Anal hygiene

Lore & Background

The process of post-defecation cleansing often involves washing the anus and inner part of the buttocks with water. Water-based cleansing typically involves either the use of running water from a handheld vessel and a hand for washing or the use of pressurized water through a jet device, such as a bidet. In either method, subsequent hand sanitization is essential to achieve the ultimate objectives of post-defecation cleansing. However, many people throughout history have instead wiped or scrubbed the area, most commonly in modern history with toilet paper.

Reader's Guide

Anal hygiene has a long history, with materials varying across cultures. The ancient Greeks used fragments of ceramic known as pessoi. The ancient Romans used a tersorium, a sponge on a wooden stick shared in public latrines, which became a breeding ground for bacteria. In ancient Japan, wooden skewers called chuugi were used. Toilet paper first started in ancient China around the 2nd century BC. The first commercially available toilet paper was invented by American entrepreneur Joseph Gayetty in 1857. In many cultures, water has been used for anal cleansing since ancient times, using methods such as Istinja in the Middle East, the lota vessel in the Indian subcontinent, and the tabo tool in Southeast Asia. The inclusion of anal cleansing facilities is often overlooked in the design of public or shared toilets in developing countries, and ensuring safe disposal of anal cleansing materials is often overlooked, contributing to the spread of diseases.

Did You Know?

• The ancient Greeks used fragments of ceramic known as pessoi for anal cleansing.
• The ancient Romans used a tersorium, a sponge on a wooden stick, shared in public latrines.
• Toilet paper first started in ancient China around the 2nd century BC.
• The first commercially available toilet paper was invented by American entrepreneur Joseph Gayetty in 1857.

Ancient Materials and the Long Road to Modern Cleansing

The history of how humans clean themselves after defecation stretches back thousands of years across multiple civilizations. In ancient Greece, people relied on broken pieces of ceramic called pessoi to wipe the area. The Romans took a different approach, employing a sponge mounted on a wooden stick known as a tersorium. In public latrines, this tool was shared among users and rinsed in buckets of salt or vinegar water, a practice that inadvertently created conditions favorable to bacterial growth and the spread of illness. Across the Pacific, ancient Japanese people used wooden skewers referred to as chuugi for the same purpose. In China, the earliest recorded use of toilet paper dates to roughly the second century BC, though it would not become a commercially produced product until Joseph Gayetty introduced his version in 1857 during the Second Industrial Revolution. Meanwhile, across much of Asia and the Middle East, water-based methods such as the Istinja practice, the lota vessel in the Indian subcontinent, and the tabo tool in Southeast Asia had been in continuous use since antiquity, representing a fundamentally different philosophical approach to post-defecation cleanliness.

Faith, Tradition, and the Left-Hand Rule

The choice between water and dry materials for anal cleansing is deeply intertwined with religious and cultural identity. In societies shaped by Islamic, Hindu, Buddhist, Catholic, and Eastern Orthodox traditions, washing with water is the standard practice, a norm also observed in certain Protestant communities such as Finland. Islamic toilet etiquette specifically encourages washing after every instance of defecation, while also offering flexible alternatives—stones or paper—when water is scarce. In Turkey, Western-style toilets feature a small nozzle called the taharet musluğu, controlled by a nearby tap, allowing the user to wet their hand for cleansing before drying with paper. In India, the traditional lota vessel remains common, though newer installations increasingly include a bidet shower. Many of these cultures maintain the convention that only the left hand should be used for the task. Christian traditions similarly reference biblical toilet etiquette that promotes washing. In contrast, in parts of the developing world where running water is unreliable, people resort to leaves, mud, snow, corncobs, or stones, making the availability of any hygienic material a matter of basic public health.

Pathogens, Taboo, and the Public Health Gap

Despite its straightforward scientific purpose—preventing exposure to disease-causing organisms—post-defecation cleansing remains one of the least academically studied aspects of personal hygiene, largely because of the social taboo that surrounds it. This knowledge gap has real consequences. In many developing regions, public and shared toilets are designed without any provision for cleansing materials, and the safe disposal of whatever materials are used is frequently neglected, leaving unhygienic debris inside and around facilities that can facilitate the spread of illness. Research has shown that the absence of proper cleansing materials in a household can be correlated with a higher frequency of diarrhea episodes. The problem is not new: in Roman public latrines, the shared sponge-and-stick device, when rinsed in salt or vinegar water, became a breeding ground for bacteria. On the other hand, medieval Sri Lanka offers a remarkable counterexample, with archaeological evidence of toilets dating from the sixth century onward that included complete plumbing and multi-stage sewage treatment, reflecting a sophisticated understanding of sanitation codified in Buddhist teachings attributed to the Buddha himself in the Tripitaka.

From Gayetty's Paper to the Shattaf: Commercializing Cleanliness

The commercialization of anal hygiene tools marks a distinct chapter in the story. While toilet paper had existed in China since the second century BC, it was not until 1857 that American entrepreneur Joseph Gayetty produced the first commercially available version, coinciding with the rise of the Second Industrial Revolution. French physician François Rabelais had earlier, in the sixteenth century, questioned the effectiveness of paper for this purpose, a skepticism that highlights how long the debate over optimal methods has persisted. In the water-based world, the bidet and its handheld variants have long served as the standard fixture. A significant modern development came in the early 1990s when Rizwan Sajan and Anis Sajan, based in Dubai, founded the Danube Group and began marketing a handheld bidet shower branded as the Shattaf. The product quickly gained widespread adoption across the Arab world and broader Asia. In water-based routines, whether using a pressurized jet or a simple vessel, the process is typically completed with hand sanitization and, in many traditions, drying the area with a cloth towel, underscoring that the full sequence of steps matters as much as the initial wash.