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BackgroundAlthough lifestyle modifications are an integral part of treatment and prevention of hemorrhoidal disease, it is largely unknown how lifestyle factors like diet and physical activity are characterized in patients with a history of advanced and invasively treated hemorrhoidal disease.MethodsIn a Northern German cross-sectional study, clinical characteristics and dietary and physical activity data of 386 patients were assessed via questionnaires at median 10 years after their first invasive hemorrhoidal treatment. Food and nutrient intake and physical activity levels of the hemorrhoid patients were compared with general population controls. Additionally, within the hemorrhoid patient cohort, dietary intake and physical activity were related to clinical characteristics using logistic regression analyses.resultsWhereas in men, there were no statistically significant differences in food intake between hemorrhoids patients and controls, women with a history of hemorrhoids had a significantly higher consumption of potatoes, nuts and animal fat, and a lower consumption of fruits, compared to women from the control group. Hemorrhoid patients reported slightly more gardening activities and less TV watching than controls. Within the hemorrhoid patient cohort, hemorrhoid grade, type of first therapy, need for further treatment, patients’ compliance for another surgery if necessary and current anal afflictions revealed individual associations with fiber, alcohol, animal fat and potato consumption and the amounts of home repair activities and sleeping time.ConclusionsAlthough we could identify some statistically significant differences in dietary and physical activity behavior between hemorrhoid patients and controls and observed associations between clinical characteristics and lifestyle factors, some findings are, in parts, still inconsistent. Whether patients are following lifestyle recommendations as part of conservative hemorrhoid treatment and tertiary prevention and which patients are more adherent than others (e.g., high-grade vs. low-grade) needs further investigation.