Risk Factors for Hemorrhoids Screening Proctoscopy

Abstract

Background: Hemorrhoids are a common anorectal condition affecting a significant proportion of adults, influenced by various risk factors such as diet, lifestyle, and genetic predisposition. Objective: This study aimed to evaluate the risk factors associated with hemorrhoidal disease in patients undergoing screening proctoscopy, identifying significant lifestyle and dietary contributors to its prevalence and severity. Method: An interventional study was conducted with 318 patients at Rajshahi Medical College Hospital from July 2017 to June 2020. Patients completed structured questionnaires assessing demographics, dietary intake, physical activity, and comorbidities. Proctoscopy examinations were performed to grade hemorrhoids. Data were analyzed using SPSS, with chi-square tests and logistic regression to assess associations. Results: The mean age of participants was 45.2 years (SD ±12.7). Hemorrhoids were more prevalent in males (58.0%) compared to females (42.0%) (p=0.021). Low fiber intake (<15g/day) was reported by 45.9% of patients, with a hemorrhoid prevalence of 72% (p < 0.001), while those consuming more than 25g/day had only 38% prevalence. Sedentary behavior (sitting >8 hours/day) was observed in 32.7% of patients, correlating with a 72% hemorrhoid prevalence (p=0.008). Water intake of less than 1.5L/day was reported by 40.3% of patients, with a 68% hemorrhoid prevalence (p=0.009), whereas patients consuming more than 2.5L/day had only 40% prevalence. Multivariate analysis confirmed that low fiber intake (OR 3.2), sedentary behavior (OR 2.5), and family history (OR 2.5) were significant predictors. Conclusions: Dietary fiber intake, sedentary behavior, and family history are strong predictors of hemorrhoidal disease. Public health initiatives should focus on promoting dietary and lifestyle changes to reduce hemorrhoid prevalence.