Toilet behaviors and lifestyle factors in anorectal diseases: a cross-sectional analysis.
Level 4 - case-series / case-control
Cross-sectional case-control comparative study
PubMed 41340992 · doi:10.3389/fsurg.2025.1683286
What was done
A cross-sectional study at Muğla Sıtkı Koçman University compared 211 proctology patients diagnosed with anorectal conditions (hemorrhoids, anal fissures, and fistulas) against 369 healthy controls. Demographic characteristics, lifestyle factors, hygiene practices, and toilet behaviors were collected through structured interviews.
What was found
Across 580 participants (211 patients vs. 369 controls), patients were significantly older (mean 46.0 ± 14.0 vs. 42.2 ± 16.4 years; p = 0.002) and more frequently male (76.3% vs. 45.0%; p < 0.001). Patients reported significantly higher rates of constipation more than once per week (18.9% vs. 5.7%; p < 0.001), back-to-front wiping (59.2% vs. 45.5%; p = 0.002), and sitting on the toilet for more than 20 minutes (8.1% vs. 0.5%; p < 0.001). Smartphone use during defecation was lower among patients compared to controls (26.1% vs. 37.4%; p = 0.001).
Why it matters
The study identifies specific modifiable toilet habits and wiping techniques correlated with anorectal pathology, providing potential targets for patient counseling and preventive behavioral interventions.
Limits
The cross-sectional design cannot establish causality or determine if behaviors preceded disease onset. Data collection relied on self-reported interviews, introducing potential recall and social desirability biases. Patients and controls had substantial baseline imbalances in age and sex. The study was conducted at a single medical center, and individual anorectal diagnoses were grouped together rather than reported with disease-specific effect sizes.
Cited by
- context Using a smartphone on the toilet can increase the risk of developing hemorrhoids.