Is a bidet good for hemorrhoids?

A bidet rinses sore skin when toilet paper feels like sandpaper. Large follow-up surveys from Japan found that people who already had hemorrhoids were more likely to use a bidet, and that habitual use did not raise the rate of new hemorrhoids over one year or three. The harm shows up when the spray is strong, thin, or left running. Excessive washing can feed itch, and a clinic series links electric bidets to stool leakage that improved after people stopped.

This page goes through those studies, including Kiuchi, Asakura, and Tsunoda, then the practical settings: low pressure, a short rinse, warm water if you have it. The buying notes are on the best bidets for hemorrhoids. Cleaning habits that do not depend on a gadget are in toilet habits for hemorrhoids.

Do bidets cause hemorrhoids?

The short research answer is that habitual use has not been shown to create new hemorrhoids. People reach for a bidet because the skin already hurts, which muddies a one-time survey.

Kiuchi and colleagues followed bidet users and non-users with a web survey from 2013 to 2014. They analyzed 7,637 adults. At the start, bidet users had higher odds of hemorrhoids, urinary infections, and vulval itch. Over the next year, the odds of newly developing those problems were not significantly higher. The one incidence result that was significant was symptoms of bacterial vaginitis (adjusted odds ratio 2.662, 95% CI 1.315 to 5.520). The authors read the hemorrhoid finding as reverse causation: the bidet did not appear to cause the hemorrhoids, because new cases were not increased. They said the vaginitis signal might be real and that the numbers were too small to be sure ¹.

Asakura and colleagues extended that kind of survey to three years, starting with 10,305 adults in 2013 and asking again in 2014 and 2016. Cumulative incidence of hemorrhoids and of urogenital infections was not significantly higher in habitual users. Several problems were more common at baseline among people who already used a bidet a lot, which again fits reverse causation. In men, habitual users were more likely to report new irritated skin around the anus (adjusted risk ratio 1.36, 95% CI 1.06 to 1.75) ².

A 2022 systematic review pooled what it could find on bidets in hemorrhoids, anal fissures, and pruritus ani (itch around the anus). Two prospective studies and one cross-sectional study found no effect of habitual use on the odds of hemorrhoids. The same sort of evidence suggested habitual use may increase the odds of pruritus ani. The authors did not run a meta-analysis, because the studies were few and uneven, and they said bidets are not established as a treatment for perianal disease ⁷.

So a gentle rinse is unlikely to give you hemorrhoids. It can irritate skin that is already fussy, especially in the pattern Asakura saw in men. If your main symptom is itch on an external hemorrhoid, turn the washing down before you turn it up.

What a gentle spray does to the muscle

A warm sitz bath lowers pressure in the anal canal. Shafik measured that in 1993: a 10-minute warm bath relaxed the internal sphincter, and the effect faded over 25 to 70 minutes ¹². Researchers in Seoul asked whether a bidet jet could do the same thing.

In a study of 20 healthy volunteers, anal pressure was measured before and after jets at different forces (40, 80, 160, and 200 millinewtons), temperatures (24 degrees C and 38 degrees C), and widths (narrow or wide). Pressure fell in three warm, gentler settings: a wide jet at 40 millinewtons and 38 degrees C (from 96.1 to 81.9 mmHg), a narrow jet at 80 millinewtons and 38 degrees C (94.3 to 80.0), and a wide jet at 80 millinewtons and 38 degrees C (92.3 to 79.6). The other settings, including the higher forces, did not produce a significant drop. The authors said a bidet could lower resting pressure the way a warm sitz bath does when the jet is low or medium force, warm, and wide ⁴.

You do not have a millinewton gauge on a home attachment. Use the lowest pressure that still rinses, warm water if the unit can heat it, and a wide soft stream. A later study built a fountain-style bidet at 38 degrees C and a very low force, 10 millinewtons, because the authors wrote that the high force of ordinary electric bidets may harm the anus. In 40 volunteers that low-force bidet dropped resting pressure about as much as a warm sitz bath (to 78.2% of the starting pressure, versus 78.1% after the bath). Rectal temperature did not rise ⁵.

High pressure and other harms

Tsunoda’s 2021 review puts the everyday picture and the problems in one place. Electric bidets are common in Japan, and about half the population washed the anus before or after a bowel movement. A rinse can help hand hygiene and local comfort, and it may help constipation. Excessive use can cause anal itch and anal incontinence, meaning leakage of stool or mucus. The review tells clinicians to have patients with itch ease off the washing, and to have patients with leakage stop the bidet. If you are judging how bad leakage is, stop the bidet first and reassess, or the spray will confuse the picture. The nozzle and the spray water can carry fecal bacteria, including Escherichia coli and Pseudomonas aeruginosa, and antibiotic-resistant bacteria. In hospital, people with weak immune systems should not share a bidet. The review says to give them their own unit, or tell them to skip the bidet ³.

The same author later reviewed 53 patients with anal incontinence who habitually used an electric bidet, and had follow-up on 49 of them. They were told to stop. After a median of 4 weeks, the fecal incontinence severity index fell from a median of 15 (range 3 to 43) to 10 (range 0 to 43). The share with fecal incontinence fell from 88% to 59%. A stronger squeeze pressure, and the absence of other causes such as a rectocele or prior anal surgery, lined up with at least a 50% score drop. The score of how heavily they had used the bidet did not ⁸. This is a retrospective series with no comparison group. It is a reason to stop the spray if you are leaking. It is not proof that every leak started with a bidet.

Two case reports show what a hard spray can do to tissue. A 61-year-old woman with anal bleeding and pain had been washing five or more times a day for a minute or longer, with a strong, thin jet, for a year. Anoscopy showed a small ulcer at the front of the anorectum. She stopped the bidet. Five weeks later the symptoms were gone and the ulcer had healed ⁹. A 66-year-old man who already used a bidet for more than 5 minutes because of constipation then switched to the highest pressure for long periods. Colonoscopy showed a serious rectal ulcer running around the lower rectum. The report describes that pattern as rare, and it ties it to excessive use ¹⁰.

A systematic review also found case series of perianal burns and of anterior anal fissures in habitual bidet users ⁷. A fissure is a small tear in the anal lining. It causes sharp pain with bowel movements, which is a different problem from a hemorrhoid, and it is one more reason not to “power wash” sore skin.

How to use a bidet when you have hemorrhoids

1. Set the pressure to the lowest level that still cleans. Raise it only if stool is left behind. The lab jets that relaxed the muscle were the gentler ones ^4,5.
2. Prefer warm water, around body warmth (the studies used 38 degrees C). Cold jets in the 2011 experiment did not lower pressure ⁴.
3. Use a wide, soft stream. The ulcer case used a thin, strong jet ⁹.
4. Rinse for a few seconds after a bowel movement. Do not wash before and after every trip, and do not sit there for minutes. The injury reports describe minute-long washes and sessions over 5 minutes ^9,10.
5. Pat dry with a soft towel. The NHS piles page says to pat rather than rub, and to keep the skin clean and dry ¹¹.
6. If itch gets worse, cut the washing back. Tsunoda’s review and Asakura’s finding in men both point that way ^2,3.
7. If you leak stool or mucus, stop and get examined. Do this before you buy a stronger nozzle ⁸.
8. In a hospital, do not share a bidet if your immune system is weak ³.

The NIDDK still lists a warm sitz bath several times a day for pain, which remains the soak with a longer track record than a bidet jet ¹³. How to do that soak is in how to take a sitz bath. When to pick a cold pack instead of warm water is in ice or heat for hemorrhoids.

Bidets compared with sitz baths after surgery

One multicenter trial, called BIDLOW, randomized people after hemorrhoidectomy to a lower-force electronic bidet or to warm sitz baths for 7 days. Fifty-one people were assigned to the bidet and 50 to sitz baths. After dropouts, 34 and 41 were analyzed. Anal pain scores at day 7 were 38.3 versus 42.0 on a visual scale, which was not a significant difference (p = 0.453). The trial had set out to show the bidet was not worse than a sitz bath, and it did not clear that bar: the upper end of the confidence interval sat above the margin the authors had chosen ⁶.

Baig’s review described a randomized trial as finding bidets non-inferior to sitz baths for pain after hemorrhoidectomy ⁷. The trial paper itself says noninferiority was not verified ⁶. Average scores can look similar in a small, incomplete study and still fail a formal test. If you are healing from surgery, use the method your surgeon named. The recovery weeks are outlined in our hemorrhoid treatment guide.

Which setup to buy

For a toilet you will use every day, a seat attachment with a pressure control is the usual switch from wiping to rinsing. Buyers of the LUXE NEO 120 say installation takes about 15 minutes and that they feel cleaner. The complaints that matter here are pressure that feels too strong, knobs that break after a few years, and cold water only. Cold water can still rinse. It is the wrong tool if you wanted the warm-jet effect from the pressure studies. If the skin is very raw, that listing’s own caution is to start at the lowest setting or use a peri bottle of warm water instead.

The TUSHY Classic is the attachment with a nozzle you can aim. Buyers like the angle control. Some find the pressure weak, which is a safer failure mode when you have hemorrhoids, and some report splashing or a unit that fails within a year.

A peri bottle is the portable version: an angled squeeze bottle you fill with warm water. People use it after birth and after procedures because the force is whatever your hand allows. The bottle holds 10 ounces, so you may refill it, and some units leak in a bag. It belongs in a postpartum hemorrhoid kit as much as in a hemorrhoid flare.

Sprays and rinse bottles that are not full bidet seats are compared on hemorrhoid sprays and rinse bottles. None of these replace softer stools and shorter toilet sits. Those habits are the ones that keep hemorrhoids from coming back, and they are laid out in how to prevent hemorrhoids.

Colon cancer screening starts at age 45 in the USPSTF recommendation ¹⁴. If a low setting still stings, stop the device and use plain warm water from a bottle or a sitz bath until a clinician has looked.