Risk factors associated with hemorrhoidal symptoms in specialized consultation.

UNLABELLED

Epidemiology and risk factors of hemorrhoidal disease are not well defined.

AIMS AND METHODS

Past history and events occurring during the last two weeks before a medical visit for acute hemorrhoidal symptoms were analyzed and compared with controls consulting for any other diagnosis without exclusion.

RESULTS

Among complete inquiries returned by 931 private gastroenterologists, files from 1033 patients (542 males) and 1028 controls (504 males) were randomly selected. Hemorrhoidal disease patients were younger (47 +/- 14.5 vs. 52 +/- 16.5 yrs; P<0.0001); sex ratio was not different from controls. Factors significantly associated with hemorrhoidal crisis were: past history of hemorrhoidal symptoms, age<50 yrs, past history of anal fissure, occupational activity (OR 5.17; 1.95; 1.72; 1.43; P<0.1) and recent unusual events: spicy diet, constipation, physical activity, alcohol intake (OR 4.95; 3.93; 2.79; 1.99; P<0.1). Stress protected against hemorrhoids (OR 0,49; P<0.0001). For women aged less than 40 yrs, no significant risk factor related with genital activity was found for hemorrhoidal disease.

CONCLUSION

For young patients, especially those with a past hemorrhoidal history, spice or alcohol intake and constipation are risk factors for hemorrhoidal crisis. For young women, prevention is essentially based on treatment of constipation associated with genito-obstetrical events.