Hemorrhoids in the Western World

Hemorrhoids are much more prevalent in the Western World compared with “Third World Countries.” Hemorrhoids are associated with constipation, heavy physical work, and the effects of erect posture. Hemorrhoids are common during pregnancy. In addition to hemorrhoids, industrialized countries are at an increased risk for colorectal cancer. If you suspect you have hemorrhoids, always talk to your doctor. Do not self-diagnose!


Hemorrhoids are one of the most frequent problems people in westernized countries face. There are estimates of up to 75 to 90 percent occurrence rates of hemorrhoids in the U.S. population (1, 2, 3, 4, 5). 

What Causes Hemorrhoids

Hemorrhoids are thought to be caused by, or associated with, increased intra-abdominal pressure resulting from:

  • chronic straining to pass constipated stools,
  • heavy physical work, or
  • the effects of erect posture (3). 

Pregnancy is a Risk Factor for Hemorrhoids 

“About 40 percent of pregnant women develop symptoms they attribute to hemorrhoids (Simmons, S. C. 1972).”

Pregnancy may predispose women to hemorrhoids because of:

  • increased intra abdominal pressure from the pregnant uterus, 
  • constipation, 
  • hormonal venous dilation (hemorrhoidal tissue contains high levels of estrogen receptors, Saint-Pierre, A., et al., 1982), and 
  • increased circulating blood volume (3).

50% of People Require Therapy for Hemorrhoids by Age 50

An estimated 50 percent of those over the age of 50 years require some type of conservative or operative therapy (4).

The cost to the community, both financial and in lost work days, is great; and by any standards, this condition must be considered a major health hazard (7).

Minimize External Compression to Reduce Risk factors for Hemorrhoids

Preventative measures to reduce risk factors for the development of hemorrhoids should be taken before it is too late. 

It is important to minimize external compression from poorly designed seating as much as possible. 

External compression from poorly designed seating concentrates forces on small areas of the body. This results in high localized pressure. 

The pressure can compress nerves, vessels, and other soft tissues, resulting in tissue-specific damage. These changes may themselves result in disease or predispose other tissues to damage.

Jimmy Carter’s Hemorrhoids

Hemorrhoids have plagued men and women for centuries, inflicting pain equally on individuals at all levels of society and of all occupations: Emperors (Napoleon); U.S. Presidents (Jimmy Carter); baseball sluggers (George Brett); judges; policemen; truck drivers; cab drivers; and jockeys (6).

Napoleon’s Hemorrhoids Changed History

It has been said that Napoleon’s hemorrhoids were troubling him during the battle of Waterloo (7, 9).

Proctology in Ancient Egypt | Ancient Greece

Proctology flourished as a specialty in Ancient Egypt. 

The surgical treatment of hemorrhoids was practiced in Ancient Greece, and Hippocrates suggested that the cause could be attributed to bile and phlegm (8).

Hemorrhoids in The Western World 

Today, hemorrhoids are considered to be one of the most common ills of men and women, a judgment made by those with vision limited to the Western World (7).

Hemorrhoids in “Third World Countries”

The high rate of hemorrhoids in westernized societies contrasts sharply with Third World countries. 

Only about one in 25 to one in 30 individuals is thought to have hemorrhoids as compared to one in two individuals in Westernized societies. 

One doctor recounted in 30 years’ practice in Africa, one of the only two patients he saw with severe hemorrhoids was a prince taking a semi-European diet (5, 7).

Industrialized Countries at Increased Risk of Colorectal Cancer

Industrialized countries are at a relatively increased risk (for colorectal cancer) compared to less developed countries that traditionally had high fiber/low fat diets.  

“This point is exemplified by the fact that persons from a low risk country who migrate to the United States over time develop colorectal cancer rates similar to those amoung native U.S. citizens, (Fry, R., et al., 1989; Levin K. et al., 1991).”

Smoking Increases Risk of Colorectal Cancer

“Cigarette smoking and alcohol consumption have been reported to increase the relative risk of an individual to develop colorectal cancer, (Kune, G., et al. 1992; Martinez, M., et al., 1995).” 


  1. Primary Care, Volume 26, Number 1, March, 1999, “Hemorrhoids,” by Joy N. Hussain, M.D., Cairns Base Hospital, Australia.
  2. Family Medicine Principles & Practices, 1998, Fifth Edition: Chapter 91, “Diseases of the Rectum and Anus,” by Thomas J. Zuber; 2b.  Family Medicine Principles & Practices, 1998, Fifth Edition: Chapter 92, “Colorectal Cancer,” written by Gregory L. Brotzman and Russell G. Robertson.
  3. MJA, Vol. 167, July, 1997, Clinical Practice, “Hemorrhoids: A Clinical Update,” written by Adrian L. Polglase, M.S., FRACS, Clinical associate Professor and Colorectal Surgeon, Australia.
  4. American Family Physician, September 1, 1995, “Non-surgical Treatment Options for Internal Hemorrhoids, written by John Pfenninger, M.D., and James Surrel, M.D.
  5. Surgical Clinics of North America, Vol. 65, No. 6, December, 1988, “Hemorrhoids, Non-operative Management,” written by A. R. Dennison, M.D.; D.C., Wherry, M.D.; and D.L. Morris, M.D., Ph.D.
  6. Southern Medical Journal, Vol. 81, No. 5, May, 1988, “Alternatives in the Treatment of Hemorrhoidal Disease,” by Emmet F. Ferguson, Jr., M.D., University of Florida, School of Medicine, Jacksonville, F.L., U.S.A.
  7. Postgraduate Medical Journal, September, 1975, 51, 631-636, “Hemorrhoids – Postulated Pathogenesis and Proposed Prevention,” written by D. P. Burkitt, C.M.G., M.D., F.R.C.S., F.R.S., and C.W. Graham-Stewart, MS, F.R.C.S.
  8. The American Journal of Proctology, Vol. 21, No. 3, June 1970, “An Epidemiological Investigation of Hemorrhoids, written by John Philpot, Ph.D., Rutgers, The State University, New Jersey, U.S.A
  9. “Napoleon’s Hemorrhoids and Other Small Events that Changed,” History by Phil Mason

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