2016 Volume 69 Issue 2 Pages 59-65
To clarify the progressive time course of the prolapse of hemorrhoids and risk factors affecting their development and progress, we conducted a questionnaire survey of 200 patients who underwent surgery. The severity of prolapse of II was subdivided into IIa (stage in which a patient felt prolapse for the first time) and IIb (stage in which a patient felt prolapse at almost every bowel movement) according to the Goligher classification, and the intervals of disease stages were measured using the Visual Analog Scale (VAS) with an interval of 1 year = 1 cm. The median intervals of II to III, III to IV, IIa to IIb, and IIb to III were 5, 1, 3, and 0.2 years, respectively, and over 70% of patients showed intervals of less than 10 years over the entire period. We examined the intervals of the disease stages of prolapse by patient factor (sex, stool hardness, functional constipation, constipation score, amount of dietary fiber intake, occupation, gross appearance of hemorrhoids) and found that the factor accelerating the progression was a constipation score of 7 or higher and that the intervals of disease stages of II to III and IIa to IIb were significantly shorter (P=0.04). It was suggested that high constipation scores might accelerate the progression of hemorrhoids.
