Smartphone Use on the Toilet and Symptomatic Hemorrhoidal Disease: A Case–Control Study

A BSTRACT Background: The habit of using smartphones during defecation can extend the time spent sitting on the toilet, potentially correlating with symptomatic hemorrhoids. However, empirical data regarding this contemporary behavior is sparse. Methods: A hospital-based case–control investigation was carried out over 12 months at a tertiary teaching center. We recruited consecutive adults (18–65 years) newly diagnosed with symptomatic hemorrhoidal disease via proctoscopy as the case group. The control group consisted of age- and sex-matched individuals with no current or historical anorectal conditions. We utilized a structured questionnaire to gather information regarding toilet smartphone habits, duration of toilet sitting, bowel patterns, dietary fiber consumption, physical activity, and baseline demographics. Adjusted odds ratios and 95% confidence intervals were calculated using multivariable logistic regression. Results: The study comprised 240 subjects (110 cases, 130 controls). A significantly greater proportion of cases engaged in frequent smartphone use while on the toilet compared to controls. Furthermore, the case group noted lengthier toilet sessions and frequently reported that their phone use extended their sitting time. Following adjustment for variables such as age, sex, body mass index, fiber intake, physical exertion, and straining, the frequent utilization of a smartphone on the toilet maintained an independent association with symptomatic hemorrhoids. Conclusion: Utilizing a smartphone while sitting on the toilet demonstrated a significant association with symptomatic hemorrhoidal disease within this case–control framework. These results underscore the clinical value of advising patients to curtail extended toilet sessions and refrain from smartphone usage during bowel movements.