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by grok2 2854 days ago
I think the ideas that hemorrhoids are not prevalent in third-world countries, not using toilet paper for cleanup and that using a western-style commode (and not squatting) is the source of problems is probably incorrect.

I base this on observations on the large numbers of advertisements for hemorrhoid treatment (most magazines, billboards, etc) in India, the fact that most people in India use water for cleanup and on the fact that squatting-type toilets are in common use in India. Again, just observation...

Most likely it's just physiology and diet.