Abstract
Objectivive To find out causes of thrombosed external hemorrhoids (TEH). Subjects and Methods Prospective cohort study of individuals with and without TEH with comparison of answers to a questionnaire. Results One hundred forty-eight individuals were enrolled, 72 patients with TEH and 76 individuals without TEH but with alternative diagnoses, such as a screening colonoscopy or colonic polyps. Six independent variables were found to predict TEH correctly in 79.1% of cases: age of 46 years or younger, use of excessive physical effort, and use of dry toilet paper combined with wet cleaning methods after defecation were associated with a significantly higher risk of developing TEH; use of bathtub, use of the shower, and genital cleaning before sleep at least once a week were associated with a significantly lower risk of developing TEH. Conclusions Six hypotheses on the causes of TEH should be considered in future studies on etiology and prophylaxis of TEH.
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