Scrolling on your smartphone while on the toilet may be doing more than passing the time. A new study has found it could raise your risk of hemorrhoids by nearly 50%, thanks to the extra minutes spent sitting.
Sitting on a cold surface. Eating spicy foods. Poor hygiene. Those are some of the old wives’ tales about hemorrhoids that are pure myth. However, sometimes such beliefs turn out to be backed by science.
New research led by Beth Israel Deaconess Medical Center (BIDMC) in Boston has found that smartphone use while on the toilet increases the risk of hemorrhoids.
“Using a smartphone while on the toilet was linked to a 46% increased chance of having hemorrhoids,” said the study’s corresponding author, Trisha Pasricha, MD, MPH, from BIDMC’s Division of Gastroenterology. “We’re still uncovering the many ways smartphones and our modern way of life impact our health. It’s possible that how and where we use them – such as while in the bathroom – can have unintended consequences.”
It's probably worthwhile starting with an explanation of what hemorrhoids are. If you’re familiar, you can skip the next couple of paragraphs.
“We all have hemorrhoid cushions – vascular cushions made of blood vessels, connective tissue, and smooth muscle – right at the end of our GI [gastrointestinal] tract,” Pasricha explained. “That’s a normal part of our body. It’s only when they get engorged that we notice them and that’s when they become symptomatic and they’re called hemorrhoids.
"When they become engorged, they often bleed and become uncomfortable. The external ones are the ones that can cause itching. It can feel like there’s a bump, it can feel like there’s something there and they’re difficult to clean. And then that kind of like causes this vicious cycle of like more discomfort, more irritation. The more angry they get, the more likely they are to bleed. It can really just spiral.”
For the study, the researchers recruited 125 adults aged 45 and older who were scheduled to undergo routine colonoscopies. Participants filled out surveys about demographics, physical activity, fiber intake, and bathroom habits (including smartphone use). The Rome IV questionnaire was used to assess bowel function and straining. Doctors performing the colonoscopies visually confirmed whether participants had hemorrhoids.
Smartphone users were compared to non-users. Statistical methods were used to adjust for confounding factors like age, sex, body mass index (BMI), fiber intake, exercise and straining. Of all the participants, 66% reported using their phone on the toilet. Phone users spent more time sitting than non-users: 37% of users stayed on the toilet for more than five minutes per visit, compared to just 7% of non-users. The most common things people did on the toilet were read the news (54%) and use social media (44%). Smartphone users were younger and exercised less on average than non-users.
Colonoscopy confirmed that 43% of all participants had hemorrhoids. After adjusting for other risk factors, smartphone use on the toilet was linked to a 46% higher risk of hemorrhoids. Straining did not independently predict hemorrhoids in the phone user group, suggesting that time spent sitting is more relevant.
“This study bolsters advice to people in general to leave the smartphones outside the bathroom and try to spend no more than a few minutes to have a bowel movement,” said Pasricha. “If it’s taking longer, ask yourself why. Was it because [having] a bowel movement was really so difficult, or was it because my focus was elsewhere?
"It’s incredibly easy to lose track of time when we’re scrolling on our smartphones – popular apps are designed entirely for that purpose. But it’s possible that constantly sitting longer on the toilet than you intended because you’re distracted by your smartphone could increase your risk of hemorrhoids. We need to study this further, but it’s a safe suggestion to leave the smartphone outside the bathroom when you need to have a bowel movement.”
The study has drawn comment from other GI experts, such as Jarrah Dowrick, PhD, a research fellow with the Gastrointestinal Research Group at the Auckland Bioengineering Institute, University of Auckland.
“From what I can see, this paper is a thinly veiled study of the relationship between time spent on the toilet and hemorrhoids, but using the catchier hook of ‘phone use’ to attract wider attention,” said Dowrick. “While the reality of modern screen addiction does make the smartphone narrative more compelling, the real story here is that spending longer on a seated toilet appears to be linked with hemorrhoid presentation.
“This is still an important finding. There is a surprising lack of evidence for commonly believed hemorrhoid risk factors like low fiber intake, straining, constipation, age, sex differences, pregnancy, and time on the toilet. Studies like this one are vital to empower clinicians to make evidence-based recommendations to patients. Phone or no, this study suggests limiting each visit to the toilet to five minutes where possible.”
There are some key limitations to the study. Its cross-sectional design means it can show associations but not prove cause and effect. Additionally, because participants’ behavior was self-reported, time spent on the toilet and straining could be affected by recall bias. And, the participants were over 45 undergoing colonoscopies, so results may not reflect younger populations or the general public. Finally, the study didn’t measure how many years people had been using phones on the toilet.
Nonetheless, the study has real-world implications. Its findings suggest that it’s not so much straining but prolonged sitting without pelvic support that raises hemorrhoid risk. So, medical professionals might want to recommend limiting toilet sessions –especially with phone – to five minutes or less.
Larger, long-term future studies could track whether years of toilet-phone use worsen hemorrhoid rates, and behavioral interventions such as timers might help reduce sitting time.
The study was published in the journal PLOS One.
Source: BIDMC in Boston, Scimex
