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The recent development of using sitting toilets rather than squat commodes was increasing the incidence of hemorrhoids among Indonesians, a doctor said on Tuesday.

Eka Ginanjar, an internist from Cipto Mangunkusumo Hospital, said Western-style toilets were more unnatural than traditional conveyances because they caused more pressure to the rectal area.

Hemorrhoids are swollen and inflamed veins around the rectum that can cause sufferers considerable discomfort.

“Pressure and friction irritate the vulnerable set of veins and it happens because the intestines and the anus are not in an upright position when we use the sitting toilet,” Eka said.

He said sitting toilets also increased the chance of hemorrhoids when people did not wash afterwards.

“Feces is full of bacteria and it surely makes the condition around the rectal area worse,” Eka said. “Friction and bacteria will cause irritation and then lead to hemorrhoids.”

But he added that there were other factors involved.

“A sedentary lifestyle and low-fiber diet are the leading factors of hemorrhoids,” he told a weekly health talk show on KBR68H.

Also on the program was Fransiska, an office worker who has had hemorrhoids for more than a year.

She said sitting for many hours at work and a dislike of fruit and vegetables led to the condition.

She said doctors suggested changing her diet by adding fiber and taking physical exercise to cure the condition.

But she said that whenever she stopped her regime, the hemorrhoids returned.

Eka said not drinking enough water also could contribute to the problem.

“Water helps to soften the stool and it also cleans your intestines,” he said, adding that a person needed 30 milliliters of water per kilogram of weight every day.

He said genetics most likely played a role and knowing one’s family history could help people reduce the risk by living a healthy life.

“The key is to decrease pressure and straining and never sit for more than two hours at a time,” Eka said. “More fiber to reduce constipation and exercise, including walking, are the cheapest and easiest ways.”

He also said people should go to the bathroom as soon as possible when nature called, adding that surgery was sometimes necessary to treat the condition.

At Cipto Mangunkusumo Hospital, 20 percent of patients who had a colonoscopy in the past two years had been suffering from hemorrhoids.

“Hemorrhoids are curable when the triggers can be reduced,” Eka said, adding there were no statistics on the prevalence of the condition in Indonesia.

But the problem is very common in developed countries.

Web Site www.ehemorrhoids.com estimates that half of all Americans have had this condition by the age of 50, and that 50 percent to 85 percent of the world’s population will be affected by hemorrhoids at some time in their life. According to the site, only a small number of sufferers seek medical treatment.

Annually, only about 500,000 people in the US are treated for hemorrhoids, with 10 percent to 20 percent of them requiring surgery.