Finally a film that addresses the age-old, burning, itching question: Can romance exist in the wake of an anal fissure? Opening in U.S. cities this month like a fresh, gaping wound is Wetlands, a spectacularly septic coming-of-age story from Germany that revels in its own filth like a pig in a mudslide. It’s a practice in perversity, but with purpose and pathos; a laugh/cringefest with the potential to make one gag and “aww” at equal measure.

In her indelible breakthrough performance, Carla Juri explodes across the screen like a supernova as Helen, a character forged in every germaphobe’s most hellish nightmares. The 18-year-old wild child declares immediately that she eschews regular hygienic practices, then subjects us to her daily bathroom routine, which consists of, but is not limited to, dragging her exposed genitals across the rim of an unfathomably foul toilet seat. Although, she proudly admits, she’s never had an infection. Helen is keen on having just about anything and anyone inside of her in one way or another, which is tenderly illustrated in a masturbation montage strictly of the vegetarian variety. All of this happens, by the way, within the first 10 minutes.

Because Helen’s haphazard bodily habits extend to her shaving ritual – waterless, creamless, with a dull and cheap razor – she nicks a particularly sensitive crevice so severely, it lands her in a hospital awaiting surgery. It’s there that she falls under the care and romantic spell of her nurse, Robin (Christoph Letkowski), and attempts to hatch a scheme to reunite her divorced and content-to-stay-that-way parents (Meret Becker and Axel Milberg).

What’s remarkable about Wetlands is how easily it transcends its taboo-busting tendencies. The film, directed by David Wnendt, is defiantly unapologetic in its approach to the material, which is in perfect confluence with Charlotte Roche’s stream-of-consciousness novel. We are so deeply submerged in Helen’s proclivities that the ick factor becomes a natural component of Wetlands’ world. It’s not that the shock value ever wears off – and oh, is said value high – but it’s easier to accept when the source is as reliable and inviting as Helen.

Her aberrant behavior, we soon find out, is not without its roots. Eventually, Helen’s emotional grime far out-sludges anything she does to herself physically, as her familial history comes into full bloom and lays a thorny foundation for an already prickly psyche. Wetlands is not unlike a bed of nails, in which each deadly-sharp instrument is evenly placed so one can walk over it barefoot with relative ease. No one point prevails as more memorable than another. The shock, the “aww” – it all stabs equally.

Roche, Wnendt and co-writer Claus Falkenberg understand the golden rule of gross-out: Tie it all to food. Our most basic human function, next to breathing, is eating. So taking something unappealing like a hemorrhoid and comparing it to a cauliflower, for example, plunges that most innocuous of vegetable into a scum pit of association. It’s brilliant, constant throughout Wetlands, and only engorges until the metaphor lines get smudged out entirely, and bodily fluids become wed with fresh edibles in the unholiest of matrimonies.

In the destined-to-be-infamous pizza sequence, one of mankind’s most prevalent fears is exploited to the fullest, glossiest extent. But what skyrockets Wetlands above and beyond is that it’s bold enough to go even further and question why such scenarios are so regularly feared at all. What is a nightmare to most is a simple fantasy to Helen, which the film posits doesn’t make her weird, but rather evolved.

We may leave Helen still with plenty in life to learn, but we could all stand to learn a little bit from Helen.

Grade: A