Hemorrhoids Clinical Trial
Official title:
An Investigation Into the Relationship Between Hemorrhoid Disease and the Use of Smartphones in the Lavatory
The objective of this study is to examine the relationship between hemorrhoids, a common
complaint, and the use of smartphones, also a common feature of modern life, in the lavatory.
As is known, hemorrhoidal disease is a frequently observed disease of the lower rectum and
anal region that seriously impairs the patient's quality of life.
Based on clinical observations, the study investigators have found that the use of mobile
phones in the lavatory has become a habit for some people. The investigators surmise that
this habit, which increases the time spent on the toilet, also leads to an increase in
pressure on the anal region and straining during defecation. There is a gap in the literature
investigating the relationship between these two situations (smartphone use in the lavatory
and the development of hemorrhoids). The basic research question of the present study is thus
designed to determine to what extent the use of smartphones increases time spent in the
lavatory and whether there is an association between this increase in time and hemorrhoidal
disease.
The objective of this study is to examine the relationship between hemorrhoids, a common
complaint, and the use of smartphones, also a common feature of modern life, in the lavatory.
As is known, hemorrhoidal disease is a frequently observed disease of the lower rectum and
anal region that seriously impairs the patient's quality of life. The underlying
pathophysiological event is vascular enlargement of the lower rectum. Hemorrhoids are
classified as internal or external, and it is assumed that the same pathological mechanisms
operate in both types. Accepted pathological mechanisms and predisposing factors of
hemorrhoids include reduced venous drainage, straining while defecating, constipation,
pregnancy, portal hypertension and anorectal varices, and other risk factors.
Given the pathophysiological and accelerating factors described above, an increase in
hemorrhoidal disease in modern society is to be expected. People today prefer a more
sedentary lifestyle and partake of a low-fiber diet richer in high calorie/high fat foods
compared with previous generations. In addition, smartphones have invaded nearly every aspect
of daily life. Based on clinical observations, the investigators have found that the use of
mobile phones in the lavatory has become a habit for some people. The investigators surmise
that this habit, which increases the time spent on the toilet, also leads to an increase in
pressure on the anal region and straining during defecation. There is a gap in the literature
investigating the relationship between these two situations (smartphone use in the lavatory
and the development of hemorrhoids), and researching this relationship could reveal important
information. The basic research question of the present study is thus designed to determine
to what extent the use of smartphones increases time spent in the lavatory and whether there
is an association between this increase in time and hemorrhoidal disease.
This clinical study will be conducted with a cross-sectional design based on retrospective
observation. Apart from the target population there will be a control group. In retrospective
studies the selection of the control group is of the utmost importance. Other than the risk
factor that is being investigated (the use of smartphones), factors that affect the
development of hemorrhoid disease are similar for the study group and the control group, thus
minimizing confounding factors. The control group, as will be noted, will thus have a social
environment resembling that of the study group. It should also be noted that members of the
control group will be completely healthy, with no health problems (e.g., hearing or visual
disturbances) that could affect their use of the risk factor (smartphones).
The study population consists of patients with complaints of hemorrhoids referred to the
General Surgery Polyclinic. The control group is comprised of healthy volunteers with no
complaints of hemorrhoids. Both the study group and the control group will include persons of
both genders between 16 and 65 years of age. Informed consent will be obtained from patients
and volunteers, following which a Likert-type survey will be given to each participant to
complete. A pilot study will be conducted for the factor analysis of the questions to be
asked in the questionnaire. In the pilot study, the target will be to survey 100 patients.
After the factor analysis is performed on 100 patients, the questionnaire that is developed
will be used in the main study.
As no prevalence study was previously performed for the sample size, it will be calculated
based on the prevalence (frequency of smartphone use in the lavatory in the study group and
the control group) determined after the pilot study, by accepting a type I error of 0.05 and
a type II error of 0.20 (80% test power).
The doctor who performs the examinations will be blinded to the questionnaire results. After
completion of the questionnaire, the patient's anal region and rectum will be examined by a
general surgeon and the presence or absence of hemorrhoids will be noted. Subsequently, if
hemorrhoids are present, they will be recorded as either external or internal. Internal
hemorrhoids will then be staged as first-degree, second-degree, third-degree, or
fourth-degree, according to the standard textbook definitions.
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