Al-Kubati Waheeb Radman
Surgical Department, 21st September University, Sana'a, Yemen.
Physiology Department, Sana'a University, Sana'a, Yemen.
Ther Clin Risk Manag. 2025 Apr 19;21:489-499. doi: 10.2147/TCRM.S498067. eCollection 2025.
Khat contains alkaloids, tannins, and flavonoids with physiological and pathological effects. In Yemen, anorectal diseases, including hemorrhoids, are prevalent, and hemorrhoidectomy is frequently performed.
This study evaluates the relationship between chronic khat chewing and high-grade hemorrhoidal disease, as well as post-operative complications such as bleeding and pain.
This prospective cross-sectional study included 1,896 patients aged 16-85 years, meeting the inclusion criteria were included and followed for three months.
Chronic khat chewers (n=1,492) and non-khat chewers (n=404) Data included khat habits, clinical assessments, digital rectal exams, anoproctoscopy, intraoperative findings, and post-operative outcomes.
Chronic khat chewing was strongly associated with thrombosed grade IV hemorrhoidal disease. Among khat chewers, 90% had hemorrhoids, with 75% requiring hemorrhoidectomy or hemorrhoidopexy, compared to 25% in non-chewers, where half underwent hemorrhoidopexy. The odds ratio (OR) for hemorrhoids in khat chewers was 27.04. Gender-specific analysis showed a six-fold higher OR for hemorrhoids in khat-chewing females versus non-chewing females. Post-operative complications, including bleeding and severe pain, were significantly higher in male khat chewers (p < 0.05), while no significant differences were observed in females.
Chronic khat chewing is strongly associated with high-grade hemorrhoidal disease and increased post-operative complications. Mechanisms include chronic constipation, increased anal sphincter tone, and prolonged sitting. These findings highlight the need for public health strategies to reduce khat use and tailored clinical approaches to improve outcomes. Future research should focus on establishing causality, identifying confounders, dose-response relationships, and exploring gender-specific management strategies that target both mechanical and pharmacological factors to optimize surgical care and long-term outcomes.
巧茶含有生物碱、单宁和黄酮类化合物，具有生理和病理作用。在也门，包括痔疮在内的肛肠疾病很普遍，痔切除术也经常进行。
本研究评估长期咀嚼巧茶与重度痔疮疾病之间的关系，以及术后出血和疼痛等并发症。
这项前瞻性横断面研究纳入了1896名年龄在16至85岁之间、符合纳入标准的患者，并对其进行了三个月的随访。
长期咀嚼巧茶者（n = 1492）和不咀嚼巧茶者（n = 404）。数据包括巧茶使用习惯、临床评估、直肠指检、肛门直肠镜检查、术中发现和术后结果。
长期咀嚼巧茶与IV级血栓性痔疮疾病密切相关。在咀嚼巧茶者中，90%患有痔疮，其中75%需要进行痔切除术或痔固定术，而在不咀嚼巧茶者中这一比例为25%，其中一半接受了痔固定术。咀嚼巧茶者患痔疮的优势比（OR）为27.04。按性别分析显示，咀嚼巧茶的女性患痔疮的OR比不咀嚼巧茶的女性高六倍。男性咀嚼巧茶者术后并发症（包括出血和剧痛）明显更高（p < 0.05），而女性未观察到显著差异。
长期咀嚼巧茶与重度痔疮疾病及术后并发症增加密切相关。其机制包括慢性便秘、肛门括约肌张力增加和久坐。这些发现凸显了制定公共卫生策略以减少巧茶使用以及采用针对性临床方法以改善治疗结果的必要性。未来的研究应侧重于确定因果关系、识别混杂因素、剂量反应关系，并探索针对机械和药理因素的性别特异性管理策略，以优化手术治疗和长期结果。
