Ann Digest Liver Dis | Volume 4, Issue 1 | Research Article | Open Access

Is Prolonged Sitting a Risk Factor in Developing Symptomatic Hemorrhoids and Anal Fissures?

Gamal Eldin Hussein A El Shallaly1*, El Fatih M Malik2, Mohamed Abdelmonem A Ali3, Babiker AB Ibrahim4, Maysa HM Hamza5, Hassan EH Mohamed Ahmed6, Mohamed MI Elhajahmed7 and Modather ME Salih8

1Department of Surgery, Alzaiem Alazhari (AAU) and Karary University, Sudan 2Department of Medicine, University of Khartoum, Sudan 3Department of Medicine, Karary University, Sudan 4Department of Medicine, Omdurman Islamic University, Sudan

*Correspondance to: Gamal Eldin Hussein A El Shallaly 

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Purpose: Anal fissures and hemorrhoids are common anal conditions. They cause significant morbidity, social embarrassment and work absenteeism. In addition, they form a significant workload on the health system. Nevertheless, the etiology of these conditions is still contentious. It has been assumed that hemorrhoids and anal fissures are associated with prolonged sitting. This study aims to investigate this assumption. Methods: This is a case-control study where we compared 81 patients with symptomatic and endoscopically proven hemorrhoids and or anal fissures with 162 controls with no symptoms or history of perianal disease. The cases and controls were matched for age. Demographic data and sitting hours per day of patients and controls were recorded in a proforma. Data were analyzed and compared using SPSS version 23. Results: The mean sitting hours for cases was 5.99 (3.4) whereas that for controls was 4.0 (3.0) with highly significant difference (p<0.001). Sitting of 5 h or more per day (exposure) was associated with increased risk of developing hemorrhoids and/or anal fissure [odds ratio 3.68, 95% CI: 2.1-6.47]. Conclusion: The study showed that sitting down for 5 h or more per day may increase the risk of developing hemorrhoids and or anal fissures. This finding could help in primary prevention of healthy people and counseling patients to help in treatment and reduce recurrence.


Hemorrhoids; Anal fissure; Endoscopy; Prolonged sitting hours


El Shallaly GEHA, Malik EFM, Ali MAA, Ibrahim BAB, Hamza MHM, Mohamed Ahmed HEH, et al. Is Prolonged Sitting a Risk Factor in Developing Symptomatic Hemorrhoids and Anal Fissures?. Ann Digest Liver Dis. 2022; 4(1): 1018..

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