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Hemorrhoidal illness, locally termed Jẹ̀díjẹ̀dí is interpreted and managed within family, cultural, and community systems. In South-Western Nigeria, this illness shows familial clustering, yet socio-cognitive and relational mechanisms guiding intergenerational adaptation remain underexplored. This study aimed to examine how hemorrhoidal illness is understood, managed, and shaped across generations, paying particular attention to intergenerational representations of illness, kin-mediated coping knowledge, secrecy-based family governance, culturally grounded emotional self-regulation, and pluralistic care sequencing. A hybrid qualitative design combining Constructivist Grounded Theory (CGT) and Participatory Concept Mapping (PCM) was used. Purposive maximum-variation sampling recruited 60 participants, including individuals with lived experience, caregivers, traditional healers, remedy vendors, and clinicians. Data were collected through semi-structured interviews, threegeneration family histories, focus groups, and a participatory conceptual mapping workshop used to refine domain boundaries and directional relationships. Constructivist grounded theory coding progressed through iterative initial, focused, and theoretical cycles, supported by reflexive memoing. Trustworthiness was enhanced through triangulation, member validation, and high intercoder reliability (Cohen’s κ = 0.82). Families manage coping through culturally grounded care routines, including dietary practices, herbal protocols, and preventive strategies. Emotional regulation is supported by secrecy, humor, cognitive reframing, and spiritual scaffolding, while care sequencing and the legitimacy of care providers are negotiated through community consensus, ensuring continuity in everyday roles and routines. Together, these processes illustrate how Yoruba families navigate hereditary hemorrhoidal adaptation via intergenerational knowledge transmission, secrecy governance, culturally informed emotion regulation, and pluralistic care escalation. These empirically derived domains form the foundation for a proposed Coping, Appraisal, and Regulation of Hemorrhoidal Illness framework, providing a preliminary conceptual structure that can be further refined, operationalized, and tested in future work