Smartphone use on the toilet and the risk of hemorrhoids | PLOS One

Browse Subject Areas

Click through the PLOS taxonomy to find articles in your field.

For more information about PLOS Subject Areas, click<br>here.

Article

Authors

Metrics

Comments

Media Coverage

Reader Comments

Figures

Figures

Abstract<br>Smartphones are ubiquitous in daily life, with many people now using them while sitting on the toilet. Despite anecdotal evidence that length of time spent on the toilet is a risk factor for hemorrhoids, a multivariate analysis of smartphone use has not been performed. This study examines the correlation between smartphone use on the toilet and prevalence of hemorrhoids. A cross-sectional study was conducted among adult patients undergoing screening colonoscopy at Beth Israel Deaconess Medical Center. Participants completed survey questions regarding their smartphone habits while using the toilet, Rome IV questionnaires, and additional behaviors including straining, fiber intake and levels of physical activity. Presence of hemorrhoids were evaluated endoscopically and independently rated by two blinded endoscopists. Categorical variables were analyzed using chi-square tests and linear variables with regression analysis. A total of 125 adult participants completed the survey and 43% had hemorrhoids visualized on colonoscopy. Participants who used smartphones on the toilet were younger than non-users (mean ages 55.4 vs. 62.1, p = 0.001). Of all respondents, 66% used smartphones while on the toilet. Participants who used smartphones on the toilet spent significantly more time there than those who did not, with 37.3% of smartphone users spending more than five minutes per visit on the toilet, compared to 7.1% of non-smartphone users (p = 0.006). Furthermore, in a multivariate logistic regression, smartphone use on the toilet was associated with a 46% increased risk of hemorrhoids (p = 0.044) after adjusting for age, sex, BMI, exercise activity, straining and fiber intake. The most common activity performed while on the toilet was reading “news” (54.3%), followed by “social media” (44.4%). The study suggests that prolonged engagement with smartphones while using the toilet may be associated with an increased prevalence of hemorrhoids.

Citation: Ramprasad C, Wu C, Chang J, Rangan V, Iturrino J, Ballou S, et al. (2025) Smartphone use on the toilet and the risk of hemorrhoids. PLoS One 20(9):<br>e0329983.

https://doi.org/10.1371/journal.pone.0329983<br>Editor: Minhui Li,, Baotou Medical College, CHINA<br>Received: January 6, 2025; Accepted: July 22, 2025; Published: September 3, 2025<br>Copyright: © 2025 Ramprasad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.<br>Data Availability: The de-identified dataset used in this analysis is available from Harvard Dataverse (DOI: https://doi.org/10.7910/DVN/HUXLUM).<br>Funding: TP: Funded by the AGA Research Foundation’s Research Scholar Award–AGA2022-13-03. The AGA did not play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.<br>Competing interests: The authors have declared that no competing interests exist.

Introduction<br>Smartphone use has become integrated into daily life, influencing behaviors related to personal health and hygiene. A growing trend is the use of smartphones while sitting on the toilet to read news, to engage in social media, or simply to pass the time. This increasingly common behavior could have significant health implications, most of which have not been adequately studied.

Hemorrhoids are the third most common outpatient gastrointestinal diagnosis with nearly 4 million office and emergency department visits annually [1] and over $800 million annually in healthcare expenditure [2]. More patients seek medical care for hemorrhoids than for colon cancer, diverticular disease, irritable bowel syndrome or inflammatory bowel disease [1]. Despite this significant burden to our health systems, there is little consensus on identifiable risk factors for development of hemorrhoids.

Historically, hemorrhoids have been associated with a number of risk factors including constipation and straining with defecation [3]. Others suggest that it is prolonged sitting on the toilet, such as while reading the newspaper on the toilet [4]. Dietary factors such as low intake of dietary fiber have been linked to hemorrhoids due to harder stools and increased straining [1,5]. Pregnancy is thought to increase risk due to increased pressure in the pelvic vasculature [6]. Additionally, obesity, sedentary behavior without physical activity are thought to increase the risk of hemorrhoids [7,8].

Despite anecdotal observation, a multivariate analysis linking smartphone use with hemorrhoids has not been conducted. In this...