The current issue of the Journal of Comparative Effectiveness Research contains two articles reporting results of
international web-based surveys: one in individuals with chronic venous disease (CVD) , and the other in those
with hemorrhoidal disease .
CVD is an umbrella term that describes conditions characterized by long-standing morphological and functional
venous abnormalities, while hemorrhoidal disease is characterized by abnormally enlarged anal venous cushions.
Both conditions have complex pathophysiological mechanisms that are not yet fully understood, with neither
condition having a single cause [5–7]; however, both involve venous abnormalities . As highlighted by the articles
published in this issue, patients with these two conditions have similar comorbidities: allergy, asthma, depression,
diabetes, hypertension and psoriasis were commonly reported in both studies [1,2]. There is also an overlap in risk
factors, with increasing age, obesity, pregnancy and sitting or standing for prolonged periods of time increasing the
risk for both conditions [8,9]. It is therefore perhaps unsurprising that CVD was reported in over half of the patients
with hemorrhoidal disease in the large CHORUS study . In the survey published in this issue, hemorrhoidal
disease was reported by 28% of those with CVD, compared with only 10% of the general population . Similarly,
49% of patients reporting hemorrhoidal disease also suffered heavy legs or varicose veins, versus 24% of the general
population . Thus, if a physician is treating a patient for one condition, it may be prudent for them to also
investigate the other.
Published Online:20 Oct 2020
For full text: Future Medicine; https://doi.org/10.2217/cer-2020-0214