Johanson J F
University of Illinois College of Medicine at Rockford, USA.
Dis Colon Rectum. 1997 Feb;40(2):215-9; discussion 219-21. doi: 10.1007/BF02054991.
Despite frequent occurrence of hemorrhoidal disease, its etiology remains controversial. Recent evidence suggests that diarrhea may represent a pathogenic risk factor. The present study examined prevalence of diarrheal disorders in elderly patients with hemorrhoidal disease to provide further insight into its pathogenic mechanisms.
Using 8.8 million Medicare patients hospitalized in the United States during 1987, the frequency distribution of all three-digit International Classification of Diseases codes was compared in patients with and without hemorrhoidal disease. A more frequent occurrence of a specific disorder in patients with hemorrhoidal disease compared with the general Medicare population suggests that this disorder may be pathophysiologically related or share common etiologic risk factors with hemorrhoidal disease.
Strong associations were observed between hemorrhoidal disease and a number of diarrheal disorders, including ulcerative colitis, noninfectious gastroenteritis, and functional diarrhea. Hemorrhoidal disease was likewise closely associated with benign and malignant anorectal neoplasms.
Results of this study must be interpreted with caution because epidemiologic studies cannot establish cause and effect relationships. Nevertheless, these data would seem to further support the pathogenic influence of diarrhea in development of hemorrhoidal disease.
尽管痔病频繁发生，但其病因仍存在争议。最近的证据表明腹泻可能是一种致病危险因素。本研究调查了老年痔病患者中腹泻性疾病的患病率，以进一步深入了解其发病机制。
利用1987年在美国住院的880万医疗保险患者，比较了有和没有痔病的患者中所有三位数国际疾病分类代码的频率分布。与一般医疗保险人群相比，痔病患者中某种特定疾病的发生率更高，这表明该疾病可能在病理生理上与痔病相关，或与痔病有共同的病因危险因素。
观察到痔病与多种腹泻性疾病之间存在密切关联，包括溃疡性结肠炎、非感染性胃肠炎和功能性腹泻。痔病同样与良性和恶性肛肠肿瘤密切相关。
本研究结果必须谨慎解读，因为流行病学研究无法确立因果关系。然而，这些数据似乎进一步支持了腹泻在痔病发生中的致病影响。
