Women Ask the Specialists
How to use a spray seat properly

ProfileBorn in Yamagata prefecture.
Graduated from Tokyo Women's Medical University Graduate School, after training at the Tokyo Women's University General Surgery Ward, worked at the Social Insurance Central General Hospital Colon proctology Center for 6 years and 3 months, then on February 1st, 2000, the Marigold Clinic opened with an all female staff in Akasaka and became the first female doctor to work as a specialist for "hemorrhoids" in Japan. Japan Society of Colon proctology Specialist, Medical Adviser.

Hemorrhoids in women and using the spray seat properly(Dr. Tokiko Yamaguchi of the Marigold Clinic)

It seems that recently women who are suffering from hemorrhoids are increasing. The spray seat that can easily clean the affected area is a great help to such women however, do people know how to use the spray seat properly?
The risk of developing hemorrhoids is surprisingly high for women due to change in hormonal balance, pregnancy, giving birth, diet, etc. This time, we asked Dr. Tokiko Yamaguchi of the Marigold Clinic about the proper use of the spray seat as a measure for hemorrhoids.


Women’s “hemorrhoids” and measures, and the proper use of spray seat

Q1.“Hemorrhoids” is known as a national ailment but is there a difference between men and women?
Additionally, we’ve heard that “hemorrhoids” are on the increase in young women but what could be the cause of this?

There is little difference between men and women for this ailment. Internal hemorrhoids or piles account for about 60%, external hemorrhoids (anal fissures) about 35% and the remaining % are anal fistula. However, in young women, external hemorrhoids are most common. In my clinic, 80% of the patients are ages 20s to 40s however, external hemorrhoids account for about 60% of cases.

The most common cause of external hemorrhoids is constipation.
When constipated, stool becomes hard and during bowel movement, this in turn injures the anus and causes external hemorrhoids.
Also because when young, muscles are more tense and are easier to lacerate.
Other causes are poor circulation, excessive stress, and dietary habits contribute to the risks.


Q2.We’ve heard that pregnancy and giving birth are common causes of hemorrhoids, what is your opinion on this?

Certainly, the effects of hormones during pregnancy, becoming constipation prone due to the enlarged uterus applying pressure on the bowels, and the straining during child birth is a heavy burden on the anus. After giving birth, lactation causes large amounts of water to be depleted and stool becomes hard as a result causing constipation and in return causing hemorrhoids. In this manner, the risk of hemorrhoids during the periods of pregnancy, child birth, and breast feeding are high. However, if you understand that during this time you are prone to hemorrhoids and pay attention to your diet, warm yourself when taking a bath and take to heart preventative measures, you will not have to feel so anxious about getting hemorrhoids. Many patients that are age 20s to 30s who come to my clinic have not experienced pregnancy or giving birth. Other factors, such as their daily lifestyle is often the cause.

Q3.What are some points to be careful of on a daily basis in order to avoid "hemorrhoids"?

Regulate your bowel movement cycle. Because individuals are different, you should understand your cycle and take care not to allow it to become abnormal and be constipated or have diarrhea. To accomplish this, it is important not to hold back the urge of bowel movement. You should relieve yourself as soon as you feel the urge to go. Just sitting on the toilet will cause hemostasis in your buttocks so prolong periods in the toilet is not good. Avoid being in the toilet for long periods and make it a point to try to leave within 3 minutes.
Additionally, making sure to eat breakfast is important. Eating will wake up your organs and the urge to move your bowels will become easier. Therefore morning is a very important time. I would like people to wake up in the mornings with a lot of time to spare. Other things are make sure to take in ample dietary fiber and liquids, warm your body when taking a bath in a bathtub, do not stay in one position for prolong periods, and not accumulating stress are points that you should keep in mind.


Q4.What are the benefits of using a spray seat when having hemorrhoids?
What are the precautions on its use, if any?

The best benefit is that the affected area can be kept clean very easily. Previously, post operative patients and patients with severe symptoms were instructed to take "hip baths". Warm water would be poured into a large tub and they would put their buttocks into it keep the area clean. It is much more convenient now with the popularization of the spray seat. Additionally, some people would wipe their buttocks forcefully after bowel movement and aggravate it to make the condition worse. Using a spray seat will also avoid this.
After use, wipe gently to remove any droplets of water. If there is a drying function, it would be good to also use it. However, be careful of overuse. This is something that people regardless of having or not having hemorrhoids should be careful of. "The more you wash, the cleaner it gets and the better it is" does not hold true. Washing too much will remove sebum and so an appropriate number of times and amount should be used. When washing your buttocks or with the bidet, you should adhere to keeping the temperature about the same as skin temperature and wash for about 10 to 20 seconds. For water pressure, try out "low" first then gradually increase until you find your preference. High water pressure can be painful for people with external hemorrhoids.

Q5.Can the way you use the spray seat cause hemorrhoids or make the symptoms worse?

I have never heard of anyone getting hemorrhoids from using a spray seat. I also haven’t heard of symptoms getting worse from its use. However, as mentioned earlier, over washing may result in removing the sebaceous glands of the skin around the anus causing itching and inflammation. This can be avoided by being careful not to over wash the area. Reading the instruction manual and using the spray seat appropriately will easily maintain cleanliness and so there is no reason to be anxious.


Q6.Is there anything that women in particular should be careful of when using a spray seat?

Women physiologically have a tendency to have an increase or decrease of the corpus luteum hormone before menstruation increasing the likelihood of becoming constipated and during menstruation, having diarrhea. This is also different for people who are easily affected by hormones and those who are not so it is difficult to determine, however people who are vulnerable to having diarrhea during menstruation may want to use the bidet washing function. This also should not present a problem as long as you don't over wash the area.

Q7.As a method for preventing “hemorrhoids” you mentioned that it was important to regulate bowel movement, I have heard that some people use the spray seat to promote bowel movement, what are your thoughts on this?

If a person is using it in this manner habitually, I think it is better to stop. Ideally, going to the toilet for bowel movement should be natural when the urge is felt. The original purpose of the spray seat is “to wash and clean your buttocks”. I do not recommend deviating from this usage.

Q8.Lastly, could you say a few worlds to women who are having concerns about their buttocks?

In our clinic, everyone including myself, are women and so we have many female patients. In the past, for many people pregnancy and giving birth was a factor in developing hemorrhoids however, recently there are many women without experience of pregnancy or child birth of ages 10’s ~ 30’s. The popularization of spicy foods, westernization of diet, and extreme diets are contributing factors.

Women might be a little embarrassed to go for checkups and that could be why many come after their symptoms have become worse. However, if there is any bleeding or pain during bowel movement, you should visit your doctor to have an examination. Conditions that require surgery are only about 10% of cases and most people can be cured with only 1 treatment. Bleeding during bowel movement can also indicate colon cancer so please don’t be afraid to go and see a doctor.foods, westernization of diet, and extreme diets are contributing factors.


10 Things to Keep in Mind to Prevent “Hemorrhoids”

1.Eat a proper breakfast2.Take in dietary fiber and water3.Do not starve yourself or go on extreme diets4.Take baths and thoroughly warm you body5.Do not stay in the same position for prolong periods6.When you feel the urge for bowel movement, do not hold back and go immediately7.Keep your stay in the toilet short (within 3 minutes as a guideline)8.Do not forcefully strain for prolong periods during bowel movement9.Do not accumulate stress or fatigue10.Keep your buttocks clean by proper use of commercially available flushable wet tissues, spray seat and other personal care products