorrhoids called asteroids?

0 ( +0 / -0 )

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