{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T01:58:21Z","timestamp":1782179901043,"version":"3.54.5"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anorectal diseases including hemorrhoids, anal fissures, and fistulas significantly impact quality of life, yet the relationship between toilet behaviors and disease development remains poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study conducted at Mu\u011fla S\u0131tk\u0131 Ko\u00e7man University compared 211 proctology patients with anorectal diseases to 369 healthy controls. Data on demographics, toilet behaviors, hygiene practices, and lifestyle factors were collected through structured interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 580 participants (211 patients vs. 369 controls), patients were significantly older (46.0\u2009\u00b1\u200914.0 vs. 42.2\u2009\u00b1\u200916.4 years;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and predominantly male (76.3% vs. 45.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). They also had higher rates of constipation (&amp;gt;1\/week: 18.9% vs. 5.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), back-to-front wiping (59.2% vs. 45.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), and prolonged toilet sitting (&amp;gt;20\u2005min: 8.1% vs. 0.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), whereas smartphone use during defecation was lower (26.1% vs. 37.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates significant associations between specific toilet behaviors and anorectal disease development. The findings suggest that constipation frequency, wiping patterns, and prolonged toilet sitting represent modifiable risk factors, while the inverse relationship with smartphone use warrants further investigation. These results support targeted behavioral interventions in anorectal disease prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1683286","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T06:23:25Z","timestamp":1763447005000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Toilet behaviors and lifestyle factors in anorectal diseases: a cross-sectional analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Cenk","family":"Yazkan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samet","family":"\u015eahin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burak","family":"Yavuz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anar","family":"Mammadov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6nder","family":"\u00d6zcan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zcan","family":"Dere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.2217\/cer-2020-0159","article-title":"The prevalence, characteristics and treatment of hemorrhoidal disease: results of an international web-based survey.","volume":"9","author":"Sheikh","year":"2020","journal-title":"J Comp Eff Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1055\/s-0035-1570390","article-title":"Anal fissure","volume":"29","author":"Beaty","year":"2016","journal-title":"Clin Colon Rectal Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"3503","DOI":"10.1007\/s12325-019-01117-y","article-title":"Prevalence of anal fistulas in Europe: systematic literature reviews and population-based database analysis.","volume":"36","author":"Garc\u00eda-Olmo","year":"2019","journal-title":"Adv Ther."},{"key":"B4","doi-asserted-by":"publisher","first-page":"729166","DOI":"10.3389\/fsurg.2021.729166","article-title":"Lifestyle and risk factors in hemorrhoidal disease","volume":"8","author":"De Marco","year":"2021","journal-title":"Front Surg"},{"key":"B5","first-page":"572","article-title":"Dietary habits associated with internal hemorrhoidal disease: a case-control study","volume":"97","author":"Labidi","year":"2019","journal-title":"Tunis Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s00384-011-1316-3","article-title":"The prevalence of hemorrhoids in adults","volume":"27","author":"Riss","year":"2012","journal-title":"Int J Colorectal Dis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e0329983","DOI":"10.1371\/journal.pone.0329983","article-title":"Smartphone use on the toilet and the risk of hemorrhoids.","volume":"20","author":"Ramprasad","year":"2025","journal-title":"PLoS One."},{"key":"B8","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s10151-020-02149-1","article-title":"Consensus statement of the Italian society of colorectal surgery: hemorrhoidal disease","volume":"24","author":"Gallo","year":"2020","journal-title":"Tech Coloproctol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1097\/MCG.0000000000001143","article-title":"Implementation of a defecation posture modification device in the management of chronic constipation","volume":"53","author":"Modi","year":"2019","journal-title":"J Clin Gastroenterol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1648","DOI":"10.1056\/NEJMcp067041","article-title":"Clinical practice. 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