{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:02:37Z","timestamp":1790024557943,"version":"4.0.1"},"reference-count":45,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Online health communities are crucial resources for individuals managing socially stigmatized and physically burdensome conditions, such as hemorrhoids. These anonymous forums provide critical avenues for emotional validation and information exchange that may be underrepresented or difficult to access in traditional clinical settings. Despite their growing importance as data sources for understanding patient experiences, large-scale longitudinal analyses of the thematic and emotional evolution within such communities remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to conduct a longitudinal computational analysis of the r\/hemorrhoids Reddit community (2013\u20102022) to characterize its thematic concerns, examine its emotional landscape, and explore how emotional expression relates to community engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected 9954 Reddit posts, which were refined through preprocessing into a final dataset of 3746 high-quality posts. Our methodology involved a multistage computational approach: (1) topic modeling was performed on the mature phase of the community (2019\u20102022) using BERTopic to identify stable thematic clusters; (2) fine-grained emotion classification used a DistilRoBERTa-based transformer model (j-hartmann\/emotion-english-distilroberta-base) to categorize posts into 7 discrete emotional states (neutral, fear, sadness, joy, anger, surprise, and disgust); and (3) longitudinal analyses examined temporal trends in topic prevalence during the mature phase (2019\u20102022) and emotional distributions across the full study period (2013\u20102022), while also assessing associations between emotional categories and engagement metrics (post score and comment count).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The analysis revealed a polarized emotional distribution dominated by neutral (n=1247, 33.29%) and high levels of negative affect (fear and disgust). Thematic modeling identified four higher-order thematic domains encompassing 19 semantically coherent topics: (1) symptom recognition and diagnosis; (2) conservative treatment and self-management; (3) medical and surgical interventions; and (4) quality of life, risk factors, and psychosocial impact. Posts expressing fear and sadness received the highest mean comment counts (7.06, SD 7.60, and 7.03, SD 6.36, respectively), exceeding those expressing neutral or positive emotions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings suggest that the Reddit hemorrhoid community serves as an important platform for information exchange and emotional expression among individuals with a stigmatized condition. Posts expressing fear and sadness were associated with higher levels of community engagement, highlighting the potential value of online health communities in supporting patient communication and informing future digital health interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/90427","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:12:51Z","timestamp":1790021571000},"page":"e90427-e90427","source":"Crossref","is-referenced-by-count":0,"title":["Evolution of Discourse in the Reddit Hemorrhoid Community: Topic and Sentiment Analysis"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8919-4932","authenticated-orcid":false,"given":"Zhiguang","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5317-5241","authenticated-orcid":false,"given":"Xinchang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8378-6608","authenticated-orcid":false,"given":"Zhenjie","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2783-6137","authenticated-orcid":false,"given":"Yan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1587-7556","authenticated-orcid":false,"given":"Xinyao","family":"Yi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1492-9414","authenticated-orcid":false,"given":"Hei Hang Edmund","family":"Yiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7761-6782","authenticated-orcid":false,"given":"Anyu","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8846-7515","authenticated-orcid":false,"given":"Wai-kit","family":"Ming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"5","key":"R1","doi-asserted-by":"publisher","DOI":"10.2196\/12891","article-title":"Impact of physician-patient communication in online health communities on patient compliance: cross-sectional questionnaire study","volume":"21","author":"Lu","journal-title":"J Med Internet Res"},{"issue":"24","key":"R2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16245084","article-title":"An empirical study on patients\u2019 acceptance of physician-patient interaction in online health communities","volume":"16","author":"Lu","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"R3","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1111\/j.1468-0009.2012.00662.x","article-title":"Health and illness in a connected world: how might sharing experiences on the internet affect people\u2019s health?","volume":"90","author":"Ziebland","journal-title":"Milbank Q"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Newman MW Lauterbach D Munson SA Resnick P Morris ME . It\u2019s not that i don\u2019t have problems, i\u2019m just not putting them on Facebook: challenges and opportunities in using online social networks for health. Presented at: Proceedings of the ACM 2011 conference on Computer supported cooperative work; Mar 19-23, 2011:341-350; Hangzhou, China. [doi: 10.1145\/1958824.1958876]","DOI":"10.1145\/1958824.1958876"},{"issue":"15","key":"R5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14155361","article-title":"Barriers to seeking medical care for hemorrhoidal symptoms: a cross-sectional observational study","volume":"14","author":"Cote","journal-title":"J Clin Med"},{"issue":"8","key":"R6","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.1002\/aur.70066","article-title":"Autism spectrum disorders discourse on social media platforms: a topic modeling study of Reddit posts","volume":"18","author":"Fong","journal-title":"Autism Res"},{"issue":"11","key":"R7","doi-asserted-by":"publisher","DOI":"10.2196\/29487","article-title":"Studies of depression and anxiety using Reddit as a data source: scoping review","volume":"8","author":"Boettcher","journal-title":"JMIR Ment Health"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","DOI":"10.1186\/s40246-024-00588-7","article-title":"Hemorrhoidal disease and its genetic association with depression, bipolar disorder, anxiety disorders, and schizophrenia: a bidirectional Mendelian randomization study","volume":"18","author":"Huang","journal-title":"Hum Genomics"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-025-03170-5","article-title":"Depression and anxiety symptom networks in hemorrhoid patients: evidence from the UK Biobank","volume":"13","author":"Huang","journal-title":"BMC Psychol"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1080\/10410236.2012.714861","article-title":"The implications of stigma and anonymity for self-disclosure in health blogs","volume":"29","author":"Rains","journal-title":"Health Commun"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","first-page":"45141","DOI":"10.1038\/srep45141","article-title":"Characterisation of mental health conditions in social media using Informed Deep Learning","volume":"7","author":"Gkotsis","journal-title":"Sci Rep"},{"issue":"3","key":"R12","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1093\/jamia\/ocad229","article-title":"A scoping review of empathy recognition in text using natural language processing","volume":"31","author":"Shetty","journal-title":"J Am Med Inform Assoc"},{"issue":"6","key":"R13","first-page":"4864","volume":"7","author":"Tabassum","journal-title":"Int Res J Eng Tech"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1007\/s10462-023-10471-x","article-title":"A systematic review of the use of topic models for short text social media analysis","author":"Laureate","journal-title":"Artif Intell Rev"},{"issue":"Jan","key":"R15","first-page":"993","volume":"3","author":"Blei","journal-title":"J Mach Learn Res"},{"key":"R16","unstructured":"Grootendorst M . BERTopic: neural topic modeling with a class-based TF-IDF procedure. arXiv. Preprint posted online on Mar 11, 2022. [doi: 10.48550\/arXiv.2203.05794]"},{"key":"R17","unstructured":"Hartmann J . Emotion English distilroberta-base. 2022. URL: https:\/\/huggingface.co\/j-hartmann\/emotion-english-distilroberta-base [Accessed 02-09-2026]"},{"key":"R18","doi-asserted-by":"crossref","unstructured":"Devlin J Chang MW Lee K Toutanova K . BERT: pre-training of deep bidirectional transformers for language understanding. In: Toutanova K , editor. Presented at: Proceedings of the 2019 Conference of the North American Chapter of the Association for Computational Linguistics; Jun 2-7, 2019:4171-4186; Minneapolis, Minnesota. [doi: 10.18653\/v1\/N19-1423]","DOI":"10.18653\/v1\/N19-1423"},{"key":"#cr-split#-R19.1","doi-asserted-by":"crossref","unstructured":"Sun C Qiu X Xu Y Huang X . How to fine-tune BERT for text classification? In: Sun M Huang X Ji H Liu Z Liu Y , editors. Presented at: Chinese Computational Linguistics: 18th China National Conference, CCL 2019. Oct 18-20, 2019","DOI":"10.1007\/978-3-030-32381-3"},{"key":"#cr-split#-R19.2","doi-asserted-by":"crossref","unstructured":"Springer. Kunming, China. 2019.[doi: 10.1007\/978-3-030-32381-3_16]","DOI":"10.1007\/978-3-030-32381-3_16"},{"key":"R20","unstructured":"Markham A Buchanan E . Ethical decision-making and internet research: recommendations from the AoIR Ethics Working Committee (version 2.0). Association of Internet Researchers; 2012. URL: https:\/\/www.aoir.org\/reports\/ethics2.pdf [Accessed 02-09-2026]"},{"key":"R21","unstructured":"International Chamber of Commerce, ESOMAR. ICC\/ESOMAR: international code on market, opinion and social research and data analytics. ESOMAR; 2016. URL: https:\/\/ana.esomar.org\/documents\/icc-esomar-international-code [Accessed 02-09-2026]"},{"issue":"7321","key":"R22","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1136\/bmj.323.7321.1103","article-title":"Ethical issues in qualitative research on internet communities","volume":"323","author":"Eysenbach","journal-title":"BMJ"},{"issue":"1","key":"R23","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1609\/icwsm.v14i1.7347","article-title":"The Pushshift Reddit dataset","volume":"14","author":"Baumgartner","journal-title":"ICWSM"},{"issue":"5","key":"R24","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1097\/00006842-197609000-00003","article-title":"Social support as a moderator of life stress","volume":"38","author":"Cobb","journal-title":"Psychosom Med"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","DOI":"10.2196\/55309","article-title":"Understanding health-related discussions on Reddit: development of a topic assignment method and exploratory analysis","volume":"9","author":"Chan","journal-title":"JMIR Form Res"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","DOI":"10.2196\/87782","article-title":"Peer support in online women\u2019s health communities: mixed methods formative analysis of Reddit discourse","volume":"10","author":"Zaman","journal-title":"JMIR Form Res"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2025.2539934","article-title":"Benign anorectal diseases and obsessive symptoms: a holistic analysis of psychological and lifestyle factors - a prospective case-control study","author":"B\u00fcy\u00fckdereli Atada\u011f","journal-title":"Psychol Health Med"},{"issue":"10","key":"R28","doi-asserted-by":"publisher","DOI":"10.2196\/22635","article-title":"Natural language processing reveals vulnerable mental health support groups and heightened health anxiety on Reddit during COVID-19: observational study","volume":"22","author":"Low","journal-title":"J Med Internet Res"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.1024237","article-title":"Psychological states could affect postsurgical pain after hemorrhoidectomy: a prospective cohort study","volume":"9","author":"Wang","journal-title":"Front Surg"},{"issue":"5","key":"R30","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.70724","article-title":"The complications of hemorrhoidectomy from patients\u2019 perspective: a qualitative study","volume":"8","author":"Tavani","journal-title":"Health Sci Rep"},{"issue":"2","key":"R31","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1080\/08934215.2019.1607516","article-title":"Anonymity and online self-disclosure: a meta-analysis","volume":"32","author":"Clark-Gordon","journal-title":"Communication Reports"},{"issue":"6","key":"R32","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1080\/10410236.2024.2386714","article-title":"Belonging, Affirmation, Safety, and Efficacy (BASE): an integrative model for shame resilience, social support, and humor in r\/hemorrhoid","volume":"40","author":"Amangalieva","journal-title":"Health Commun"},{"key":"R33","unstructured":"Cutrona CE Russell DW . Type of social support and specific stress: toward a theory of optimal matching social support: an interactional view. In: Sarason BR Sarason IG Pierce GR , editors. Social Support: An Interactional View. John Wiley & Sons; 1990:319-366. ISBN: 978-0471606246"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.2196\/90152","article-title":"Reddit discussions during the 2022 Mpox outbreak: observational analysis of sentiment, topics, and audience engagement","volume":"28","author":"Luo","journal-title":"J Med Internet Res"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-018-0206-2","article-title":"Are recovery stories helpful for women with eating disorders? A pilot study and commentary on future research","volume":"6","author":"Dawson","journal-title":"J Eat Disord"},{"issue":"1","key":"R36","doi-asserted-by":"publisher","first-page":"195","DOI":"10.25300\/MISQ\/2022\/17018","article-title":"Unintended emotional effects of online health communities: a text mining-supported empirical study","volume":"47","author":"Zhou","journal-title":"MIS Q"},{"key":"R37","unstructured":"Jozani M Williams JA Aleroud A Bhagat S . The role of emotions in informational support question-response pairs in online health communities: a multimodal deep learning approach. arXiv. Preprint posted online on May 21, 2024. [doi: 10.48550\/arXiv.2405.13099]"},{"issue":"1","key":"R38","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-025-01854-1","article-title":"Communication strategies driving online health community patient awareness and engagement investigated within atrial fibrillation context","volume":"8","author":"Kuipers","journal-title":"NPJ Digit Med"},{"issue":"3","key":"R39","doi-asserted-by":"publisher","DOI":"10.1177\/21582440251376147","article-title":"Engagement dynamics in online mental health communities: the role of trust and social support in young adults\u2019 attitudes and norms","volume":"15","author":"Naga","journal-title":"SAGE Open"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.2196\/46867","article-title":"Investigating COVID-19\u2019s impact on mental health: trend and thematic analysis of Reddit users\u2019 discourse","volume":"25","author":"Zhu","journal-title":"J Med Internet Res"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.2196\/45249","article-title":"Disruptions in the cystic fibrosis community\u2019s experiences and concerns during the COVID-19 pandemic: topic modeling and time series analysis of Reddit comments","volume":"25","author":"Yao","journal-title":"J Med Internet Res"},{"issue":"23","key":"R42","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182312743","article-title":"Come for information, stay for support: harnessing the power of online health communities for social connectedness during the COVID-19 pandemic","volume":"18","author":"Green","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"R43","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0282368","article-title":"Online health communities influence people\u2019s health behaviors in the context of COVID-19","volume":"18","author":"Chen","journal-title":"PLoS ONE"},{"issue":"15","key":"R44","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11152142","article-title":"A study on online health community users\u2019 information demands based on the BERT-LDA model","volume":"11","author":"Xiang","journal-title":"Healthcare (Basel)"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:13:01Z","timestamp":1790021581000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e90427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":45,"URL":"https:\/\/doi.org\/10.2196\/90427","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"article-number":"v28i5e90427"}}