title: Survey of electric bidet toilet use among community dwelling Japanese people and correlates for an itch on the anus.
abstract: OBJECTIVE
  We conducted a survey to investigate the use of bidet toilets among community dwelling Japanese people and explored the correlates for an itch on the anus.
  
  
  METHODS
  A questionnaire-based survey was conducted among a convenience sample of individuals, who were derived from outpatients and employees of Kameda Medical Center, and students and employees of two technical colleges.
  
  
  RESULTS
  A total of 4,963 respondents were evaluated in this study, 55 % of whom used bidet toilets either before or after defecation, and at least 30 % of bidet users washed the anus before defecation, partly to aid defecation. Men rather than women, and older people (aged ≥50 years) rather than younger people used bidets more actively. Logistic regression analysis showed that the correlates for an itch on the anus included male sex, younger age, washing the anus before defecation, warmer water for washing the anus after defecation, and the frequency of fecal leakage.
  
  
  CONCLUSIONS
  Nearly, one-third of bidet toilet users washed the anus before defecation. An itch on the anus may be associated with the active use of bidets.
authors.affiliation: Department of Gastroenterological Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan. tsunoda.akira@kameda.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Tsunoda
authors.affiliation: Department of Gastroenterological Surgery, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Nursing, Kameda College of Health Sciences, Kamogawa, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Arika
authors.affiliation: Department of Nursing, Kameda College of Health Sciences, Kamogawa, Japan.
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Kubo
authors.affiliation: Kameda Institute of Nursing and Advanced Practice, Kamogawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tokita
authors.affiliation: Department of Nursing, Kameda College of Health Sciences, Kamogawa, Japan.|Kameda Institute of Nursing and Advanced Practice, Kamogawa, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Kameda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011538:Pruritus Ani / Q000453:epidemiology*; D012307:Risk Factors; D014038:Toilet Facilities / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Electric bidet toilet; Itch on the anus; Japanese people