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editorial
. 2025 Jan 7;87(2):441–443. doi: 10.1097/MS9.0000000000002962

Enhancing bowel health and hygiene with portable toilet sprayers for low- and middle-income countries

Md Kamrul Hasan a,b,*
PMCID: PMC11918581  PMID: 40110285

Constipation and hygiene-related illnesses are prevalent in underdeveloped regions, primarily due to inadequate sanitation facilities and poor hygiene practices[1]. While various interventions have been implemented to address these issues, the specific role of portable toilet sprayers in enhancing bowel health and hygiene has not been thoroughly investigated. This editorial highlights portable toilet sprayers as a novel, practical solution for resource-constrained settings, emphasizing their potential to improve health outcomes efficiently. Conventional means of treating constipation, such as dietary adjustments and laxatives, are sometimes ineffective due to inadequate resources. Portable toilet sprayers offer a unique approach by directly facilitating bowel movements through perineal stimulation and improving hygiene by effectively cleaning the anal area. Although no direct studies on portable sprayers exist, their mechanisms align with broader findings on water-based sanitation innovations and their impact on public health. Unlike conventional methods, such as toilet paper, sprayers provide a water-based cleaning mechanism that can reduce friction and irritation, potentially decreasing the incidence of constipation and anal fissures. These underexposed benefits highlight the potential of portable sprayers as a focused intervention for addressing sanitation-related challenges in resource-constrained settings, where improved access to hygiene tools can have a significant public health impact[2,3].

Water-based interventions, including transanal irrigation, are effective in managing severe bowel dysfunctions by promoting stool evacuation and improving anorectal coordination. Although portable toilet sprayers are not medical devices and have not been studied for such conditions, they may operate on similar principles. The application of water to the anal area may reduce friction, ease the passage of hard stools, and promote relaxation of the anal sphincter muscles. These attributes suggest that portable sprayers could serve as a noninvasive tool for improving hygiene and potentially alleviating mild constipation in resource-limited settings[4].

Beyond facilitating bowel movements, portable toilet sprayers can significantly enhance public health by reducing the transmission of fecal-oral diseases. By providing a more thorough cleaning method, sprayers can decrease the presence of pathogenic microorganisms, thereby lowering infection rates. This aligns with findings from studies on improved sanitation practices leading to better health outcome[3]. Using water to clean up feces removes more fecal matter than toilet paper, lowering the risk of illness and improving overall hygiene[5]. This is especially crucial in locations where access to clean water and soap is limited. Portable sprayers could represent a low-cost solution, potentially making them accessible to low-income households. While their affordability and convenience need further evaluation, they hold promise as a practical intervention to improve health outcomes and enhance the quality of life for many people in resource-limited settings.

Implementing portable toilet sprayers in underdeveloped regions requires a comprehensive strategy that includes community engagement, education on proper usage, and collaboration with local health organizations. Implementing portable toilet sprayers in low- and middle-income countries (LMICs) necessitates a multifaceted approach with specific measures and methods to ensure success:

  1. Pilot Studies: Conduct small-scale pilot projects in selected LMIC communities to assess the feasibility and effectiveness of portable sprayers. Metrics such as user satisfaction, frequency of use, and impact on bowel health and hygiene can guide scalability decisions[6].

  2. Community Engagement: Incorporate participatory approaches by involving local leaders, healthcare workers, and community members. Educational workshops and live demonstrations on the benefits and proper use of sprayers can improve acceptance and adoption rates[7].

  3. Distribution and Accessibility: Partner with local manufacturers and NGOs to produce low-cost sprayers locally, reducing costs and ensuring consistent supply. Distribution through healthcare centers, schools, and community hubs can maximize reach[8].

  4. Monitoring and Evaluation: Establish a framework to track the impact of sprayer use on health outcomes such as reduced constipation rates and improved hygiene. Collecting user feedback and conducting periodic evaluations can help refine the intervention[9].

Low-cost sanitation technologies have shown promise in improving hygiene and health outcomes in resource-limited settings, suggesting that portable sprayers could be integrated into existing public health frameworks. Programs such as UNICEF’s Water, Sanitation, and Hygiene initiative have successfully collaborated with local communities to implement affordable solutions, such as handwashing stations, highlighting the potential for similar scalable interventions. These collaborations have led to significant improvements in hygiene practices and reductions in waterborne diseases[10]. Pilot studies in specific communities will give helpful information about the effectiveness and acceptability of portable sprayers. These investigations can assist in modifying the intervention to meet local requirements and preferences[11]. Raising awareness regarding the advantages of utilizing toilet sprayers is critical. Educational resources should explain the health benefits and show proper usage. Community workshops and collaborations with local health workers can help to increase outreach efforts[12]. Collaboration with local and international health organizations can help to distribute sprayers more efficiently. These alliances can also assist in securing funds and resources for long-term implementation[13]. Making sprayers inexpensive and accessible is critical to broader adoption. While the initial cost of portable toilet sprayers may be a consideration, they are more affordable than constructing conventional sanitation facilities. For example, basic portable sprayers can be produced locally at a low cost, and their use has been associated with improved hygiene and reduced incidence of sanitation-related diseases. Additionally, the long-term health benefits and potential healthcare cost savings make them a cost-effective solution for improving sanitation in low- and middle-income countries[14]. Local manufacturing and distribution through medical facilities and community centers may contribute to this goal[15]. Continuous monitoring and evaluation will assist in determining the intervention’s effectiveness and identifying areas for improvement. Collecting user feedback will also guarantee that the sprayers meet the community’s needs[1].

In conclusion, portable toilet sprayers provide a simple but efficient solution for enhancing bowel health and cleanliness in undeveloped areas. Sprayers can treat common health conditions associated with poor sanitation by increasing bowel movement and hygiene. Implementing this intervention necessitates a multidisciplinary team (MDT) that includes research, education, partnerships, and close monitoring. Future studies should include randomized controlled trials to assess sprayer efficacy in lowering constipation rates, longitudinal studies to track long-term health outcomes, and qualitative studies to better understand user experiences and challenges to adoption. Portable toilet sprayers, when used correctly, can make a major contribution to public health gains in resource-limited settings.

Acknowledgements

None.

Footnotes

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Published online 7 January 2025

Ethical approval

Not applicable.

Consent

Not applicable.

Sources of funding

No funding from any public, private or non-profit research agency was received for this study.

Author’s contribution

M.K.H.: conceptualization, investigation, formal analysis, methodology, project administration, writing – original draft, writing – review & editing.

Conflicts of interest disclosure

The authors report no competing interests. The authors alone are responsible for the content and writing of this article.

Research registration unique identifying number (UIN)

Not applicable.

Guarantor

Md. Kamrul Hasan.

Provenance and peer review

Not commissioned, externally peer-reviewed.

Data availability statement

Dataset used in this study will be available as per request (mailing to the corresponding author).

References

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

Dataset used in this study will be available as per request (mailing to the corresponding author).


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