Cansu KOSTAKOĞLU DUMAN, Muhammed YILDIRIM, Talha YAMAK, Döndü Melek ULUSOY, Ersin Kasım ULUSOY
European Journal of Therapeutics - 2026;32(4):455-463
Objective: Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure in the absence of any underlying structural cause. Functional constipation (FC), by increasing intra-abdominal pressure, may influence intracranial pressure dynamics. This study aimed to compare the prevalence of FC in patients with IIH versus healthy controls, and to investigate clinical differences between IIH patients with and without FC. Methods: This cross-sectional case-control study included 54 patients diagnosed with IIH and 64 healthy controls. FC was assessed according to the Rome IV criteria. Headache severity at presentation was evaluated using the Visual Analog Scale (VAS), and depressive symptoms were measured with the Beck Depression Inventory (BDI). In IIH patients, cerebrospinal fluid (CSF) opening pressure, body mass index (BMI), the presence of papilledema, and peripheral visual field defects were recorded. Results: The prevalence of FC was significantly higher in the IIH group (53.7%) compared with controls (10.9%) (p<0.001). No significant associations were found between FC and BMI, CSF opening pressure, papilledema, or visual field loss in IIH patients. However, patients with FC had significantly higher VAS scores at presentation (p<0.001). In the regression model including selected clinical variables, higher VAS scores were associated with FC; however, residual confounding cannot be excluded (OR=3.76, 95% CI: 1.85-7.65, p<0.001). Conclusion: Functional constipation is common in patients with IIH and is associated with greater headache severity. These findings highlight a potential role of the gut-brain axis in IIH pathophysiology, warranting further investigation in future studies.
