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Anal cleansing is the hygienic practice that a person performs on the anal area of themselves after defecation. The anus and buttocks may be either washed with liquids or wiped with toilet paper or other solid materials. In many Muslim, Hindu and Sikh cultures, as well as Southeast Asia, water is usually used for anal cleansing using a jet, as with a bidet, or most commonly, splashed and washed with the hand. Some people follow this up with toilet paper afterwards for drying purposes.
In low-income settings of developing countries or during camping trips, materials such as vegetable material, mudballs, stones, sticks and leaves are sometimes used.
Having a hygienic means for anal cleansing available at the toilet is important for overall public health. The absence of anal cleansing material in households can in some circumstances be correlated to the number of diarrhea episodes per household.
The use of toilet paper for post-defecation cleansing first started in China. It became widespread in Western culture. In some parts of the world, especially before toilet paper was available or affordable, the use of newspaper, telephone directory pages, or other paper products was common. The widely distributed Sears Roebuck catalog was also a popular choice until it began to be printed on glossy paper (at which point some people wrote to the company to complain). With modern flush toilets, using newspaper as toilet paper is liable to cause blockages. This practice continues today in parts of Africa; while rolls of Western-style toilet paper are readily available, they can be fairly expensive, prompting poorer members of the community to use newspapers. Sometimes a gel or foam is applied to paper to clean pores and moisturize skin. 
Although wiping from front to back minimizes the risk of contaminating the urethra, the directionality of wiping varies based on sex, personal preference, and culture.
Predominantly Muslim countries
The use of water in Muslim countries is due in part to Islamic toilet etiquette which encourages washing after all instances of defecation. Further, Islam has made flexible provisions for when water is scarce; stones or papers can be used for cleansing after defecation and in ablution.
In Turkey, all Western-style toilets have a small nozzle on the centre rear of the toilet rim aiming at the anus. This nozzle is called taharet musluğu and it is controlled by a small tap placed within hand's reach near the toilet. It is used to wash the anus after wiping and drying with toilet paper. Squat toilets in Turkey do not have this kind of nozzle (a small bucket of water from a hand's reach tap or a bidet shower is used instead).
Another alternative resembles a miniature shower and is known as a "health faucet" or a bidet shower. It is commonly placed in an alcove to the right hand side of the toilet where it is easy to reach. These are commonly used in the Muslim world. In the Indian subcontinent, a lota vessel is often used to cleanse with water, though the shower or nozzle is common among new toilets.
In India and the Indian subcontinent, over 95% of the population use water for cleansing the anal area after defecating. In places where water is scarce or not closely available, a stone or similar hard material might be used instead. Use of toilet paper is rare in this region and is seen only in some urban settings. The cleaning of hands with soap after this cleansing process is very important. If soap is not available, soil, ash or sand could be used to clean the used hand or both hands. Toilets may also have spray bidets (health faucets). Simpler toilet rooms may not have running water for anal cleansing and handwashing, but buckets, bails and mugs are used for storage of water and for the purpose of cleaning.
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In Southeast Asian countries such as Indonesia, the Philippines, and Thailand, house bathrooms usually have a medium size wide plastic dipper (called gayung in Indonesia, tabo in the Philippines) or large cup, which is also used in bathing. However, most general households utilize toilet paper, "health faucets", or bidets (in some rich mansions) as well. Some health faucets are metal sets attached to the bowl of the water closet, with the opening pointed at the anus. Toilets in public establishments mainly provide toilet paper for free or dispensed, though the dipper (often a cut up plastic bottle or small jug) is occasionally encountered in some establishments. Though most Thais find it difficult not to cleanse their anus with water, most of the shopping malls do not provide health faucets since they are considered to be dirty and could make it hard for them to keep the bathrooms clean. Owing to its ethnic diversity, restrooms in Malaysia often feature a combination of anal cleansing methods where most public restrooms in cities offer toilet paper as well as a built in bidet or a small hand-held bidet shower connected to the plumbing in the absence of a built-in bidet.
The first "paperless" toilet seat was invented in Japan in 1980. A spray toilet seat, commonly known by Toto's trademark Washlet, is typically a combination of seat warmer, bidet and drier, controlled by an electronic panel or remote control next to the toilet seat. A nozzle placed at rear of the toilet bowl aims a water jet to the anus and serves the purpose of cleaning. Many models have a separate "bidet" function aimed towards the front for feminine cleansing. The spray toilet seat is common only in Western-style toilets, and is not incorporated in traditional style squat toilets. Some modern Japanese bidet toilets, especially in hotels and public areas, are labeled with pictograms to avoid language problems, and most newer models have a sensor that will refuse to activate the bidet unless someone is sitting on the toilet.
Europe and the Americas
Some people in Europe and the Americas use bidets for anal cleansing with water. The availability of bidets varies widely within this group of countries. Furthermore, even where bidets exist, they may have other uses than for anal washing.
Immigrants who come from countries where anal cleansing with water is the norm, tend to use a combination of methods - initial wiping with toilet paper combined with water cleansing or wet wipes - to adapt to their new country where toilets are not equipped with anal washing options.
In rural areas of developing countries, sticks, stones, leaves, corn cobs and similar are also used for anal cleansing. This may be due to the unavailability of toilet paper/similar paper products and water or due to cultural reasons.
When cleaning babies' buttocks during nappy changes wet wipes are often used, in combination with water if available.
Roman anal cleansing was done with a sponge on a stick called a xylospongium. The stick would be soaked in a water channel in front of a toilet, and then stuck through the hole in front of the toilet for anal cleaning. In ancient Japan, a wooden skewer known as chuugi was used for cleaning after defecation.
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