Hemorrhoids are among the most frequent gastrointestinal complaints in the United States, sending millions of people to clinics and emergency rooms each year and costing the health system hundreds of millions of dollars.
Despite their prevalence, the causes remain poorly defined. Constipation, straining, pregnancy, and low-fiber diets have all been implicated, but Indian American gastroenterologist Trisha Pasricha and colleagues wondered whether the modern habit of lingering in the bathroom with a phone might also play a role.
In a study of 125 adults undergoing routine colonoscopy at Beth Israel Deaconess Medical Center, a teaching affiliate of Harvard Medical School in Boston, the team surveyed participants about toilet habits, smartphone use, diet, and activity levels, then compared responses with direct colonoscopy findings.
The results revealed some surprising patterns:
Two-thirds of participants admitted to using their phones on the toilet.
Smartphone use on the toilet was associated with a 46 percent increased risk of having hemorrhoids.
Phone users were five times more likely to sit for more than five minutes per trip.
Younger adults were especially prone to the habit.
Smartphone users reported less weekly exercise than non-users.
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Pasricha explained to Harvard Gazette what these findings mean for patients and how they might change the way we think about everyday bathroom routines.
Pasricha, who is writing a book that’s coming out in the spring called “You’ve Been Pooping All Wrong” says she tells her patients not to spend longer than a couple minutes on the toilet.
“We all have this sense that spending too long on the toilet is bad for you. But when I was writing this book chapter, I went back to literature to see what is this five-minute rule really based on? And the data is pretty sparse out there.”
More hemorrhoids were found amongst people who spent time reading on the toilet, according to a 1989 study in the Lancet. “Now in 2025, I don’t think anyone’s reading the newspaper, but we know everybody’s on their phones in the bathroom. So I thought we needed to update this literature for the modern TikTok era,” Pasricha said.
“In our study,” Pasricha said, “about two-thirds of people reported using smartphones on the toilet. When we asked those users whether they ever sat on the toilet longer than they intended because of their phone, only about half said yes.”
But here’s the interesting part, she said: “Smartphone users were five times more likely to spend more than five minutes on the toilet compared to non-users. So clearly, people are spending more time — but only half of them recognize that their phone is the reason.”
Pasricha’s team also looked at whether constipation or straining might explain the extra time, but there were no differences between the groups. That suggests the phone itself is driving the behavior.
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“I think what’s happening is that time sort of slows down when you’re scrolling, and people don’t realize just how much longer they’re sitting there. Half admit it, but the other half are still doing it without making the connection,” she said.
“Let me just say it: We did suspect there was going to be a sex divide. We stratified our data by sex and you can see there’s a trend that men are spending more time on the toilet,” Pasricha said.
“That surprised absolutely nobody in our in our group,” she said. “There’s also something to be said about how in general with GI concerns, women are more likely to get help. Actually, they’re more likely to seek treatment in general, and sometimes men are a little bit less likely to get help and talk to their providers. “
Pasricha said they often see men who come in having been dragged in by their wives and they’re like, “I actually don’t have a problem.” And their wives say, “You spend 40 minutes in the bathroom every morning. There’s a problem.”
Pasricha said it’s important to normalize conversations about gut health and other “embarrassing” topics “because if you can’t eat the food you love and poop it out comfortably, you don’t have a quality of life. “
“And if we can’t bring ourselves to even talk about it, we can’t get help and physicians can’t help our patients,” she said.
“It’s a big passion of mine to try to normalize these conversations,” Pasricha said. “The gut is just like any other part of your body and I think we need to treat it with respect and love.”