Araştırma Makalesi
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KRONİK KONSTİPASYONU OLAN VE OLMAYAN KADINLARDA PSİKOLOJİK DURUM, UYKU KALİTESİ VE TUVALET DAVRANIŞLARININ KARŞILAŞTIRILMASI

Yıl 2026, Cilt: 7 Sayı: 1 , 35 - 48 , 30.04.2026
https://izlik.org/JA52NJ37CY

Öz

Amaç: Kronik konstipasyonu olan ve olmayan kadınlarda psikolojik durum, uyku kalitesi ve tuvalet davranışlarının karşılaştırılması amaçlandı.
Yöntem: Çalışmaya Roma IV tanı kriterlerine göre kronik konstipasyonu olan (konstipasyon grubu, n=30) ve konstipasyonu olmayan (kontrol grubu, n=30) kadınlar dahil edildi. Kadınların fiziksel, demografik ve klinik özellikleri sorgulandı. Psikolojik durum “Depresyon Anksiyete ve Stres Ölçeği (DASÖ-21)” ile, uyku kalitesi “Pittsburgh Uyku Kalite İndeksi (PUKİ)” ile ve tuvalet davranışları “Tuvalet Davranışı-Kadınların Boşaltım Davranışları Ölçeği (TD-KBD)” ile değerlendirildi. Grupların karşılaştırılmasında Mann-Whitney U testi kullanıldı.
Bulgular: Konstipasyon grubunda kontrol grubuna göre DASÖ-21 ölçeğinde depresyon (p=0.013, r=0.32; orta düzey etki), anksiyete (p=0.026, r=0.29; küçük-orta düzey etki) ve stres (p=0.006, r=0.33; orta düzey etki) puanlarının anlamlı düzeyde daha yüksek olduğu, PUKİ ölçeği alt parametrelerinde uyku süresi (p=0.045, r=-0.26; orta düzey etki), gündüz işlev bozukluğu (p=0.021, r=-0.30; orta düzey etki) ve toplam puanın (p=0.012, r=-0.32; orta düzey etki) anlamlı düzeyde daha yüksek olduğu, TD-KBD ölçeğinde ise işeme sırasında ıkınma davranışı (p=0.006, r=0.35; orta düzey etki) puanının anlamlı düzeyde daha yüksek olduğu tespit edildi.
Sonuç: Konstipasyonda psikolojik durum, uyku kalitesi ve tuvalet davranışları olumsuz olarak etkilenebilmektedir. Konstipasyon yalnızca kolona ait bir problem değildir, konstipasyonun değerlendirme ve tedavi programının çok boyutlu olarak ele alınması önemlidir.

Etik Beyan

Ankara Yıldırım Beyazıt Üniversitesi Sağlık Bilimleri Etik Kurulu

Kaynakça

  • 1. Han D, Iragorri N, Clement F, Lorenzetti D, Spackman E. Cost effectiveness of treatments for chronic constipation: a systematic review. Pharmacoeconomics. 2018 Apr;36(4):435-449.
  • 2. Staller K. Refractory constipation: what is the clinician to do? J Clin Gastroenterol. 2018 Jul;52(6):490-501.
  • 3. Camilleri M, Ford AC, Mawe GM, Dinning PG, Rao SS, Chey WD, et al. Chronic constipation. Nat Rev Dis Primers. 2017 Dec 14;3:17095.
  • 4. Pauwels N, Willemse C, Hellemans S, Komen N, Van den Broeck S, Roenen J, et al. The role of neuromodulation in chronic functional constipation: a systematic review. Acta Gastroenterol Belg. 2021 Jul-Sep;84(3):467-476.
  • 5. Scott SM, Simrén M, Farmer AD, Dinning PG, Carrington EV, Benninga MA, et al. Chronic constipation in adults: contemporary perspectives and clinical challenges. 1: Epidemiology, diagnosis, clinical associations, pathophysiology and investigation. Neurogastroenterol Motil. 2021 33(6): e14050.
  • 6. Włodarczyk J, Waśniewska A, Fichna J, Dziki A, Dziki Ł, Włodarczyk M. Current overview on clinical management of chronic constipation. J Clin Med. 2021 Apr 16;10(8):1738.
  • 7. Li X, Bian C, Dai H, Chen X, Qian H, Zhang D. Association of anxiety status and anxiety duration with constipation in adult Americans: a cross-sectional study using data from the NHANES 2007-2010. BMC Gastroenterol. 2025 Jan 22;25(1):31.
  • 8. Huang Y, Wang Y, Xu B, Zeng Y, Chen P, Huang Y, et al. The association between constipation and anxiety: a cross-sectional study and Mendelian randomization analysis. Front Psychiatry. 2025 Mar 31;16:1543692.
  • 9. Hosseinzadeh ST, Poorsaadati S, Radkani B, Forootan M. Psychological disorders in patients with chronic constipation. Gastroenterol Hepatol Bed Bench. 2011 Summer;4(3):159-163.
  • 10. Moezi P, Salehi A, Molavi H, Poustchi H, Gandomkar A, Imanieh MH, et al. Prevalence of Chronic Constipation and Its Associated Factors in Pars Cohort Study: A Study of 9000 Adults in Southern Iran. Middle East J Dig Dis. 2018 Apr;10(2):75-83.
  • 11. Gozali FS, Febiana B, Putra IGNS, Karyana IPG, Hegar B. Relationship between psychological stress with functional constipation in children: a systematic review. Pan Afr Med J. 2023 Sep 7;46:8.
  • 12. Krystal AD, Edinger JD. Measuring sleep quality. Sleep Med. 2008 Sep;9 Suppl 1:S10-S17.
  • 13. Ding G, Yang X, Li Y, Wang Y, Du Y, Wang M, et al. Gut microbiota regulates gut homeostasis, mucosal immunity and influences immune-related diseases. Mol Cell Biochem. 2025 Apr;480(4):1969-1981.
  • 14. Wang Z, Wang Z, Lu T, Chen W, Yan W, Yuan K, et al. The microbiota-gut-brain axis in sleep disorders. Sleep Med Rev. 2022. 65, 1–14.
  • 15. Li J, Yu K, Sui X, Deng H, Leng Y, Liu T. Gut jet lag: how circadian rhythm disruption undermines the Chrono-Microbiota-Motility axis and induces functional constipation. Front Nutr. 2025 Oct 2;12:1678482.
  • 16. Jiang Y, Tang YR, Xie C, Yu T, Xiong WJ, Lin L. Influence of sleep disorders on somatic symptoms, mental health, and quality of life in patients with chronic constipation. Medicine (Baltimore). 2017 Feb;96(7):e6093.
  • 17. Yamamoto S, Kawamura Y, Yamamoto K, Yamaguchi Y, Tamura Y, Izawa S, et al. Internet survey of japanese patients with chronic constipation: focus on correlations between sleep quality, symptom severity, and quality of life. J Neurogastroenterol Motil. 2021 Oct 30;27(4):602-611.
  • 18. Chiba T, Kikuchi S, Omori S, Seino K. Chronic constipation and acute urinary retention. Eur J Gastroenterol Hepatol. 2022 Jan 1;34(1):e1-e2.
  • 19. Çam S. Bağırsak-mesane disfonksiyonu: konstipasyon üriner sistem hastalıklarının ilk belirtisi olabilir mi? Konuralp Med J. 2015;7(3), 186-191.
  • 20. Karaaslan Y, Korkut Z, Yilmaz H, Guneyligil Kazaz T, Toprak Celenay S. Lower urinary tract symptoms, toileting behaviors, and pelvic floor health knowledge in younger and older women. Int Urogynecol J. 2024 Jul;35(7):1457-1468.
  • 21. Toprak Celenay S, Düşgün ES, Karaaslan Y, Uruş G, Karadag M, Özdemir E. Lower urinary tract symptoms and toileting behaviors in Turkish adult women. Women Health. 2023 Sep 14;63(8):577-586.
  • 22. Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010 Aug;111(1):278-284.
  • 23. Saricam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. J Cogn Behav Psychother Res. 2018;7(1):19-30.
  • 24. Buysse DJ, Reynolds CF, Monk TH. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193-213.
  • 25. Ağargün MY, Kara H, Anlar O. Pittsburgh Uyku Kalitesi İndeksi’nin geçerliği ve güvenirliği. Turk Psikiyatri Derg. 1996;7:107-111.
  • 26. Seyhan Ak E, Mecdi Kaydırak M, Aydın Sayılan A, Özbaş A. Tuvalet Davranışı-Kadınların Boşaltım Davranışları Ölçeğini Türkçe’ye uyarlama çalışması. Turkiye Klinikleri J Nurs Sci. 2019;11(4):339-346.
  • 27. Cohen J. Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.
  • 28. Liang J, Zhao Y, Xi Y, Xiang C, Yong C, Huo J, et al. Association between depression, anxiety symptoms and gut microbiota in Chinese elderly with functional constipation. Nutrients. 2022 Nov 25;14(23):5013.
  • 29. Mason HJ, Serrano-Ikkos E, Kamm MA. Psychological morbidity in women with idiopathic constipation. Am J Gastroenterol. 2000 Oct;95(10):2852-2857.
  • 30. Tian M, Song Y, Guo Y, Jiang T. Association between sleep disorders and constipation Risk: a systematic review and meta-analysis. J Clin Neurosci. 2024 Aug;126:12-20.
  • 31. Xu S, Chen C, Ouyang Z, Duan C, Xu Z, Bai T, et al. Association between multiple sleep dimensions and functional bowel disorders among Chinese college freshmen. Sleep Med. 2022 Oct;98:168-173.
  • 32. Liu J, Wang W, Tian J, Lv C, Fu Y, Fass R, et al. Sleep deficiency ıs associated with exacerbation of symptoms and ımpairment of anorectal and autonomic functions in patients with functional constipation. Front Neurosci. 2022 Jul 7;16:912442.
  • 33. Liu Y, Wang K, Palmer MH. Reliability and validity of the Chinese version of women’s toileting behavior scale in community-dwelling women wıth urinary incontinence. Neurourol Urodyn. 2012;31(6):760.
  • 34. Wyndaele M, De Winter BY, Pelckmans PA, De Wachter S, Van Outryve M, Wyndaele JJ. Exploring associations between lower urinary tract symptoms (LUTS) and gastrointestinal (GI) problems in women: a study in women with urological and GI problems vs a control population. BJU Int. 2015 Jun;115(6):958-967.
  • 35. Ortega MV, Kim Y, Hung K, James K, Savitt L, Von Bargen E, et al. Women with chronic constipation have more bothersome urogenital symptoms. Tech Coloproctol. 2022 Jan;26(1):29-34.

COMPARISON OF PSYCHOLOGICAL STATUS, SLEEP QUALITY AND TOILET BEHAVIORS IN WOMEN WITH AND WITHOUT CHRONIC CONSTIPATION

Yıl 2026, Cilt: 7 Sayı: 1 , 35 - 48 , 30.04.2026
https://izlik.org/JA52NJ37CY

Öz

Aim: The aim of this study was to compare psychological status, sleep quality, and toileting behaviors in women with and without chronic constipation.
Methods: The study included women with chronic constipation according to the Rome 4 diagnostic criteria (constipation group, n=30) and without constipation (control group, n=30). Physical, demographic, and clinical characteristics of the women were assessed. Psychological status was evaluated using the "Depression Anxiety and Stress Scale (DASS-21)," sleep quality using the "Pittsburgh Sleep Quality Index (PSQI)," and toilet behavior using the "Toileting Behavior-Women’s Elimination Behaviors (TB-WEB) Scale." Mann-Whitney U test was used to compare the groups.
Results: In the constipation group, compared to the control group, significantly higher scores were found on the DASS-21 scale for depression (p=0.013, r=0.32; moderate effect), anxiety (p=0.026, r=0.29;small to moderate effect), and stress (p=0.006, r=0.33; moderate effect); significantly higher scores were found on the PSQI scale for sleep duration (p=0.045 r=-0.26; moderate effect), daytime dysfunction (p=0.021, r=-0.30; moderate effect), and total score (p=0.012, r=-0.32; moderate effect); and significantly higher scores were found on the TB-WEB scale for straining during urination (p=0.006, r=0.35; moderate effect) compared to the control group.
Conclusion: In constipation, psychological well-being, sleep quality, and toilet habits may be negatively affected. Constipation is not solely a colon problem; assessment and treatment programs of constipation are important to approach from a multifaceted perspective.

Etik Beyan

Ankara Yıldırım Beyazıt University Health Sciences Ethics Committee

Kaynakça

  • 1. Han D, Iragorri N, Clement F, Lorenzetti D, Spackman E. Cost effectiveness of treatments for chronic constipation: a systematic review. Pharmacoeconomics. 2018 Apr;36(4):435-449.
  • 2. Staller K. Refractory constipation: what is the clinician to do? J Clin Gastroenterol. 2018 Jul;52(6):490-501.
  • 3. Camilleri M, Ford AC, Mawe GM, Dinning PG, Rao SS, Chey WD, et al. Chronic constipation. Nat Rev Dis Primers. 2017 Dec 14;3:17095.
  • 4. Pauwels N, Willemse C, Hellemans S, Komen N, Van den Broeck S, Roenen J, et al. The role of neuromodulation in chronic functional constipation: a systematic review. Acta Gastroenterol Belg. 2021 Jul-Sep;84(3):467-476.
  • 5. Scott SM, Simrén M, Farmer AD, Dinning PG, Carrington EV, Benninga MA, et al. Chronic constipation in adults: contemporary perspectives and clinical challenges. 1: Epidemiology, diagnosis, clinical associations, pathophysiology and investigation. Neurogastroenterol Motil. 2021 33(6): e14050.
  • 6. Włodarczyk J, Waśniewska A, Fichna J, Dziki A, Dziki Ł, Włodarczyk M. Current overview on clinical management of chronic constipation. J Clin Med. 2021 Apr 16;10(8):1738.
  • 7. Li X, Bian C, Dai H, Chen X, Qian H, Zhang D. Association of anxiety status and anxiety duration with constipation in adult Americans: a cross-sectional study using data from the NHANES 2007-2010. BMC Gastroenterol. 2025 Jan 22;25(1):31.
  • 8. Huang Y, Wang Y, Xu B, Zeng Y, Chen P, Huang Y, et al. The association between constipation and anxiety: a cross-sectional study and Mendelian randomization analysis. Front Psychiatry. 2025 Mar 31;16:1543692.
  • 9. Hosseinzadeh ST, Poorsaadati S, Radkani B, Forootan M. Psychological disorders in patients with chronic constipation. Gastroenterol Hepatol Bed Bench. 2011 Summer;4(3):159-163.
  • 10. Moezi P, Salehi A, Molavi H, Poustchi H, Gandomkar A, Imanieh MH, et al. Prevalence of Chronic Constipation and Its Associated Factors in Pars Cohort Study: A Study of 9000 Adults in Southern Iran. Middle East J Dig Dis. 2018 Apr;10(2):75-83.
  • 11. Gozali FS, Febiana B, Putra IGNS, Karyana IPG, Hegar B. Relationship between psychological stress with functional constipation in children: a systematic review. Pan Afr Med J. 2023 Sep 7;46:8.
  • 12. Krystal AD, Edinger JD. Measuring sleep quality. Sleep Med. 2008 Sep;9 Suppl 1:S10-S17.
  • 13. Ding G, Yang X, Li Y, Wang Y, Du Y, Wang M, et al. Gut microbiota regulates gut homeostasis, mucosal immunity and influences immune-related diseases. Mol Cell Biochem. 2025 Apr;480(4):1969-1981.
  • 14. Wang Z, Wang Z, Lu T, Chen W, Yan W, Yuan K, et al. The microbiota-gut-brain axis in sleep disorders. Sleep Med Rev. 2022. 65, 1–14.
  • 15. Li J, Yu K, Sui X, Deng H, Leng Y, Liu T. Gut jet lag: how circadian rhythm disruption undermines the Chrono-Microbiota-Motility axis and induces functional constipation. Front Nutr. 2025 Oct 2;12:1678482.
  • 16. Jiang Y, Tang YR, Xie C, Yu T, Xiong WJ, Lin L. Influence of sleep disorders on somatic symptoms, mental health, and quality of life in patients with chronic constipation. Medicine (Baltimore). 2017 Feb;96(7):e6093.
  • 17. Yamamoto S, Kawamura Y, Yamamoto K, Yamaguchi Y, Tamura Y, Izawa S, et al. Internet survey of japanese patients with chronic constipation: focus on correlations between sleep quality, symptom severity, and quality of life. J Neurogastroenterol Motil. 2021 Oct 30;27(4):602-611.
  • 18. Chiba T, Kikuchi S, Omori S, Seino K. Chronic constipation and acute urinary retention. Eur J Gastroenterol Hepatol. 2022 Jan 1;34(1):e1-e2.
  • 19. Çam S. Bağırsak-mesane disfonksiyonu: konstipasyon üriner sistem hastalıklarının ilk belirtisi olabilir mi? Konuralp Med J. 2015;7(3), 186-191.
  • 20. Karaaslan Y, Korkut Z, Yilmaz H, Guneyligil Kazaz T, Toprak Celenay S. Lower urinary tract symptoms, toileting behaviors, and pelvic floor health knowledge in younger and older women. Int Urogynecol J. 2024 Jul;35(7):1457-1468.
  • 21. Toprak Celenay S, Düşgün ES, Karaaslan Y, Uruş G, Karadag M, Özdemir E. Lower urinary tract symptoms and toileting behaviors in Turkish adult women. Women Health. 2023 Sep 14;63(8):577-586.
  • 22. Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010 Aug;111(1):278-284.
  • 23. Saricam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. J Cogn Behav Psychother Res. 2018;7(1):19-30.
  • 24. Buysse DJ, Reynolds CF, Monk TH. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193-213.
  • 25. Ağargün MY, Kara H, Anlar O. Pittsburgh Uyku Kalitesi İndeksi’nin geçerliği ve güvenirliği. Turk Psikiyatri Derg. 1996;7:107-111.
  • 26. Seyhan Ak E, Mecdi Kaydırak M, Aydın Sayılan A, Özbaş A. Tuvalet Davranışı-Kadınların Boşaltım Davranışları Ölçeğini Türkçe’ye uyarlama çalışması. Turkiye Klinikleri J Nurs Sci. 2019;11(4):339-346.
  • 27. Cohen J. Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.
  • 28. Liang J, Zhao Y, Xi Y, Xiang C, Yong C, Huo J, et al. Association between depression, anxiety symptoms and gut microbiota in Chinese elderly with functional constipation. Nutrients. 2022 Nov 25;14(23):5013.
  • 29. Mason HJ, Serrano-Ikkos E, Kamm MA. Psychological morbidity in women with idiopathic constipation. Am J Gastroenterol. 2000 Oct;95(10):2852-2857.
  • 30. Tian M, Song Y, Guo Y, Jiang T. Association between sleep disorders and constipation Risk: a systematic review and meta-analysis. J Clin Neurosci. 2024 Aug;126:12-20.
  • 31. Xu S, Chen C, Ouyang Z, Duan C, Xu Z, Bai T, et al. Association between multiple sleep dimensions and functional bowel disorders among Chinese college freshmen. Sleep Med. 2022 Oct;98:168-173.
  • 32. Liu J, Wang W, Tian J, Lv C, Fu Y, Fass R, et al. Sleep deficiency ıs associated with exacerbation of symptoms and ımpairment of anorectal and autonomic functions in patients with functional constipation. Front Neurosci. 2022 Jul 7;16:912442.
  • 33. Liu Y, Wang K, Palmer MH. Reliability and validity of the Chinese version of women’s toileting behavior scale in community-dwelling women wıth urinary incontinence. Neurourol Urodyn. 2012;31(6):760.
  • 34. Wyndaele M, De Winter BY, Pelckmans PA, De Wachter S, Van Outryve M, Wyndaele JJ. Exploring associations between lower urinary tract symptoms (LUTS) and gastrointestinal (GI) problems in women: a study in women with urological and GI problems vs a control population. BJU Int. 2015 Jun;115(6):958-967.
  • 35. Ortega MV, Kim Y, Hung K, James K, Savitt L, Von Bargen E, et al. Women with chronic constipation have more bothersome urogenital symptoms. Tech Coloproctol. 2022 Jan;26(1):29-34.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Fizyoterapi
Bölüm Araştırma Makalesi
Yazarlar

Saliha Beste Bülbül 0000-0002-2425-5257

Şeyda Toprak Çelenay 0000-0001-6720-4452

Gönderilme Tarihi 24 Ocak 2026
Kabul Tarihi 14 Nisan 2026
Yayımlanma Tarihi 30 Nisan 2026
IZ https://izlik.org/JA52NJ37CY
Yayımlandığı Sayı Yıl 2026 Cilt: 7 Sayı: 1

Kaynak Göster

Vancouver 1.Saliha Beste Bülbül, Şeyda Toprak Çelenay. KRONİK KONSTİPASYONU OLAN VE OLMAYAN KADINLARDA PSİKOLOJİK DURUM, UYKU KALİTESİ VE TUVALET DAVRANIŞLARININ KARŞILAŞTIRILMASI. TSAD [Internet]. 01 Nisan 2026;7(1):35-48. Erişim adresi: https://izlik.org/JA52NJ37CY