Test Anxiety on Bowel Health and Constipation in Students

The Effect of Test Anxiety on Bowel Health and Constipation in University Students

This observational cross-sectional study aims to examine the relationship between test anxiety, bowel health, and constipation in university students. The study will include undergraduate students aged 18 years and older who are studying in the Physiotherapy and Rehabilitation Department at Lokman Hekim University and who are in their final examination period.

Participants will complete self-report questionnaires during a single face-to-face assessment session. Constipation status will be evaluated using the Rome IV criteria, stool form will be assessed using the Bristol Stool Scale, constipation severity will be assessed using the Constipation Severity Instrument, and test anxiety level will be assessed using the Test Anxiety Inventory. Sociodemographic characteristics and bowel-related symptoms will also be recorded.

The study does not include any intervention or treatment. The findings are expected to help better understand whether test anxiety during examination periods is associated with bowel health problems and constipation in university students.

Study Overview

• Status: Recruiting
• Conditions: Constipation; Anxiety; Bowel Habits
• Intervention / Treatment: Other: Observational assessment

Detailed Description

Constipation is a common gastrointestinal problem that may affect quality of life, daily activities, and psychosocial well-being. University students may be particularly vulnerable to bowel habit changes during examination periods because of increased academic stress and test-related anxiety.

This study is designed as an observational, cross-sectional, and analytical study. It will evaluate whether test anxiety is associated with bowel health indicators and constipation among university students during the final examination period. The study will be conducted at Lokman Hekim University with undergraduate students from the Department of Physiotherapy and Rehabilitation.

After providing informed consent, participants will complete self-report forms and questionnaires in a single face-to-face assessment session. The assessment will include questions about sociodemographic characteristics, bowel habits, bowel-related symptoms, constipation status, stool form, constipation severity, and test anxiety level. No intervention, treatment, randomization, or follow-up assessment will be performed.

The study is expected to provide information about the possible relationship between psychological stress related to examinations and bowel health in university students. The findings may contribute to a better understanding of stress-related bowel problems and may support future preventive approaches for young adults.

• Study Type: Observational
• Enrollment (Estimated): 200

Contacts and Locations

• Study Contact: Name: Demet Öztürk, Phd; Phone Number: +905068394288; Email: demett.ozturkk@gmail.com
• Study Contact Backup: Name: Mustafa Sarı, Phd; Phone Number: +905068394288; Email: mustafa.sari@lokmanhekim.edu.tr

Study Locations

• Turkey (Türkiye)
  • Ankara
    • Ankara, Ankara, Turkey (Türkiye), 06510
      • Recruiting
      • Lokman Hekim University, Ankara, Ankara
      • Contact: Demet Öztürk, Phd; Phone Number: 05068394288; Email: demett.ozturkk@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population will include undergraduate Physiotherapy and Rehabilitation students at Lokman Hekim University who are in their final examination period during the data collection process. Eligible participants will be 18 years of age or older, able to read and complete the self-report questionnaires independently, and willing to provide written informed consent.

Description

Inclusion Criteria:

• Being an undergraduate student in the Department of Physiotherapy and Rehabilitation at Lokman Hekim University
• Being in the final examination period during the data collection process
• Having sufficient reading and comprehension skills to complete the questionnaires independently
• Voluntarily agreeing to participate in the study after reading and signing the informed consent form

Exclusion Criteria:

• Having inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, celiac disease, colorectal cancer, or a history of major gastrointestinal surgery
• Having diagnosed irritable bowel syndrome or another organic gastrointestinal disease
• Regular use of laxatives or medications that directly affect bowel movements, such as opioids
• Having neurological diseases that may affect bowel function, such as multiple sclerosis, Parkinson's disease, or spinal cord injury
• Having had an acute gastrointestinal infection within the last month

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

University Students; Undergraduate students aged 18 years and older who are studying in the Department of Physiotherapy and Rehabilitation at Lokman Hekim University and who are in their final examination period. Participants will complete self-report questionnaires assessing test anxiety, bowel habits, stool form, constipation status, and constipation severity during a single face-to-face assessment session.

Other: Observational assessment; Participants completed assessment forms and diaries. No intervention was administered.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Constipation Status Assessed by the Rome IV Criteria	Constipation status will be assessed using the Rome IV criteria. Participants will be classified as having constipation or not having constipation according to the presence of constipation-related symptoms, including reduced stool frequency, straining, hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction, and need for manual maneuvers.	At a single assessment during the final examination period

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Constipation Severity Assessed by the Constipation Severity Instrument	Constipation severity will be assessed using the Constipation Severity Instrument. The scale includes 16 items and evaluates constipation-related symptoms across three subdomains: obstructive defecation, colonic inertia, and pain. The total score ranges from 0 to 73, with higher scores indicating more severe constipation symptoms.	At a single assessment during the final examination period
Stool Form Assessed by the Bristol Stool Scale	Stool form will be assessed using the Bristol Stool Scale. Participants will be asked to select the stool type that best represents their most common stool form during the last week. The scale classifies stool form into seven types, ranging from hard separate lumps to watery stool.	At a single assessment during the final examination period
Test Anxiety Level Assessed by the Test Anxiety Inventory	Test anxiety level will be assessed using the Test Anxiety Inventory. The scale consists of 20 self-report items evaluating cognitive, emotional, and physiological symptoms of anxiety experienced before and during examinations. Total scores range from 20 to 80, with higher scores indicating higher test anxiety.	At a single assessment during the final examination period
Bowel Habits and Bowel-Related Symptoms	Bowel habits and bowel-related symptoms will be assessed using a researcher-developed evaluation form. The form includes questions about stool frequency, postponement of defecation, perceived bowel health, preferred toilet type, and symptoms such as abdominal pain, bloating, gas, diarrhea, nausea, vomiting, indigestion, and constipation during the last week.	At a single assessment during the final examination period

Collaborators and Investigators

• Sponsor: Lokman Hekim University

Study record dates

Study Major Dates

• Study Start (Actual): February 25, 2026
• Primary Completion (Estimated): August 25, 2026
• Study Completion (Estimated): February 25, 2027

Study Registration Dates

• First Submitted: June 12, 2026
• First Submitted That Met QC Criteria: June 12, 2026
• First Posted (Actual): June 17, 2026

Study Record Updates

• Last Update Posted (Actual): June 17, 2026
• Last Update Submitted That Met QC Criteria: June 12, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: University students; Rome IV criteria; Bowel health; Test anxiety; Examination stress
• Additional Relevant MeSH Terms: Mental Disorders; Signs and Symptoms, Digestive; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Anxiety Disorders; Constipation
• Other Study ID Numbers: 2026032

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No