Abstract
Haemorrhoidal disease and lower extremity venous insufficiency are both congestive venous disorders. The research regarding the common risk factors between haemorrhoidal disease and varicose veins is limited. The present research aimed to study the prevalence of the co-existence of haemorrhoids and varicose veins and to identify common risk factors. One hundred thirty-one patients aged > 20 years were included in this cross-sectional observational study. All patients presented with symptoms of the haemorrhoidal disease were subjected to digital rectal examination and proctoscopy for confirmation and also examined for the presence of signs and symptoms of varicose veins. All patients presented with signs and symptoms of varicose veins were subjected to a duplex ultrasonography scan and also physically examined for the presence of varicose veins. The comparison of qualitative variables was done using the chi-square test or Fisher’s exact test The prevalence of varicose veins was 22.0% in patients who had haemorrhoids, whereas the prevalence of haemorrhoidal disease was 22.6% in patients who had varicose veins. Prolonged standing and a history of pregnancy were significantly higher in the group of patients with varicose veins as compared to the group of patients having haemorrhoids, whereas constipation was significantly higher in the group of patients with haemorrhoids as compared to the group of patients with varicose veins. The coexistence of haemorrhoidal disease and varicose veins emphasises the significance of checking for both haemorrhoids and varicose veins in patients with a diagnosis of haemorrhoids or varicose veins especially when shared risk factors are present.
Similar content being viewed by others
References
Pfenninger JL, Zainea GG (2001) Common anorectal conditions: Part I. Symptoms and complaints. Am Fam Physician 63:2391–2398
Chong PS, Bartolo DC (2008) Hemorrhoids and fissure in ano. Gastroenterol Clin North Am 37:627–644
Jacobs D (2014) Clinical practice. Hemorrhoids N Engl J Med 371:944–951
Burkitt DP (1972) Varicose veins, deep vein thrombosis, and haemorrhoids: epidemiology and suggested aetiology. Br Med J 2:556–561
Yun MJ, Kim YK, Kang DM, Kim JE, Ha WC, Jung KY, et al (2018) A Study on Prevalence and Risk Factors for Varicose Veins in Nurses at a University Hospital. Saf Health Work 9:79–83
Piazza G (2014) Varicose veins. Circulation 130:582–587
WHO (2021) Obesity and overweight [Internet]; [cited 2022 Sep 16]. https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
Nugent K (2018) The anus and anal canal. In: Williams NS, O’Connell PR, McCaskie A (eds). Bailey and Love’s short practice of surgery. 27th edition. United Kingdom. CRC Press
Lurie F, Passman M, Meisner M, Dalsing M, Masuda E, Welch H et al (2020) The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord 8:342–352
Ekici U, Kartal A, Ferhatoglu MF (2019) Association between hemorrhoids and lower extremity chronic venous insufficiency. Cureus 11:e4502
Charan J, Biswas T (2013) How to calculate sample size for different study designs in medical research? Indian J Psychol Med 35:121–126
Godeberge P, Sheikh P, Zagriadskiĭ E, Lohsiriwat V, Montaño AJ, Košorok P et al (2020) Hemorrhoidal disease and chronic venous insufficiency: concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research). J Gastroenterol Hepatol 35:577–585
Sheikh P, Mital K, Maheshwari U, Prabakaran J, Sharda P, Dumbre R (2020) Clinical presentation of hemorrhoids and its correlation with chronic venous disease in India: a subgroup analysis of the international CHORUS survey. Indian J Surg 82:1–9
Chang SS, Sung FC, Lin CL, Hu WS (2017) Association between hemorrhoid and risk of coronary heart disease. Medicine (Baltimore) 96:e7662
Singh G, Lingala V, Wang H, Vadhavkar S, Kahler KH, Mithal A et al (2007) Use of health care resources and cost of care for adults with constipation. Clin Gastroenterol Hepatol 5:1053–1058
Riss S, Weiser FA, Schwameis K, Mittlböck M, Stift A (2011) Haemorrhoids, constipation and faecal incontinence: is there any relationship? Colorectal Dis 13:e227–e233
Peery AF, Sandler RS, Galanko JA, Bresalier RS, Figueiredo JC, Ahnen DJ et al (2015) Risk factors for hemorrhoids on screening colonoscopy. PLoS ONE 10:0139100
Risk factors for develo** hemorrhoids | Colon and rectal surgical specialists, New York (2021); [Internet]. [cited 2022 Jun 22]. https://www.crssny.com/risk-factors-for-develo**-hemorrhoids/
Avsar AF, Keskin HL (2010) Haemorrhoids during pregnancy. J Obstet Gynaecol 2010(30):231–237
Hollingshead JR, Phillips RK (2016) Haemorrhoids: modern diagnosis and treatment. Postgrad Med J 92:4–8
Scott TE, LaMorte WW, Gorin DR, Menzoian JO (1995) Risk factors for chronic venous insufficiency: a dual case-control study. J Vasc Surg 22:622–628
Brand FN, Dannenberg AL, Abbott RD, Kannel WB (1988) The epidemiology of varicose veins: the Framingham study. Am J Prev Med 4:96–101
Cesarone MR, Belcaro G, Nicolaides AN, Geroulakos G, Griffin M, Incandela L et al (2002) ‘Real’ epidemiology of varicose veins and chronic venous diseases: the San Valentino Vascular Screening Project. Angiology 53:119–130
Ismail L, Normahani P, Standfield NJ, Jaffer U (2016) A systematic review and meta-analysis of the risk for development of varicose veins in women with a history of pregnancy. J Vasc Surg Venous Lymphat Disord 4:518–524
Author information
Authors and Affiliations
Contributions
Author 1: Research design, acquisition of data, analysis of data, approving the submitted version
Author 2: Research design, revising critically, approving the submitted version
Author 3: Research design, analysis of data, interpretation of data, drafting the paper, revising critically, approving the submitted version
Author 4: Research design, revising critically, approving the submitted version
Corresponding author
Ethics declarations
Consent for Publication
The manuscript has been read and approved by all the authors; the requirements for authorship as stated earlier in this document have been met; and each author believes that the manuscript represents honest work.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Darshakkumar, V., Dikshit, B., Phalgune, D. et al. Association Between Haemorrhoidal Disease and Chronic Venous Insufficiency. Indian J Surg 85, 1390–1395 (2023). https://doi.org/10.1007/s12262-023-03759-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-023-03759-3