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One of the reasons people develop hemorrhoids is due to straining during bowel movements, which can happen when someone is constipated

Barkallah M, et al

J Clin Oncol 25: 4315-6, 2007

At the same time, Smac (second mitochondria-derived activator of caspase) inactivates caspase-inhibiting X-linked inhibitor of apoptosis protein (XIAP), which functionally contributes to the recruitment of caspase-3 and caspase-7 [82]