Pigot François, Siproudhis Laurent, Allaert François-André
Service de Proctologie, Hôpital Bagatelle, 33401 Talence Cedex.
Gastroenterol Clin Biol. 2005 Dec;29(12):1270-4. doi: 10.1016/s0399-8320(05)82220-1.
Epidemiology and risk factors of hemorrhoidal disease are not well defined.
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.
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.
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.
痔病的流行病学和危险因素尚未明确界定。
分析在因急性痔症状就诊前两周内发生的既往病史和事件，并与因其他任何诊断而就诊的对照组（无排除标准）进行比较。
在931名私人胃肠病学家返回的完整询问中，随机选择了1033例患者（542例男性）和1028例对照（504例男性）的病历。痔病患者更年轻（47±14.5岁对52±16.5岁；P<0.0001）；性别比与对照组无差异。与痔危象显著相关的因素有：既往痔症状史、年龄<50岁、既往肛裂史、职业活动（OR 5.17；1.95；1.72；1.43；P<0.1）以及近期异常事件：辛辣饮食、便秘、体育活动、酒精摄入（OR 4.95；3.93；2.79；1.99；P<0.1）。压力对痔有预防作用（OR 0.49；P<0.0001）。对于年龄小于40岁的女性，未发现与生殖活动相关的痔病显著危险因素。
对于年轻患者，尤其是有既往痔病史者，摄入辛辣食物或酒精以及便秘是痔危象的危险因素。对于年轻女性，预防主要基于治疗与生殖-产科事件相关的便秘。
