Scrolling while on the toilet? You could be risking hemorrhoids.

Prolonged smartphone use on the toilet could be linked to a higher risk of hemorrhoids, not because of increased straining, but because of how much longer people sit, according to recently published research.

A cross-sectional analysis of 125 patients undergoing screening colonoscopies found that smartphone users in the group spent significantly more time on the toilet, according to the study published in PLOS One from Beth Israel Deaconess Medical Center in Boston.

About 37% of people who were part of the study and reported using smartphones on the toilet spent more than five minutes per bathroom visit compared with 7% of nonusers.

After adjusting for age, sex, body mass index (BMI), fiber intake, physical activity and straining, smartphone use was associated with a 46% increased risk of hemorrhoids.

Chethan Ramprasad, one of the study authors who specializes in gastrointestinal motility, said hemorrhoids are often overlooked because they are “not taken as seriously,” even though millions of dollars of health care expenditure go to treating hemorrhoids.

“No one really wants to talk about something that’s in their anus rectum, but this is incredibly human,” Ramprasad said.

Trisha Pasricha, the senior author of the study, is the Ask a Doctor columnist for The Washington Post. She was not involved in the reporting of this article.

Why is sitting on the toilet with your phone a problem?

Phones are now a bathroom companion for most people. A 2022 study found that 65% of Americans said they use their phones on the toilet. Researchers said the distraction leads to longer toilet sessions, which leads to the increased risk of hemorrhoids.

Straining, which has been historically considered a major factor, was not significantly associated with hemorrhoids in the study group, which researchers say suggests that time spent sitting on the toilet may be a more important risk factor.

Many gastroenterologists have long warned against sitting on the toilet for prolonged periods of time. The study authors say “sitting on a standard toilet seat, without any support to the pelvic floor, disproportionately increases pressure in the hemorrhoidal cushions. As this pressure persists over time, these cushions may become engorged, and thereby develop into appreciable hemorrhoids.”

Most people surveyed as part of the study did not realize their phones were prolonging their toilet visits, underscoring a gap between perception and actual behavior.

Hemorrhoids are swollen or inflamed veins located in the anus and lower rectum and can be caused by several factors, including pregnancy, low fiber intake, chronic constipation or diarrhea and being overweight. While not cancerous, hemorrhoids can be uncomfortable, painful and are sometimes accompanied with bleeding.

And nonsurgical treatment of the ailment is costly. Research from 2014 found that about 1.4 million people insured by their employers sought hemorrhoid care that year costing $770 million. And nearly half of people older than 50 will have hemorrhoids at some point in their life, according to Johns Hopkins Medicine.

The National Institute of Diabetes and Digestive and Kidney Diseases recommends maintaining a fiber-rich diet, staying hydrated, exercising regularly and avoiding long periods of sitting on the toilet to help reduce the risk.

What measures can you take to prevent hemorrhoids?

Jessica D. Dahmus, assistant professor of medicine at the Penn State College of Medicine and a gastroenterologist with Penn State Health, who was not involved in the survey, said she recommends her patients spend only five to 10 minutes on the toilet and avoid bringing their cellphones into the bathroom.

She also said increasing a person’s fiber can help minimize constipation, which can prevent the straining that can lead to hemorrhoids.

The recommended daily intake is 25 grams for women and 30 grams for men, but most Americans fall short, Dahmus said.

Research published in 2017 from the American Journal of Lifestyle Medicine found that only about 5% of the population meets the daily recommendation for fiber intake.

Experts say fiber-rich foods include beans, lentils, whole grains, berries and leafy greens, which can help soften stool and bowel movement, reducing pressure on rectal veins.