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Assessment of venous leg symptoms in patients with hemorrhoidal disease (VEIN-HEMORRHOID study)

Coexistence of dilating venous diseases in different vascular territories has raised the idea that they have similar vascular wall abnormality in their evolutionary process.

Accordingly, we aimed to evaluate venous leg symptoms in patients with hemorrhoidal disease (HD) by means of VEINES-Sym questionnaire.

The study involved 249 consecutive patients who underwent colonoscopy and met the inclusion criteria. The presence and grading of HD were made according to Goligher's classification. All patients were examined for the existence of varicose veins and classified in respect of CEAP classification. All participants were requested to answer the VEINES-Sym questionnaire.

In the results, there were not statistically significant differences between the patients without HD (grade 0 or I) and with HD (Grade II or III) in respect to clinical characteristics except female predominance in the hemorrhoid group (p = 0.07). Scores of heavy legs, swelling, burning sensation, restless leg, throbbing, tingling, and total VEINES score were significantly lower (ie: worse) in the hemorrhoid group. Logistic regression analysis revealed that female gender and total VEINES score were independently associated with HD (OR: 2.03, 95% CI: 1.17-3.52, p = 0.01; OR: 0.96, 95% CI: 0.92-0.99, p = 0.02, respectively). Among all venous leg symptoms, severity of heavy legs, night cramps, swelling and aching were significantly correlated with the grades of HD.

We have shown a significant association between the HD and venous leg symptoms reflected by total VEINES score and a significant correlation between the HD grade and venous leg symptoms severity, including heavy legs, swelling, night cramps, and aching legs.

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