Hemorrhoidal disease and chronic venous insufficiency: Concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research)
Journal of Gastroenterology and Hepatology Nov 09, 2019
Godeberge P, Sheikh P, Zagriadskiĭ E, et al. - In CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research) of adult people attending a consultation for hemorrhoidal complaints, experts gave data on people presenting with hemorrhoidal disease (HD) in clinical practice and investigated the frequency with which it coexisted with chronic venous disease (CVD) and shared risk factors. A total of 5,617 individuals were investigated. Bleeding, pain, swelling, itching, and prolapse were symptoms often reported. Multivariate analysis exhibited the variables with the most robust relationship with HD severity were elderly age, higher CVD CEAP (Clinical manifestations, Etiologic factors, Anatomic distribution of disease, and underlying Pathophysiology) class, constipation, and male gender. Increased BMI was a risk factor for HD recurrence. Among women, the number of births had an important relationship with both HD grade and recurrence. The presence of CVD reported in nearly half the study population was strongly related to the advanced grade of HD. Venoactive drugs, dietary fiber, topical treatment, analgesics, and surgery were the most often prescribed treatments. Thus, CHORUS gave a snapshot of prevailing profiles, risk factors, and treatments of cases with HD worldwide. Moreover, in more than half the study population, the coexistence of HD and CVD reflects the significance of testing for CVD among people with a hemorrhoid diagnosis, especially when shared risk factors are there.
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