Using your phone on the toilet won't just leave it covered in germs, it could also lead to an increased risk of haemorrhoids, according to a study from the United States.
The study surveyed 125 adults and found that those who reported using a phone on the throne had a higher risk of haemorrhoids than non-users.
Participants were asked how often they used their phones while on the toilet, and for how long.
The survey found 66 per cent of all participants used smartphones while on the toilet, with that group spending "significantly more time there" — often more than five minutes per visit — compared with those who didn't.
Checking the news and using social media were the most common smartphone toilet activities, according to the study, which was published in scientific journal PLOS ONE in early September.
The researchers suggest that smartphone use may inadvertently prolong toilet time, potentially increasing pressure in anal tissues, which may then lead to haemorrhoids.
After accounting for other factors linked with haemorrhoid risk — including exercise habits, age and fibre intake — the researchers found that those who scrolled on the toilet had a 46 per cent higher risk of haemorrhoids than those who didn't.
What are haemorrhoids?
Gastroenterologist Graeme Young from Flinders University says there are a number of clear signs of a haemorrhoid.
"Haemorrhoids are, in the beginning, internal and small," Young tells SBS News.
"It's only when they start to bulge down a bit through the anus that they become apparent and you can feel uncomfortable in that area."
"Usually, when you're wiping yourself after passing a bowel action, you will feel something is not right."
He says that you will be able to feel if you have a haemorrhoid and says it might feel like there's "a couple of grapes in there". You might also be able to see blood on your toilet paper as a result of them.
Haemorrhoids are one of the most common anorectal health conditions in Australia.
What's scrolling got to do with it?
Professor Rupert Leong, a gastroenterologist based at Concord Hospital in Sydney, says the prevailing theory is that haemorrhoids are caused by straining.
"People who sit on toilets, especially those who sit on for extensive periods of time and may not be focused on just defecating, they are distracted doing other things whilst defecating — i.e. on smartphones," he tells SBS News.
"This activity may be prolonging the defecation process, resulting in excessive straining, which can then increase the pressure of the blood vessels that lead to vascular swelling, and eventually rupture of the vessels that lead to bleeding."
However, the recent study found straining while using the toilet was not, in and of itself, associated with increased haemorrhoid risk, in contrast to some prior studies.
"It is possible that time spent on the toilet is a more accurate predictor of haemorrhoids than straining," the study authors write.
Dr Jarrah Dowrick, a research fellow at the University of Auckland, says time spent on the toilet is most likely the primary potential risk-factor being captured by the study.
"From what I can see, this paper is a thinly veiled study of the relationship between time spent on the toilet and haemorrhoids, but using the catchier hook of "phone use" to attract wider attention," he told the Australian Science Media Centre (ASMC).
"The real story here is that spending longer on a seated toilet appears to be linked with haemorrhoid presentation."
He notes that it's still an "important finding", adding that there is a lack of evidence for commonly believed haemorrhoid risk factors like low fibre intake, straining, or time on the toilet.
Another possible reason for the findings is that smartphone use on the toilet might be disrupting gut-brain communication, says Dr Kate MacKrill, gastroenterology psychologist at Middlemore Hospital and a lecturer at the University of Auckland.
"Our digestive system is controlled by the enteric nervous system, which is essentially the body's second brain," she told ASMC.
"Sitting on the toilet for longer than you need to might start to change the signals the bowel sends.
"The bowel becomes unsure whether it has completely evacuated, leading to abdominal pain, actual constipation, discomfort, and an even longer time sitting on the toilet."
Some tips to lower haemorrhoid risk
To lower the risk of developing haemorrhoids, try to be efficient, strain-free, and focus on the job at hand, Young says.
"For people who have a difficult bowel habit in terms of initiating the bowel action, the chances are they are going to be sitting longer on the toilet and straining.
"What it really boils down to is it's not a good idea to be sitting on the toilet for ages, waiting and hoping for something to happen, and especially straining to achieve that."
Instead, he says that, if there is no action, "you need to get up and leave it, and come back to it later on".
Along with time spent on the toilet, other commonly believed haemorrhoid risk factors include low fibre intake, straining, constipation, age, sex differences and pregnancy.
Young encourages people to address any constipation and says that's one of the "real problems" associated with haemorrhoid formation.
"If there is a real problem of constipation — and by constipation we mean not going to the toilet often enough — then you really need to get the constipation dealt with by dietary fibre, and discuss with the doctor if that doesn't work," he says.
"So I'm not sure that it's to do with reading the phones — I think people are reading the phones cause they're sitting there waiting for something to happen … it's more about sitting on the toilet for too long than it is about scrolling down the phone."
How can you treat haemorrhoids?
If you suspect you might have haemorrhoids, experts say you should visit a GP, who will ask you about your symptoms and will examine your anal passage to look for any swollen blood vessels.
Dr Leong says the GP visit could also be useful in ruling out more serious conditions, including bowel cancer.
"The symptoms of haemorrhoids are non-specific — so a passage of red blood can be something as benign as a haemorrhoid or it can be something more sinister that includes bowel cancer," he says.
"So anyone who's got bleeding in the bowel should present to the general practitioner, who would perform an external examination."
The pain and inflammation from haemorrhoids can often be easily treated with over-the-counter medications from the pharmacy.
For more severe cases, your doctor may prescribe a corticosteroid cream. Less often, a surgical procedure might be needed.
