Johanson J F, Sonnenberg A
Department of Medicine, Veterans Administration Medical Center, Milwaukee, Wisconsin.
Gastroenterology. 1990 Feb;98(2):380-6. doi: 10.1016/0016-5085(90)90828-o.
Hemorrhoids are a frequently occurring disorder widely believed to be caused by chronic constipation. In the present study, the epidemiology of hemorrhoids was evaluated and compared with the epidemiology of constipation. The analysis was based on 4 data sources: from the United States, the National Health Interview Survey, the National Hospital Discharge Survey, and the National Disease and Therapeutic Index; from England and Wales, the Morbidity Statistics from General Practice. Results showed that 10 million people in the United States complained of hemorrhoids, corresponding to a prevalence rate of 4.4%. In both sexes, a peak in prevalence was noted from age 45-65 yr, with a subsequent decrease after age 65 yr. The development of hemorrhoids before age 20 yr was unusual. Whites were affected more frequently than blacks, and increased prevalence rates were associated with higher socioeconomic status. This was in contrast to the epidemiology of constipation, which demonstrated an exponential increase in prevalence after age 65 yr and was more common in blacks and in families with low incomes or low social status. The data presented illustrate differences in the epidemiologic behavior of hemorrhoids and constipation, calling the presumption of causality between constipation and hemorrhoids into question.
痔疮是一种常见疾病，人们普遍认为它是由慢性便秘引起的。在本研究中，对痔疮的流行病学进行了评估，并与便秘的流行病学进行了比较。该分析基于4个数据源：来自美国的国家健康访谈调查、国家医院出院调查和国家疾病与治疗指数；来自英格兰和威尔士的全科医疗发病率统计数据。结果显示，美国有1000万人主诉患有痔疮，患病率为4.4%。在两性中，患病率在45至65岁达到峰值，65岁以后患病率随后下降。20岁之前患痔疮的情况并不常见。白人比黑人更容易受到影响，患病率的增加与较高的社会经济地位相关。这与便秘的流行病学情况形成对比，便秘的患病率在65岁以后呈指数增长，在黑人和低收入或低社会地位家庭中更为常见。所呈现的数据说明了痔疮和便秘在流行病学行为上的差异，这使得便秘与痔疮之间存在因果关系的假设受到质疑。
