Association of Hemorrhoids With Hashimoto's Thyroiditis and Associated Comorbidities: A Nationwide Population-Based Cohort Study

Abstract

Background: To evaluate the relationship between hemorrhoids and Hashimoto's thyroiditis (HT). Methods: Using Taiwan's Longitudinal Health Insurance Database, we compared the incident risk of HT between the study cohort (comprising patients with hemorrhoids) and the comparison cohort (comprising patients without hemorrhoids). Both cohorts were followed from index date until the date of HT diagnosis, withdrawal from the National Health Insurance program, or the end of 2015. Results: The study cohort and comparison cohort comprised 6,486 patients with hemorrhoids and 25,944 patients without, respectively. The mean follow-up time was ∼3 years. The incidence rate of HT in the study cohort was 5.37 per 1,000 person-years, which was higher than that of the control cohort (2.46 per 1,000 person-years). The risk of developing HT in the study cohort was 2.06 times (95% confidence interval [CI] = 1.02, 4.19) higher than that in the comparison cohort. Conclusion: In our study, patients with hemorrhoids could be at increased risk of HT compared with patients with other comorbidities of HT, such as cardiovascular disease.

Association between haemorrhoids and Graves’ disease: a retrospective cohort study using data from Taiwan’s Longitudinal Health Insurance Database

“…4 17 Population-based studies have indicated that haemorrhoids are also associated with peripheral arterial occlusive disease and coronary heart disease. 18 19 By considering these findings and those of our previous study, 14 we performed a large database study to evaluate the association between haemorrhoids and GD. Although no direct pathophysiological mechanism linking the two has been identified, future studies should attempt to evaluate relevant gastrointestinal, cardiovascular and psychological factors.…”

“…Our previous study based on a similar population and study design found an increased risk of Hashimoto's thyroiditis in patients with haemorrhoids. 14 AITD is a complex disease spectrum without a clear aetiology; two major AITDs are GD and Hashimoto's thyroiditis, which have been the targets of our current and previous studies, respectively. A study revealed that the aetiology of AITD is multifactorial, including multiple genetic and environmental factors; environmental triggers, including dietary iodine, smoking, infections, stress and some medications, contribute to approximately 20% of GD risk.…”

“…13 Our previous work found an increased risk of Hashimoto's thyroiditis, an autoimmune thyroid disease (AITD), in patients with haemorrhoids. 14 No study has evaluated the correlation between haemorrhoids and GD, another AITD. In this study, we analysed the association between haemorrhoids and GD by using Taiwan's National Health Insurance (NHI) Research Database (NHIRD).…”

Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers and hemorrhoids: A nationwide, population-based study

“…In modern countries, hemorrhoids are a commonly encountered disorder; recently, hemorrhoids were found to be related to several systemic cardiovascular disease. [10][11][12][13] To fill the knowledge gaps and to verify and test the novelty and plausible reasons of the hypothesis, we designed this investigation to dissect whether there exists an association between hemorrhoids and ACEI/ARB users.…”