Interstitial Cystitis Advice

Undoubtedly we as ICers know a thing or too about toilet paper. But do you know the history behind this infamous role? First we will look at the interesting path that lead to modern toilet paper. Next we will discuss how toilet paper can affect your IC as well as some of different types of paper that are currently on the market, so that you can make the best possible toilet paper choices.

A brief history of toilet paper

Through out most of recorded history it appears that humans have used something - be it bark, twigs, grass, corn husks, moss, snow, shells, newspaper, hemp, lace (French nobility), sponges – as toilet paper, though we should, in all seriousness be very thankful that we as ICers do not have to resort to these materials. Yet the subject of toilet paper is not one with a lot of literature behind it. Seen as an “off-topic” area through out most off time, folks did not make a habit of recording or talking about how and what they used to clean themselves with after a trip to the outhouse, indoor toilet or behind a tree for that matter.

The first commercial toilet paper came on the market in 1879, manufactured by the Scott Paper Co. It was sold primarily in drug stores, and came in packages of five hundred sheets for fifty cents. In 1890 the Scott Company was also the first to put their toilet paper on a role (one can only wonder if that was also the first year that some people starting leaving empty roles on the dispenser…). Soon after 1879 many other brands followed heel, some tooting outrageous medical claims that were keen to use words like “hygienic” and “medicated”. In the mid eighteen eighties a brand by the name of “Albany Medicated” even came in its own tin canister.

The late Victorian era saw the beginning of a cultural change towards better sanitation. People began to wash and bath more, and cleanliness was seen as a healthy change. Though at the time toilet paper was something of a taboo subject, it was seen as too personal a subject for general conversation. A feeling that would continue for many more decades.

Yes, toilet paper has come a long, long way in little more than a century. Countless brands have come and gone, some bought out by bigger companies others simply fell into TP obscurity. In 1942 the first two-ply came on the market, it was produced by St. Andrew's Paper Mill in Walthamstow, London. Prior to that all paper had been single-ply, or nothing more than a sheet of paper that could hardly be called “ply-able” at all.

1 ply VS 2 ply

Nowadays the majority of us opt for two-ply paper, though one-ply is still available. One-ply toilet paper is a single layer of tissue that is generally of a #13 thickness (an industry grading system). Two-ply is not generally two layers of this thickness, but instead a double layer of paper which are of a #10 thickness each. However, both of these thicknesses can vary substantially depending on the manufacturer and country of origin.

One-ply is often marketed as more economical, however what you save in price you may end up paying for in terms of thickness, absorbency, softness and overall toilet paper quality. In a few instances such as when dealing with boat and camper toilets it may be a good idea to use one-ply, but as a general rule those who are using toilet paper on a “more than frequent” basis should, whenever possible opt for two-ply, I know that I always do.

Upping the toilet paper ante you can now find three-ply and even four-ply paper in some countries (Germany in particular). In North America most brands are still primarily producing one and two-ply varieties. (A new three-ply Canadian variety called “cashmere” is now available; it’s marketed by the brand Cottonelle.) If by chance you happen upon a higher ply, by all means avail of it. Please note that sometimes people come across septic tank issues with higher plies of toilet paper. So it may help to multi-flush if this is a potential concern.

One thing that some people encounter, the world over, is an issue with toilet paper lint. Toilet paper lint, is in other words the small particles of paper that adhere themselves to you after wiping. Aside from switching brands, you may find that lightly cleaning yourself with water after you’ve finished whipping may help. I know that personally my genital skin has a radar detector-like sensory system should anything (aside from underwear) be on my skin in that neck of the woods. So much so that I have developed small IC flares and increased frequency if anything is touching my urethra (this sometimes includes menstrual pads). I cannot really explain how or why this happens, other than to guess that it ties into my vulvodynia and perhaps the nerves in the urethra that in turn lead back to the bladder (through the urethra, pelvic muscles, etc).

So many options…

Yes, there is indeed a plethora of toilet papers on the markets today. They range from the rough and gruff one-ply found almost ubiquitously in every gas station and campground bathroom to the comfy, cosy aloe enhanced, quilted paper that is popular with many ICers (and non-ICers) – a personal favourite of mine. A good brand to choice in the aloe department is “Cottonelle unscented rippled with aloe and vitamin E”, it also is free of inks and dyes. (Toilet paper lint is not a common problem with this brand.)

Embossed, scented (and/or scented roles), woven, plush, quilted, luxury, medicated, rippled, ultra, premium, cotton, recycled, yes even coloured and patterned are all words and descriptions that exist in the toilet paper world. Though coloured paper has (thank-fully) fallen out of use in North America it’s still alive and thriving in many other parts of the world. My jaw just about hit the ground the first time I went for “loo-role” in Ireland. To my shock pink, blue, green, yellow, beige and peach hued papers all stared back at me. In fact plain white (the only “colour” I will ever use!) is the minority. As well the cost was double or even triple (or more!) the cost per package that I was accustomed to paying for in Canada, and in my opinion the softness and quality of the Irish brands is horribly lacking in comparison with American and Canadian papers. To get what would be considered a normal (“nothing too special”), sort of soft, kind of absorbent paper in Canada you are buying the cream of the Irish crop of toilet paper, proving that not all paper is created equal in all places.

In some counties designer (many papers now exist with a multitude of different designs on them, everything from pictures of currency to celebrities to designer logos) and luxury papers are all the range amongst those with the means to pay about seven to twelve times the cost of regularly priced paper. The word “luxury” can be misleading though as it is often applied to both good quality paper that is perhaps quilted or embossed, and “high end” designer paper (a Spanish brand has recently put out an all black toilet paper that is quite the rage with rich trendsetters) that you will not spot on the grocery store shelves any time soon.

When it comes to roll size (single, double, jumbo, etc) it is really a matter of personal taste and budget. Compare the number of sheets per role and see if one gives you a better deal. One tip I recommend is always (whenever possible) stocking up on your favourite toilet paper when it goes on sale. As a general IC rule I try to always have one week to a months supply of paper in the house. You never know when a flare can strike, when money might be tight, and so on. I subscribe to the “you can never have too much TP” rule, and it has seen me through many flares when I was too ill to leave the house. (I also stash a couple roles in “hiding spots” should I ever get desperately low). If you ever run out of toilet paper entirely I recommend that you use facial tissues, not paper towels (kitchen towels), as facial tissues are typically much more gentle on your skin and are less likely to clog your toilet.

Aside from toilet paper your post-potty cleaning options are largely a bidet (not common in North America), or cleaning with water by some other means. One device that is both popular and highly functional for those with IC and vulva conditions is a perennial squirt bottle (available for a couple of dollars from most large drugstores, medical supply stores and through the ICN). This small plastic bottle is filled with clean water and the user gently squirts/sprays the water onto their urethral/vulvar area after urinating (gently dry with a soft towel). Many ICers find that this greatly reduces the affects of “urine burn”, a painful symptom that numerous IC patients experience wherein the flesh in these areas become inflamed/raw/hypersensitive either as a result of a medical condition itself (for example vulvodynia), excessive (but of course unavoidable if you have IC) wiping, or perhaps even a reaction to some chemical component in the urine itself.

The right toilet paper choice for ICers

As it is best for ICers to use as few chemical products (especially on delicate and often sore/raw) tissues, I absolutely recommend that (barring a true emergency) you avoid all coloured, patterned and scented (perfumed) paper. Stick to white (and/or “unbleached”), unscented paper (aloe seems to be fine for most ICers), and switch brands immediately if you encounter a negative reaction. The same is doubly true for those with overlapping conditions such as IBS, vulvodynia, candida and other medical conditions where you are whipping on a more than “average” frequency, or when and where skin is prone to sensitivity.

Other things to look for if you prone to sensitive skin, chemical allergies/sensitivities or are environmentally conscious are words (on the packaging) like hypo-allergenic, whitened without chlorine bleach (“oxygen-based bleaching” is process that some chlorine free papers go through, it utilizes oxygen, ozone or hydrogen peroxide to bleach the paper pulp), dioxide-free (dioxide is a harsh, toxic chemical that is used in many paper bleaching processes), recycled (from other types of paper/paper fibre, not recycled toilet paper itself) and environmentally friendly (though this is something of a catch all term). These types of toilet paper brands are almost always more expensive than normal paper, but it may be worth the investment if it means saving yourself undo pain and/or if you are concerned about the environmental repercussions of harsh chemical bleaching. A good choice in this area is the brand “Seventh Generation” which is made with 100% recycled paper, whitened without chlorine bleach, hypoallergenic and free of dyes, fragrances and inks. “Cotton Soft” is another brand which has the same benefits, it is also available in three-ply.

A different type of toilet paper that can be especially helpful for those with sensitive skin is Purely Cotton Toilet Paper, instead of coming from paper it is made from cotton. While it is quite pricey (around $2 US per roll), the company says that it is “clinically proven to be non-irritating, even for sensitive skin.”

An early Scott Paper Company advertisement claimed that that "harsh toilet tissue may cause serious injury". Quite the slogan! When it comes to IC we want to avoid injuring any area connected to our bladders as much as we possibly can. We are typically urinating many more times a day than those without IC, and it is wise to try and avoid irritating the skin around our urethra and genitals as much as is feasible. Remember that whether the package has a kitty, a puppy, or a teddy bear on it as general rule softer, gentler and as chemically free as possible always is your best bet when it comes to TP and IC.