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Not Medical Advice: This article is an educational review of scientific literature and does not account for individual health conditions. Always consult with healthcare professionals before making any health-related decisions.

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You sat down, opened Instagram, and suddenly twenty minutes just vanished. Then something down there started to ache. If that sounds familiar, you're in very normal company. A 2025 paper took the unglamorous step of actually asking people whether they use their phone on the toilet and then looking inside to see what was going on ^[1].

The results are interesting because, honestly, most of us blame hemorrhoids on things like genetics, eating spicy food, or just pushing too hard. But the study suggests something much more boring: the phone in your hand.

Wait, how does sitting longer actually cause hemorrhoids to form?

The short version: your toilet seat isn't really designed to be a chair, folks. It has a hole in it, and that hole changes everything about the pressure on the tissue around your bottom.

• There's a ring of cushiony blood vessels around the anal canal. A 2025 pharmacist review focuses on managing hemorrhoids, a common anorectal condition ^[3].
• When you sit on a regular chair or couch, your thighs and the seat support your pelvic floor. That 2025 phone study looked at how spending more time on the toilet, often thanks to our phones, might ramp up hemorrhoid risk ^[1].
• That same study found that phone users spent way, way longer on the toilet: 37% of them sat there more than five minutes per visit, versus only 7% of non-users ^[1].
• After the researchers adjusted for things like age, weight, exercise, fiber, and straining, using your phone on the toilet still came with a 46% higher risk of hemorrhoids ^[1].

Here's the part that genuinely surprised the authors: straining wasn't actually the main villain in their numbers. It was time on the seat ^[1]. Guidelines from Taiwan's colorectal surgery society develop consensus statements regarding hemorrhoid management, which includes considering various risk factors ^[2].

So what should I actually do differently when I go to the bathroom?

The research just keeps circling back to the same boring idea that consistently shows positive results: get in, do your business, get out.

• The 2025 pharmacist review discusses managing symptomatic hemorrhoids and emphasizes the pharmacist's role in patient education ^[3].
• That same review discusses evidence-based hemorrhoid management strategies, which can include lifestyle modifications ^[3].
• The Taiwan consensus group worked to develop statements on hemorrhoid management, which often involves addressing modifiable risk factors ^[2].
• The 2025 phone study's practical takeaway connects smartphone use to longer toilet visits and points to this increased time as a factor in hemorrhoid risk ^[1].

Translation of all that into plain behavior: based on what the research shows, one practical step to consider is leaving the phone outside the bathroom. The research doesn't really need to tell you what to do once you realize the phone is the exact thing keeping you seated.

When do hemorrhoid creams actually help versus just waste my money?

Topical stuff is everywhere at the drugstore, but the research is kinda lukewarm on most of it.

• The Taiwan consensus review addresses pharmacologic treatments as symptomatic agents and provides recommendations based on available evidence ^[2].
• That same review discusses therapeutic approaches to manage hemorrhoid symptoms ^[2].
• The 2025 pharmacist review mentions traditional over-the-counter (OTC) options as part of hemorrhoid management ^[3].

So the honest summary from the papers: the papers showed creams could take the edge off itching, burning, and irritation for a few days, but no paper in this set claims they make the hemorrhoid go away. They're symptom blankets, not repairs.

What's the deal with these "phlebotonics" the new guidelines mention?

Phlebotonics is an ugly word for "pills often described as helping to tone up veins." They're the newer thing showing up in guidelines.

The 2025 pharmacist review points out that the 2024 American Society of Colon and Rectal Surgeons guidelines added updates on phlebotonics and mentioned them as vein-acting drugs for which symptom relief has been observed, but they are still underused in US practice ^[3]. The Taiwan consensus discusses pharmacologic treatments, providing recommendations based on available evidence for their role in symptom relief ^[2]. The Taiwan paper's literature search informed its recommendations for pharmacologic treatments in managing hemorrhoids ^[2]. The literature review process for the Taiwan consensus contributed to its guidance on the use of pharmacologic treatments ^[2].

The catch: these are prescription-territory drugs in many places, and the pharmacist review flags them as underused rather than proven miracle pills ^[3]. The research treats them as a real option, not a cure.

How do I know if this is actually something worse that needs a doctor?

This is where the papers get careful, and for good reason. "Bleeding from down there" is a symptom a lot of different things can cause.

• The 2025 pharmacist review lists the classic hemorrhoid symptoms as bleeding, pain, itching, prolapse, fecal seepage, and mucus discharge, with painless bleeding during a bowel movement being the most common first sign ^[3].
• It also flags that pharmacists should watch for "red flag signs" when evaluating someone, including family history of cancer or polyps ^[3].
• The Taiwan consensus specifically recommends considering colorectal cancer screening as part of hemorrhoid workup, because bleeding can look identical ^[2].
• A 2024 case-control study on anal fissures (the other common cause of "something hurts down there") found that longer duration of fissure symptoms was linked to a higher chance of developing a tunnel-like complication called a fistula, with the researchers recommending early management rather than waiting it out ^[4].
• That same study also found chili pepper consumption was associated with roughly 3x higher odds of that complication in people who already had fissures ^[4].

The pattern across these papers: a one-off painless streak of red on the toilet paper that resolves in a few days is the usual hemorrhoid story. Bleeding that keeps going, pain that keeps getting worse, or anything that lasts weeks is the signal the research treats as "get it looked at."

💊 Bottom Line

The phone-in-bathroom study reframes hemorrhoids in a way that's almost funny once you see it: the thing giving millions of people a painful backside is the same thing giving them a sore neck and tired eyes. The pressure damage isn't from pushing. It's from waiting. Every extra minute on an unsupported seat is load time on the blood vessels that aren't built for it.

What the rest of the research adds is a treatment order that flips the drugstore aisle upside down. Fiber and shorter visits come first. Phlebotonics are the newer pill-based option guidelines are starting to take seriously. Creams sit at the bottom of the evidence pile: useful for itching and burning, not useful for making the actual hemorrhoid disappear. And any bleeding that doesn't stop behaving like a simple hemorrhoid is the point where the papers quietly agree you've outgrown self-treatment.

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Sources I drew from for this post

[1] Ramprasad C, Wu C, Chang J, et al. Smartphone use on the toilet and the risk of hemorrhoids. PloS one. 2025.

[2] Chang T, Ke T, Hsieh P, et al. Taiwan society of colon and rectal surgeons' consensus on the management of hemorrhoidal disease. International journal of colorectal disease. 2025.

[3] Nakhla N, Hospattankar A, Siddiqui K, et al. Improving Hemorrhoid Outcomes: A Narrative Review and Best Practices Guide for Pharmacists. Pharmacy (Basel, Switzerland). 2025.

[4] Gorgi K, Ghanbarzadegan Z, Safarpour A, et al. Chili pepper consumption and duration of fissure symptoms onset are associated with perianal fistula development among patients with anal fissure: a case-control study. BMC nutrition. 2024.