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Toilet disease

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A 23-year old lady, who works in the administration department of a general hospital in one of the large cities, popularly called ‘Lady B’, a spinster, ran towards a doctor before she entered her consulting office.

The following conversations ensued:- Lady B:-Good morning doctor.

Doctor:- Good morning Lady B. You are not looking bad this morning, any goodies?

LadyB:-Oh! No Doc. I need your help, please ma.

Doctor:-Go ahead, tell me.

LadyB:- Hmm! ma, I have a terrible infection. Doctor:-Infection? Follow me.(the doctor opened the door and both of them entered the consulting room).

Doctor:-Do have a seat(she said, pointing to a seat).

LadyB:- Thanks.

Doctor:-So,lady, what’s the matter?

LadyB:- For over a month now, since our office ‘loo’ had problem and needed repair, I’ve been making use of the general toilet. I mean the public one.

Doctor:- Alright, so?…..

LadyB:- I presently discovered that I have contracted a” toilet infection”.

Doctor:-Toilet infection?

LadyB:- Yes doc, each time I want to urinate, it pains. I experience burning sensation, urinate frequently, with occasional abdominal discomfort. I also notice stains on my undies. It’s like I’m having a vaginal discharge, with itching…..

Doctor:-LadyB, there’s nothing like toilet infection, (she cuts her short).

LadyB:-I had similar experience when I travelled with my sister for a wedding last year. Both of us contracted it because we  shared the same pit toilet with everyone throughout our stay.

Sexually transmitted infections/diseases and urinary tract infections

There’s nothing worse than desperately needing to go to the toilet when the only option is public toilet. Hmmm! You hold your breath and try not to think about the disease-causing germs that are probably crawling all over the seat and bowl-chlamydia, gonorrhea, syphilis and trichomoniasis, to name but a few.

Come to think of it, can one actually catch a sexually transmitted infection/disease from a toilet seat? No! you cannot, because even if the bacteria and viruses that can cause an STI (Sexually Transmitted Infection) got onto the seat, they cannot survive for long after leaving human body.

As their name suggests, STIs are most commonly spread through sexual activities, including intercourse, oral sex and in the case of some diseases such as genital wart, direct skin-to-skin contact. Note: “There is nothing very magical or unusual about STI. They are fastidious bugs which do not like dry conditions, heat,” says Prof. Basil Donovan.

But if for argument’s sake, enough disease causing organisms had survived on a “loo” seat to make you sick, could you actually pick up an infection?

Again, Donovan says it’s highly unlikely as none of our body parts that are vulnerable to sexual infections actually touch the toilet seat.

Viruses such as warts cannot get in unless there is a break in the skin, and when you have sex, it induces micro-trauma and break the outer layer of the skin.

Assuming one has a cut on the bottom, and there were bacteria or viruses on the seat, it is theoretically possible that you could catch an STI. But it has never been proven that a toilet seat can serve as a source of any STI.

Toilet seats are also unlikely to be the source of urinary tract infections, most commonly caused by the bacteria Escherichia coli(E.coli),because your urethra (the tube) that connect the bladder to the genital which opens outside can never touch the seat  We can now establish that ‘Toilet Infection’  is a misnomer.

There are problems ranging from sexually transmitted infections to urinary tract infections that people collectively refer to wrongly as toilet infections.

The most common complaints, when people talk about toilet infections are, itching, redness, discharge, pain, odour. These are signs of an inflamed vagina called vaginitis(inflammation of the vagina).A variety of things, both infectious and not can cause vaginitis.

Vagina has its own environment. It has its own microorganisms that balance the pH levels and prevent other infectious organisms from taking a hold, so anything that messes with the environment of the vagina could cause inflammation and present with the symptoms like sexually transmitted infections,

Bacterial Vaginosis, Trichomoniasis, Fungal infections, tight under wear, poor hygiene, douching, vaginal creams, use of perfumes on the genital area, wearing wet under wear, others are contraceptives use especially IUCD (Intrauterine contraceptive device),change in  sexual partners. All these could mess with the vagina environment and cause symptoms.

It is a fact that microorganisms cannot live long outside their host and as such, are liable to die in some environment outside a living cell. So, how then is it that people believe they contract an infection in the toilet since the organism cannot survive on its own? Rather one cannot get infected from the toilet.

The chances of one getting an infection from the toilet seat are nonexistent. However, can one get a”bug”from the toilet? Yes, the very same way one can get it from the bus or the office, that is why it is advised one washes his or her hands before and after using the toilet.

Ways to prevent messing with the vaginal environment are, wear clean and dry(preferably cotton) underwear, wipe from front to the back after defecation, don’t wear tampoons/pads for too long, be faithful to your partneror abstain(the best)or have safe sex.

Do not douche, spray or bake or put anything in the vagina. The most possible infection that can be contacted from the toilet is a skin infection, and that could be from a dirty toilet seat; most by people with immune suppressed or of low immunity.

Example, people living with diabetes or people with highly sensitive skin. Therefore for prevention, you can line the toilet seat with some toilet tissues or papers before seating on it. Also, avoid the toilet water splashing on your vagina.

It could actually cause an infection.  Practice good hygiene, wash your hands thoroughly after using the loo, most especially the public ones.

These are the commonest vaginal infections, which can be due to bacterial, vira or protozoan infections that grow in skin in the sexual secretions or on the skin, generally in the genital area. Examples are;

(1)Candidiasis:-Characterized by milky discharge, itching, soreness, and pain during intercourse.

(2)Trichomoniasis:-Characterized by grey or greenish-yellow frothy vaginal discharge, distinguished by fishy or pungent smell, painful urination, itching, soreness, irritation, Inflammation

(3)Chlamydia Vaginitis:-Is characterized by the inflammation of vagina, discharge ,bleeding especially after intercourse.

(4)Gonorrhea:-Greenish-yellow discharge, burning sensation when urinating.

(5)Syphilis:-Characterized by a single, painless sore (chancre),headache, fever, aches, chill, swollen lymph nodes.

(6)Genital warts:-This is characterized by small wart-like bumps on the genitals or anal region.

(7)Genital Herpes:-Is characterized by painful sores and blisters on the genitals.

(8)HIV:-is a virus that is often sexually transmitted. But it can also be transmitted by needles shared by infected drug addicts, from infected mothers to babies during delivery and by contact with infected blood.

Investigation:-This involves both blood, swabs in which it will be used to do microscopy, culture and sensitivity, urinalysis, culture and sensitivity. HIV screening, urethral exudates, High Vaginal swab and Endocervical swab  microscope, culture and sensitivity swab, etc.

Other infections include bacterial vaginosis, non-infection vaginitis, viral vaginitis, molluscum contagiosum.  It is not so common but some men have now imbibed this misnomer of  complaining of having uncommon “toilet infections”.

However some infections like gonorrhea, non-gonoccocal infection(the symptoms resemble those of gonorrhea but are milder), Ballanitis (this is characterized by the affected area either been generally or patchily erythematous with erosion in severe cases, there may be White or purulent exudate),Genital ulceration, Cytomegalo virus are common in men.

 

Note: Hepatitis can also be transmitted sexually but in Nigeria parlance, it’s not generally associated with the syndrome of toilet disease.

Treatment:-One needs to see a doctor who will make the right diagnosis. Antibiotics, antivirals drugs, chemotherapeutic agents, electrocautery could be used during the treatment. Also, regular hospital visits or admissions can be required.

 

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