Comments on: “You Are Wiping To Hard When You Go To The Bathroom.”

By: Claire

Claire — Fri, 19 Mar 2010 23:19:00 +0000

A man I’d guess, having to protect silly little woman from herself.

By: Sheva

Sheva — Mon, 01 Mar 2010 00:24:26 +0000

Thank you for this information. I didn’t know the specifics and conditions of its efficacy.

By: Nicholas Fogelson, MD

Nicholas Fogelson, MD — Sun, 28 Feb 2010 23:44:52 +0000

Nitrazine alone is a very poor test for ruptured membranes – unless rupture is obvious, a speculum may be needed to confirm or deny rupture of membranes. Wiping a nitrazine paper on the perineum is not an accurate way to do it. Other things turn it positive, and it may not turn if the rupture isn’t large.

By: MDL

MDL — Fri, 26 Feb 2010 04:58:41 +0000

OUCH! That ‘Izal Medicated’ paper sounds horrid. And only one piece? Wow – I think I’d rather splash water on my bits! (and no I am not British) – but I do love to learn our differences in culture and terminology… You might have laughed when I first learned of ‘spotted dick’ from a friend in Wales) Thanks for the info – I learned something today – and the day is not wasted! Blessings!

By: jespren

jespren — Tue, 23 Feb 2010 02:12:30 +0000

I’m not in the medical profession but I have been told by them that nitrazine paper is dubious at best because it reacts to normal vaginal secretions the same way it reacts to amniotic fluid, so, even if you try to first make sure everything is super ‘clean’, you can’t ever be sure what its reacting to.

By: Andy

Andy — Mon, 22 Feb 2010 21:50:30 +0000

Sorry, I am being dim- just finished 5 nights in a row. Like I said, we don’t use nitrazine paper (it has a different name over here but I can’t remember it) because it only tells one part of the overall picture. Of course, if a woman says ‘don’t come near me with that,’ then the speculum stays out anyway, and we assess conservatively (i.e. wait and see).

By: Sheva

Sheva — Mon, 22 Feb 2010 16:32:50 +0000

I was referring to your mention of ruptured membranes. I realize that it can’t be used on bleeding.

By: Andy

Andy — Mon, 22 Feb 2010 16:27:12 +0000

Not for bleeding. It is important to identify the source of bleeding, whether uterine or cervical. Nitrazine will tell you if liquor is there, but sometimes it is good to asses the cervix, especially if it is preterm. Of course, the less you do, the better. Which is why a woman who is term (ie 37 weeks onwards), who gives a clear history of SROM, needs no intervention at all if the baby is ok. We don’t use nitrazine much- I’ve only see it once. I can’t remember why, but there is some clinical issue. Women with hindwater leaks, for example, may only leak small amounts. In any case, as I said, it is only a small part of the overall clinical picture.

By: Sheva

Sheva — Mon, 22 Feb 2010 15:59:58 +0000

Why can’t they just use the Nitrazine paper? That way nothing has to be stuck inside her, just touch it to her and see what happens!

By: Andy

Andy — Mon, 22 Feb 2010 15:46:58 +0000

You are clearly not British! When I was in primary school, in the early 70′s, the standard toilet roll was ‘Izal Medicated’. This was a heavy duty gloss finished paper that didn’t so much wipe as smear around. This stuff could probably be used to polish diamonds, and could definitely remove skin, especially in the outside toilets that existed those days (aaaah.. the heady days of Empire!) And, you were only allowed one piece! Actually, Izal Medicated is still available from larger chemists,as is the even older Bronco, an even heavier duty paper (I use the term loosely- it is more like thick greaseproof baking paper. Probably from the same factory.) I imagine it is bought by older folk with a nostalgia for the days when rectal discomfort was seen as a badge of honour.
Seriously though, it is possible to bleed, vaginally and rectally from rough wiping. Piles will give an increased risk, as will the hormone changes of pregnancy and menopause. It tends to present as smearing on the paper reather than active fresh blood, which is not a good clinical sign.