Impact of Lifestyle and Hydration on Chronic Constipation and Related Anal Disorders in the Kurdistan Region

Background: Chronic constipation is a common gastrointestinal disorder that significantly impairs quality of life and often leads to anorectal complications such as hemorrhoidal disease (HD) and anal fissures (AF). Lifestyle habits and hydration status play critical roles in bowel function, yet limited data exist in the Kurdistan Region of Iraq. Objective: This study investigated the impact of poor lifestyle behaviors and inadequate hydration on the occurrence of chronic constipation and its progression to HD and AF. Methods: A cross-sectional study was conducted from 2023 to 2025 at Shaqlawa Teaching Hospital and affiliated private clinics, involving 645 adult patients diagnosed with anorectal disorders. Data on demographics, hydration, diet, toilet habits, and bowel characteristics were collected using a structured questionnaire. Statistical analysis was performed using SPSS version 26, applying t-tests, ANOVA, chi-square, and regression models to determine associations and predictors. Results: Poor hydration, low-fiber diets, obesity, and straining during defecation were significantly associated with higher constipation severity (p < 0.001). Hydration emerged as the strongest independent predictor of both constipation and combined HD + AF (OR = 2.56, p = 0.011). Male gender and prolonged toilet sitting also showed significant associations. Conclusion: Constipation and its complications are largely preventable through simple lifestyle modifications. Encouraging adequate water intake, a high-fiber diet, regular physical activity, and proper toilet habits can substantially reduce the burden of constipation-related anorectal disorders in the community.