Association of chronic obstructive pulmonary disease and hemorrhoids

Abstract

According to traditional Chinese medicine (TCM) theory, a specific physiological and pathological relationship exists between the lungs and the large intestine. The aim of this study is to delineate the association of chronic obstructive pulmonary disease (COPD) and hemorrhoids in order to verify the “interior–exterior” relationship between the lungs and the large intestine. A retrospective cohort study is conceived from the National Health Insurance Research Database, Taiwan. The 2 samples (COPD cohort and non-COPD cohort) were selected from the 2000 to 2003 beneficiaries of the NHI, representing patients age 20 and older in Taiwan, with the follow-up ending on December 31, 2011. The COPD cohort (n = 51,506) includes every patient newly diagnosed as having Chronic Obstructive Pulmonary Disease (COPD, ICD-9-CM: 490–492, 494, 496), who have made at least 2 confirmed visits to the hospital/clinic. The non-COPD cohort (n = 103,012) includes patients without COPD and is selected via a 1:2 (COPD: non-COPD) matching by age group (per 5 years), gender, and index date (diagnosis date of COPD for the COPD cohort). Compared with non-COPD cohorts, patients with COPD have a higher likelihood of having hemorrhoids and the age-, gender- and comorbidies-adjusted hazard ratio (HR) for hemorrhoids is 1.56 (95% confidence intervals [CI]:1.50–1.62). The adjusted HR of hemorrhoids for females is 0.79 (95% CI: 0.77–0.83), which is significantly less than that for males. The elderly groups, 40 to 59 years and aged 60 or above, have higher adjusted HRs than younger age groups (20–39 years), 1.19 (95% CI: 1.14–1.26), and 1.18 (95% CI: 1.12–1.24), respectively. Patients with COPD may have a higher likelihood to have hemorrhoids in this retrospective cohort study. This study verifies the fundamental theorem of TCM that there is a definite pathogenic association between the lungs and large intestine.

Recurrence Rates and Pharmacological Treatment for Hemorrhoidal Disease: A Systematic Review

“…Among 1079 patients, 74 presented with a new diagnosis of HD (6.9% or 69 per 1000 persons) [ 5 ]. Lin et al reported on the new HD diagnosis (International Classification of Diseases, Ninth Revision, Clinical Modification: 455) among patients with and without chronic obstructive pulmonary disease (COPD) as reported in a Taiwanese national database between 2000 and 2003 and followed up until 2011 [ 9 ]. Overall incidence among patients with COPD was approximately 1.6 times greater than in patients without COPD (average annual incidence 11.5 vs. 7.1 per 1000 person-years) [ 9 ].…”

“…Overall incidence among patients with COPD was approximately 1.6 times greater than in patients without COPD (average annual incidence 11.5 vs. 7.1 per 1000 person-years) [ 9 ]. These findings were consistent between men and women, and across different age groups [ 9 ]. Neither study was designed specifically to measure HD incidence in the general population, and thus estimates are likely to be imperfect.…”

Pathogenese des Hämorrhoidalleidens

“…Einen genetischen Hintergrund vermutet man schon lange, und rezente Studien zeigen auch einen deutlichen Hinweis hierfür [13,14]. Nicht zuletzt deswegen werden aus Hämorrhoiden-Studien zunehmend Patienten mit assoziierten Erkrankungen, wie genetischen Bindegewebserkrankungen, chronisch-obstruktiver Lungenerkrankung (COPD) oder Gefäßerkrankungen, Herniationen und genitourethralem Prolaps, ausgeschlossen [3, 11,12].…”

The efficacy and tolerability of Avaricon® hemor medical preparation in the treatment of hemorrhoids compared to placebo – a prospective double blind randomized clinical study

“…It is characterized by clusters of vascular tissues, smooth muscles and connective tissues which occur due to abnormal dilatation of the vascular channel and pathological changes within the anal cushions [3,4]. Although the etiology underlying the development of hemorrhoids has not been completely elucidated, increased intra-abdominal pressure during pregnancy or straining may be the cause venous engorgement of the hemorrhoidal plexus [5,6]. Patients who suffer from hemorrhoids experience bleeding, fecal soiling, pruritus etc., which strongly affects their quality of life [7].…”

“…Patients who suffer from hemorrhoids experience bleeding, fecal soiling, pruritus etc., which strongly affects their quality of life [7]. While internal hemorrhoids are often painless, external hemorrhoids are associated with significant pain and discomfort due to activation of perianal innervations associated with thrombosis [3,5].…”