Prevalence and risk factors of hemorrhoids: a study in a semi-urban centre

G. G. Ravindranath, B. G. Rahul


Background: Hemorrhoids, also called piles are masses or clumps of tissues which consist of muscle and elastic fibers with enlarged, bulging blood vessels and surrounding supporting tissues present in the anal canal of an individual. This condition is a common ailment among the adults. The actual burden of the disease remains unknown. Hence author had undertaken this study to assess the incidence and the risk factors of this disease among the patients in the area.

Methods: 63 patients between the ages 20 and 80 who had come to the outpatient ward with hemorrhoids were included into the study. The demographic details from all the patients were noted. Their dietary habits, bowel habits, amount of physical activity, smoking and alcohol use as well as over the counter medication use were noted in detail.

Results: Out of the 63 patients under study, 66.67% were males and 33.33% were females, with the most common age group affected was below 40 years of age. Less than 40% of the patients were vegetarians, with more than half of the patients having a mixed diet. More number of women history of hemorrhoids in their family (47.6%), while the history in the males was only 26.2%. Straining and constipation was seen in majority of the patients while many of them also had chronic cough. Bleeding and mass through the rectum was seen in majority of the patients (96.8% and 93.7% respectively) while 76.2% of them had pain during defecation. Few of the patients (33.3%) soiled their clothes.

Conclusions: Hemerrhoids are one of the common diseases observed in patients below 40 years of age, especially if they are under stress. Proper diet, which is inclusive of adequate quantities of fibre as well as with less spice is essential to prevent this disease.


Diet, Hemorrhoids, Incidence, Risk factors

Full Text:



Kona V. Conditions and diseases of digestive system, 2010. available at: http/

Health Grades. Hemorrhoids. 2011. Available at:

Bailey HR. Innovations for age-old problem: hemorrhoids in the female patient. Female Patient. 2004;29:17-23.

Heaton ND, Davenport M, Howard ER. Symptomatic hemorrhoids and anorectal varices in children with portal hypertension. J Pediatr Surg.1992;27(7):833-5.

Navarra L, Pietroletti R, Maggi G, Leardi S, Simi M. Diagnosis and treatment of haemorrhoids in the eldery: results from 291 patients. Techniques in Coloproctology. 2000;3(3):127-30.

Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part I: overall and upper gastrointestinal diseases. Gastroenterol. 2009;136(2):376-86.

Liebach JR, Cerda JJ. Hemorrhoids: modern treatment methods. Hosp Med. 1991;53:68.

Dennison AR, Whiston RJ, Rooney S, Morris DL. The management of hemorrhoids. Am J Gastroenterol. 1989;84:475-81.

Madoff RD, Fleshman JW. American Gastroenterological Association technical review on the diagnosis and treatment of hemorrhoids. Gastroenterol. 2004;126:1463-73.

Dennison AR, Whiston RJ, Rooney S, Morris DL. The management of hemorrhoids. Am J Gastroenterol. 1989;84:475-81.

Yarnell E. Naturopathic Gastroenterology, Wenatchee WA, Healing Mountain Publishing, 2000.2009.

Pfenninger JL, Surrell J. Nonsur gical treatment options for internal hemorrhoids. Am Fam Phys. 1995;52:821-34.

Parks AG. Surgical treatment of haemorrhoids. Br J Surg. 1956;43:337-8.

Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterol. 2009;136(3):741-54.

Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-95.

Ali SA, Shoeb MFR. Study of risk factors and clinical features of hemorrhoids. Int Surg J. 2017;4:1936-9.

Khan RM, Itrat M, Ansari AH, Zulkifle M. A study on associated risk factors of haemorrhoids. J Biol Sci Opinion. 2015;3(1):36-8.

Warshaw LJ, Turell R. Occupational aspects of proctological disease. New York State J Med. 1957;57:3006.

Johanson JF, Sonnenberg A. Constipation is not a risk factor for hemorrhoids: a case-control study of potential etiological agents. Am J Gastroenterol. 1994;89:1981-6.

François Pigot, Laurent Siproudhis, François-André Allaert. Risk factors associated with hemorrhoidal symptoms in specialized consultation. 2005; 29(12):1270-1274.

Kaidar P, Person B. Hemorrhoidal Disease: A compreative study. J Am Coil Surg. 2007:204(1):102-17.

Sielezneff I, Antoine K, Lecuyer J, Saisse J, Thirion X, Sarles JC. Is there a correlation between dietary habits and hemorrhoidal disease? Presse Med. 1998;27:513-7.

Alonso-Coello P, Mills E, Heels-Ansdell D, Lopez-Yarto M, Zhou Q, Johanson JF, et al. Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101(1):181-8.

Loder PB, Kamm MA, Nicholls RJ, Phillips RK. Haemorrhoids: pathology, pathophysiology and aetiology. Br J Surg. 1994;81:946-54.