Department of General Surgery, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey.
Department of General Surgery, Medical Park Hospital, Fatih, Istanbul, Turkey.
Turk J Gastroenterol. 2020 Apr;31(4):289-294. doi: 10.5152/tjg.2020.19183.
BACKGROUND/AIMS: An anal fissure (AF) is a linear tear in the distal anal canal and is one of the most common causes of anal pain. Hemorrhoidal disease (HD) is a symptomatic growth and distal displacement of normal anal cushions. Numerous studies have addressed the contributing factors of these conditions, yet the results remain controversial. In this study, we hypothesize that increasing patients' awareness of hidden risk factors could reduce the rate of HD and AF.
A questionnaire-based controlled study was planned. After power analysis, patients with HD (n=60) and AF (n=60) were enrolled consecutively into the study group and compared with the control group (n=60) of healthy individuals. The survey was designed to assess the participants' toilet and dietary habits and anxiety risk. Odds ratios were calculated and a binary logistic regression model was constructed to identify associated factors.
Hard stools, spending more than 5 minutes in the toilet, frequent straining during defecation, and increased spice intake were more frequent in the patients with HD; and hard fecal consistency, time elapsed in toilet greater than 5 min, straining during defecation, and high anxiety risk were more frequent in the patients with AF as compared to the control group (p<0.05).
Possible associations were identified between habitual factors or conditions (i.e., fecal consistency, the time elapsed in the toilet, straining during defecation) and anxiety and benign anorectal diseases (i.e., HD and AF). Patients should be advised about these hidden threats.
背景/目的:肛裂是肛管远端的线性撕裂,是肛门疼痛最常见的原因之一。痔病是正常肛门垫的症状性生长和远端移位。许多研究都探讨了这些疾病的致病因素,但结果仍存在争议。在本研究中,我们假设提高患者对隐藏风险因素的认识可以降低痔病和肛裂的发病率。
计划进行一项基于问卷的对照研究。经过功效分析,连续纳入痔病(n=60)和肛裂(n=60)患者进入研究组,并与健康对照组(n=60)进行比较。该调查旨在评估参与者的厕所和饮食习惯以及焦虑风险。计算了比值比,并构建了二项逻辑回归模型以确定相关因素。
硬便、在厕所花费超过 5 分钟、排便时频繁用力和增加香料摄入在痔病患者中更为常见;而硬粪便稠度、在厕所花费超过 5 分钟、排便时用力以及高焦虑风险在肛裂患者中更为常见,与对照组相比(p<0.05)。
习惯性因素或情况(即粪便稠度、在厕所花费的时间、排便时用力)与焦虑和良性肛肠疾病(即痔病和肛裂)之间可能存在关联。应向患者提供有关这些隐藏威胁的建议。