The prevalence, characteristics and treatment of hemorrhoidal disease: results of an international web-based survey
Publication: Journal of Comparative Effectiveness Research
Abstract
Background: This international study assessed the characteristics and treatment of individuals with hemorrhoids. Materials & methods: Online survey among nationally representative populations of adults from Brazil, Czech Republic, France, Hungary, Italy, Romania, Russia and Spain, that identified participants who self-reported having hemorrhoidal disease. Results: Hemorrhoid prevalence was 11% (1725/16015); most respondents had low-severity disease (71%). Compared with the general population, participants with hemorrhoidal disease had more comorbidities (mean 3.1 vs 1.3) and included more women who had been pregnant (81 vs 68%). Common initial signs/symptoms were pain (60%), bleeding (47%) and discomfort (43%). Hemorrhoid respondents who consulted a physician were more likely to undergo interventions and take medications. Conclusion: The prevalence of hemorrhoidal disease in the adult population is 11%, mostly low-severity disease.
Supplementary Material
File (supplementary materials.docx)
- Download
- 59.99 KB
References
Papers of special note have been highlighted as: • of interest
1.
Acheson AG, Scholefield JH. Management of haemorrhoids. BMJ 336(7640), 380–383 (2008).
• Provides a review of the literature on the management of hemorrhoids.
2.
Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J. Gastroenterol. 18(17), 2009–2017 (2012).
3.
Caglayan M, Turkoglu A, Oktayoglu P et al. Evaluation of the incidence of haemorrhoidal disease in patients with ankylosing spondylitis. Clin. Rheumatol. 34(3), 511–514 (2015).
4.
Negri E, Pagano R, Decarli A, La Vecchia C. Body weight and the prevalence of chronic diseases. J. Epidemiol. Community Health 42(1), 24–29 (1988).
5.
Ravindranath GG, Rahul BG. Prevalence and risk factors of hemorrhoids: a study in a semi-urban centre. Int. J. Surg. 5(2), 496–499 (2018).
6.
Tournu G, Abramowitz L, Couffignal C et al. Prevalence of anal symptoms in general practice: a prospective study. BMC Fam. Pract. 18(1), 78 (2017).
7.
Abramowitz L, Benabderrahmane M, Pospait D, Philip J, Laouenan C. The prevalence of proctological symptoms amongst patients who see general practitioners in France. Eur. J. Gen. Pract. 20(4), 301–306 (2014).
8.
Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology 98(2), 380–386 (1990).
9.
Violan C, Foguet-Boreu Q, Hermosilla-Perez E et al. Comparison of the information provided by electronic health records data and a population health survey to estimate prevalence of selected health conditions and multimorbidity. BMC Public Health 13, 251 (2013).
10.
Asakura K, Nakano M, Omae K. Relationship between bidet toilet use and haemorrhoids and urogenital infections: a 3-year follow-up web survey. Epidemiol. Infect. 146(6), 763–770 (2018).
11.
Mao L, Ma L, Liu N et al. Self-reported health problems related to traditional dietary practices in postpartum women from urban, suburban and rural areas of Hubei province, China: the ‘zuo yuezi’. Asia Pac. J. Clin. Nutr. 25(1), 158–164 (2016).
12.
Poskus T, Buzinskiene D, Drasutiene G et al. Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG 121(13), 1666–1671 (2014).
13.
Jensen SL, Harling H, Arseth-Hansen P, Tange G. The natural history of symptomatic haemorrhoids. Int. J. Colorectal Dis. 4(1), 41–44 (1989).
14.
Trilling JS, Robbins A, Meltzer D, Steinbardt S. Hemorrhoids: associated pathologic conditions in a family practice population. J. Am. Board Fam. Pract. 4(6), 389–394 (1991).
15.
Allen EN, Chandler CI, Mandimika N, Leisegang C, Barnes K. Eliciting adverse effects data from participants in clinical trials. Cochrane Database Syst. Rev. 1, MR000039 (2018).
• This is a Cochrane systematic review of studies that compared various methods (open questions, checklist, interview) of eliciting adverse event information from clinical trial participants.
16.
Chrysant SG. Proactive compared with passive adverse event recognition: calcium channel blocker-associated edema. J. Clin. Hypertens. (Greenwich) 10(9), 716–722 (2008).
17.
Clinical Practice Committee, American Gastroenterological Association. American Gastroenterological Association medical position statement: diagnosis and treatment of hemorrhoids. Gastroenterology 126(5), 1461–1462 (2004).
• Position statement of the American Gastroenterological Association on the diagnosis and treatment of hemorrhoidal disease.
18.
Altomare DF, Roveran A, Pecorella G, Gaj F, Stortini E. The treatment of hemorrhoids: guidelines of the Italian Society of Colorectal Surgery. Tech. Coloproctol. 10(3), 181–186 (2006).
• Guidelines on the treatment of hemorrhoidal disease from the Italian Society of Colorectal Surgery.
19.
Davis BR, Lee-Kong SA, Migaly J, Feingold DL, Steele SR. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis. Colon Rectum 61(3), 284–292 (2018).
• Guidelines on the management of hemorrhoidal disease from the American Society of Colon and Rectal Surgeons.
20.
Rivadeneira DE, Steele SR, Ternent C, Chalasani S, Buie WD, Rafferty JL. Practice parameters for the management of hemorrhoids (revised 2010). Dis. Colon Rectum 54(9), 1059–1064 (2011).
21.
Van Tol RR, Kleijnen J, Watson AJM et al. European Society of ColoProctology: guideline for haemorrhoidal disease. Colorectal Dis. 22(6), 650–662 (2020).
• Clinical practice guidelines from the European Society of ColoProctology on the diagnosis and treatment of hemorrhoidal disease.
22.
Choi BC, Pak AW. A catalog of biases in questionnaires. Prev. Chronic Dis. 2(1), A13 (2005).
23.
Villalba H, Abbas MA. Hemorrhoids: modern remedies for an ancient disease. Perm. J. 11(2), 74–76 (2007).

Information & Authors
Information
Published In
Pages: 1219 - 1232
PubMed: 33079605
Copyright
© 2020 Parvez Sheikh. This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License
History
Received: 28 July 2020
Accepted: 11 September 2020
Published online: 20 October 2020
Keywords:
Topics
Authors
Funding Information
Metrics & Citations
Metrics
Article Usage
Article usage data only available from February 2023. Historical article usage data, showing the number of article downloads, is available upon request.
Citations
How to Cite
The prevalence, characteristics and treatment of hemorrhoidal disease: results of an international web-based survey. (2020) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2020-0159
Export citation
Select the citation format you wish to export for this article or chapter.
Citing Literature
- Wei Zhang, Zhengfei Han, Qiang Lu, Effects of Transcutaneous Electrical Acupoint Stimulation Combined With Propofol–Sufentanil Intravenous Anesthesia on Perioperative Analgesia and Stress Response in Patients Undergoing Mixed Hemorrhoid Surgery, Acupuncture & Electro-Therapeutics Research: International Journal of Integrated Medicine, 10.1177/03601293261461851, (2026).
- Gaetano Gallo, Antonella Salvatore, Giovanni Tomasicchio, Alberto Realis Luc, Arcangelo Picciariello, Angelo Di Vittori, Mario Trompetto, Marcella Rinaldi, Use of mesoglycan in the acute phase of hemorrhoidal disease, The aCute HaemORrhoidal MEsoglycan Study (CHORMES): a double-blind, randomized controlled trial, Surgery, 10.1016/j.surg.2026.110402, (110402), (2026).
- Ankit Saha, Sk Monsur Alam, Rajat Kumar Pal, Subhranil Saha, Munmun Koley, Shubhamoy Ghosh, Sangita Saha, Soumya Bhattacharyya, Sagarika Muduli, Indrani Halder, Mousumi Koley, Amit Gunin, Suhisna Das, Doly Chakraborty, Abdur Rahaman Shaikh, Priyanka Ghosh, Satarupa Sadhukhan, Shyamal Kumar Mukherjee, Treatment of Hemorrhoids with Individualized Homeopathic Medicinal Products: A Double-Blind, Randomized, Placebo-Controlled Trial, Journal of Integrative and Complementary Medicine, 10.1177/27683605261435779, (2026).
- K Satanova, A Fursov, R Fursov, A Kaipova, A Talassov, RISKS OF COMPLICATIONS AND STATISTICAL CRITERION OF “ODDS RATIO” (OR) AS INDICATORS OF THE EFFECTIVENESS OF LASER VAPORIZATION OF HEMORRHOIDAL VESSELS, BULLETIN OF SURGERY OF KAZAKHSTAN, 10.35805/BSK2026I009, 22, 1, (58), (2026).
- Chris M Prince, Adhya M Tom, Sofia Ali, Jagat S Gopinath, Ashish Enos, Anusha Sreejith, Spectrum and Management of Anorectal Disorders: A Retrospective Analysis From the United Arab Emirates, Cureus, 10.7759/cureus.104155, (2026).
- Fabrício Doin Paz de Oliveira, Bruno Lorenzo Scolaro, Ana Carolina Buffara Blitzkow, Sonia Cristina Cordero Time, Alline Maciel Pinheiro Borges, Thais Alencar Pinto dos Santos, Alfadl Abdulfattah, Elisa Treptow Marques Lemos, Glicia Estevam de Abreu, Laser Hemorrhoidoplasty for Grade III Hemorrhoidal Disease: Safety and Efficacy in a Brazilian Multicenter Retrospective Cohort Study, Photobiomodulation, Photomedicine, and Laser Surgery, 10.1177/25785478251386982, (2026).
- Muhammad Usama Talib, Faiza Hameed, Qambar A Laghari, Zameer Hussain Laghari, Aijaz Ahmed Shaikh, Renad Al Mefleh, Comparative Study of Blood Loss and Hemostasis in Doppler-Guided Hemorrhoidal Artery Ligation Versus Open Hemorrhoidectomy, Cureus, 10.7759/cureus.102186, (2026).
- Mohammad Hossein Golezar, Hamed Ghorani, Fakhroddin Alemi, Farzad Fayedeh, Maryam Yeganegi, Samaneh Toutounchian, Hanieh Amani, Hadi Rokni Yazdi, Arterial Embolization for the Internal Hemorrhoids Management: A Systematic Review, Health Science Reports, 10.1002/hsr2.71577, 9, 1, (2026).
- Isaac Seow-En, Lionel Raphael Hui Chen, Yun Zhao, Yvonne Ying-Ru Ng, Emile Kwong-Wei Tan, Cryotherapy reduces pain post-hemorrhoidectomy (CYPHER): a randomized, controlled, superiority trial of intra-anal ice after surgery for grade III hemorrhoids, Annals of Coloproctology, 10.3393/ac.2025.00549.0078, 41, 6, (537-544), (2025).
- Amin Esmaeilnia Shirvani, Kimia Pakdaman, Zahra Maleki, Soroush Soraneh, Fatemeh Rezaei chegini, Kasra Pakdaman, Mohebat Vali, Hossein-Ali Nikbakht, Layla Shojaie, Pouyan Ebrahimi, Worldwide prevalence of haemorrhoids: a systematic review and meta-analysis, Annals of Medicine, 10.1080/07853890.2025.2606433, 58, 1, (2025).
- See more
