Hemorrhoids, often colloquially referred to as piles, are a prevalent medical condition affecting individuals worldwide. Characterized by the swelling and inflammation of blood vessels in the rectal and anal region, hemorrhoids can cause discomfort, pain and bleeding, significantly impacting an individual's quality of life [1,2].

Hemorrhoids can manifest as either internal or external, with common symptoms including rectal bleeding, anal itching and pain during bowel movements. These symptoms can often be misattributed to other gastrointestinal disorders, leading to delayed diagnosis and management. Timely recognition and education about hemorrhoids are pivotal in preventing unnecessary suffering and complications [3,4].

In Peru, a country with a diverse cultural landscape and varying healthcare access, understanding the awareness and knowledge of hemorrhoids becomes particularly important. Lima, as the capital and largest city, represents a significant segment of the Peruvian population. Therefore, assessing the awareness and knowledge levels within this urban center can offer valuable insights into the broader Peruvian context [5,6].

Several international studies have investigated public awareness of hemorrhoids in different regions, revealing varying degrees of understanding and misconceptions. Studies conducted in the United States and Europe have demonstrated that a significant portion of the population lacks adequate knowledge about the causes, symptoms and management of hemorrhoids. However, no such comprehensive study has been conducted in the Peruvian context, making this research timely and significant [7,8].

Despite their widespread occurrence, there remains a considerable gap in public awareness and knowledge about this condition. Understanding the level of awareness among the general public is crucial for public health initiatives, early detection and timely intervention. This study endeavors to bridge this gap by investigating the awareness and knowledge of hemorrhoids within the population of Lima, Peru.

Additionally, the findings of this study can serve as a reference point for future research in other regions of Peru and contribute to the broader understanding of hemorrhoid awareness within the South American context.

Study Objectives

This study aims to address the following objectives:

• To assess the general public's awareness of hemorrhoids in Lima, Peru

• To evaluate the knowledge levels regarding the causes, symptoms and risk factors associated with hemorrhoids

• To identify common misconceptions and beliefs about hemorrhoids within the Lima population

Objectives of the Study

The objective of this study is to gauge the levels of awareness and knowledge about hemorrhoids among the general public in Lima, Peru.

Research Methodology

• Research Approach: Descriptive

• Research Design: Cross-sectional survey design

• Study area: Lima, Peru

• Study duration: March 2023 to May 2023

• Study population: The study's target population encompassed all adults aged 18 and above who had been residents of Lima, Peru for a minimum of 12 months

• Sample size: A robust sample size of 400 adults was determined using a 95% confidence level, an estimated knowledge level of 50% regarding hemorrhoids, a precise 5% absolute error margin and a conservative 5% non-response rate

• Study tool: A Google Form questionnaire consisting of questions regarding socio-demography and knowledge regarding hemorrhoids was created. The questionnaire was initially pre-tested on a small number of participants to identify any difficulty in understanding by the respondents

• Description of Tool:

• Demographic data survey instrument: The demographic form elicited information on participants’ background, including age, marital status, religion, employment, education and more

• Questionnaire: The questionnaire contains 20 structured knowledge related questions regarding hemorrhoids. One mark was given for each correct answer and zero was given for an incorrect answer. The maximum score was 20 and the minimum score was zero. Scoring was done on the basis of marks as follows: >80% (16-20) = Very good, 60-79% (12-15) = Good, 41-59% (8-11) = Fair, <40% (<8) = Poor

• Validity of Tool: By the experts in this field

• Data collection: Data were collected under the guidance of supervisors. The Google Form questionnaire was distributed to residents of Lima, Peru, via online platforms such as email and social media platforms like WhatsApp groups, Facebook, Instagram and LinkedIn until 400 responses were obtained

• Data analysis: Data were collected and entered into a Microsoft Excel spreadsheet, cleaned for errors and analyzed using Epi Info V7 software with appropriate statistical tests for frequencies and percentages

• Ethical Considerations: Participants confidentiality and anonymity were maintained

The primary objective of this study was to gauge the understanding of hemorrhoids among the general population of Lima, Peru through a non-experimental descriptive survey. A total of 400 participants took part in the study, with 271 (67.75%) residing in urban areas and 129 (32.25%) in rural areas (Table 1).

Table 1: Knowledge Regarding Hemorrhoids Among Study Participants

In the present study 28.25% (113) participants had very good knowledge (16-20 marks) towards hemorrhoids, 39.0% (156) had good knowledge (12-15 marks), 24.25% (97) had fair knowledge (8-11 marks) and 8.5% (34) having poor knowledge (<8 marks) (Table 2).

Table 2: Knowledge Score Regarding Hemorrhoids Among Study Participants

The findings of this study provide a comprehensive insight into the levels of awareness and knowledge regarding hemorrhoids among the general population of Lima, Peru. Hemorrhoids, although a prevalent medical condition, remain an area where misconceptions and gaps in understanding persist among the residents of Lima.

Our study revealed that a substantial portion of participants had a limited understanding of the causes, symptoms and management of hemorrhoids. Only 70.25% correctly identified what hemorrhoids are and a similar percentage (69.75%) knew their anatomical location. These results align with international studies conducted in diverse regions, such as the United States and Europe, which have consistently shown suboptimal knowledge levels among the general population regarding hemorrhoids [1,4,7].

Regarding symptoms and consequences associated with hemorrhoids, our study participants exhibited relatively better awareness. Approximately 69% correctly identified common symptoms, such as rectal bleeding and discomfort, while 71.25% recognized the importance of seeking medical attention for hemorrhoids. Nevertheless, there was room for improvement in understanding the underlying causes of hemorrhoids, with only 40% of participants correctly identifying potential factors. This highlights the need for targeted educational campaigns emphasizing causative factors, as also noted in previous research [7].

Misconceptions about hemorrhoids were evident in our study. While 45.75% acknowledged that lifestyle factors can contribute to hemorrhoid development, a notable portion of participants incorrectly attributed causes, indicating a need for public education on this topic. This is in line with the findings of international studies, which have demonstrated that lifestyle factors are often misunderstood as direct causes of hemorrhoids [4,8].

Regarding the management of hemorrhoids, participants displayed varying levels of awareness. While 62.5% recognized the role of preventive measures and lifestyle changes, only 58.25% wereaware that over-the-counter medications could provide relief for hemorrhoid symptoms. This suggests a need for disseminating information about available treatment options. Additionally, 59.75% of participants correctly identified non-surgical treatment options, indicating a reasonable understanding of conservative management strategies.

Our study's findings underscore the importance of public health initiatives in Lima, Peru, to enhance knowledge and awareness of hemorrhoids. A multi-faceted approach involving educational campaigns, accessible healthcare information resources and increased engagement of healthcare professionals is essential to bridge the existing knowledge gap. These efforts should aim to clarifying misconceptions, emphasizing causative factors and promoting early intervention and prevention, which are consistent with recommendations from previous research [9,10].

In conclusion, our study highlights the need for targeted public health interventions to improve awareness and knowledge of hemorrhoids among the general population of Lima, Peru. By addressing misconceptions and enhancing understanding, we can promote early detection, timely treatment and ultimately improve the quality of life of individuals affected by this common condition.

Limitations

It is essential to acknowledge some limitations of this study. While the sample size of 400 participants provides a representative overview of awareness levels, it may not fully capture the diversity of Lima's population. Additionally, self-reporting bias and social desirability bias may have influenced participants' responses.

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