The bidirectional effects of hemorrhoids, depression, and anxiety: a prospective cohort study in the UK Biobank

This study identifies a significant bidirectional association between hemorrhoidal disease and mental health conditions. Notably, the interaction between smoking and anxiety highlights a subgroup at elevated risk that may benefit from closer clinical attention. These findings support an integrated care perspective that considers both gastrointestinal and mental health conditions, while acknowledging that causal inferences cannot be definitively established from observational data.