Elderly woman receiving gentle care with advanced ultrasound technology.

Navigating Constipation in the Elderly: A Modern Approach to Relief

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"Discover how colonic ultrasonography offers a personalized solution for managing constipation in older adults, improving their comfort and care."

Chronic constipation significantly affects many older adults, with up to 50% of those in long-term care (LTC) facilities experiencing its discomfort. However, defining constipation in the elderly can be challenging due to varying perceptions and communication difficulties, especially among those with cerebrovascular diseases or dementia.

Untreated constipation can lead to severe complications such as impaction or perforation. Therefore, effective management and prevention are crucial. While conventional methods include diet and lifestyle changes, inappropriate medication is common. Precisely assessing fecal retention is essential to avoid over-management and potential adverse effects.

Traditional diagnostic tests like abdominal radiography and colonoscopy have limitations, including radiation exposure and invasiveness. Colorectal ultrasonography (US) offers a safe, cost-effective alternative for assessing fecal retention. A recent study explores the use of colonic US in Japanese LTC facilities to provide insights into constipation management in the elderly, considering their unique physiological factors.

Colonic Ultrasonography: A New Perspective on Fecal Retention

Elderly woman receiving gentle care with advanced ultrasound technology.

A study conducted in a Japanese LTC medical facility (Sengi Hospital) from March to April 2016, explored using colonic ultrasonography to assess fecal retention in elderly patients experiencing chronic constipation. The study aimed to determine the correlation between nutrition management methods and fecal retention as visualized by US. Participants included individuals aged 65 years and older who met the Rome III criteria for functional constipation, while those with abdominal surgery history, irritable bowel syndrome, organic disease, or significant colon gas were excluded.

Before the standard management of constipation began, US imaging was performed to assess patients without any defecation for four days. Nurses then administered regular constipation management techniques, such as laxatives and enemas, until defecation occurred. Post-defecation, the stool was checked using the King's Stool Chart and Bristol Stool Chart to assess consistency and quantity.

US Imaging Process: The colorectum of each patient was scanned using a systematic method, capturing images at the ascending, transverse, descending, and sigmoid colon, as well as the rectum. This process, lasting approximately 10 minutes, was conducted by a certified sonographer using a curved-array probe.
Data Analysis: US images taken before constipation management were classified based on fecal retention. High echogenicity, brightness of the colon wall, and posterior acoustic shadows indicated fecal retention. Two certified sonographers visually classified the images to ensure reliability.
Statistical Analysis: The correlation between fecal retention, nutrition management methods, stool characteristics, and bowel movement frequency were analyzed using statistical tests to determine significant relationships.

Out of 41 eligible patients, the final analysis included 32 individuals. All patients were managed with laxative suppositories and were classified as grade C in terms of daily life independence. The results indicated that the King's Stool Chart did not detect more than 200g of fecal matter in any patient, while the Bristol Stool Chart showed type 5-7 stools (diarrhea) in 56.2% of the patients. Total parenteral nutrition (TPN) and tube feeding did not completely detect type 1-2 stools (constipation) in any of the 17 patients.

Embracing Personalized Care Through Technology

Colonic ultrasonography offers a promising avenue for personalized medical care for elderly patients experiencing constipation. By accurately assessing fecal retention and tailoring nutrition management accordingly, healthcare providers can avoid uniform, potentially excessive treatments. Further research and application of this technology may significantly improve the quality of life for older adults in long-term care facilities, ensuring their comfort and well-being through targeted and effective interventions.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5582/ddt.2018.01033, Alternate LINK

Title: Constipation In The Elderly In A Japanese Long-Term Medical Facility: An Ultrasonographic Investigation

Subject: Pharmacology (medical)

Journal: Drug Discoveries & Therapeutics

Publisher: International Research and Cooperation Association for Bio & Socio-Sciences Advancement (IRCA-BSSA)

Authors: Koichi Yabunaka, Gojiro Nakagami, Keiko Tabata, Junko Sugama, Masaru Matsumoto, Yoshifumi Kido, Terumi Iuchi, Hiromi Sanada

Published: 2018-08-31

Everything You Need To Know

What is colonic ultrasonography?

Colonic ultrasonography (US) is a non-invasive imaging technique that uses sound waves to visualize the colon and rectum. This allows healthcare providers to assess the extent of fecal retention in elderly patients experiencing constipation. The process involves scanning different segments of the colorectum, including the ascending, transverse, descending, and sigmoid colon, as well as the rectum, using a specialized ultrasound probe. The images obtained provide valuable information about the presence and characteristics of fecal matter.

Why is it important to accurately assess fecal retention in elderly patients with constipation?

Assessing fecal retention using colonic ultrasonography (US) is significant because it helps healthcare providers tailor constipation management strategies to the individual needs of elderly patients. Traditional methods of assessing and managing constipation often rely on subjective measures and may lead to over- or under-treatment. By accurately visualizing fecal retention, colonic US enables more precise and personalized interventions, such as adjusting dietary plans or medication regimens. This approach can minimize the risk of complications associated with both untreated constipation and excessive use of laxatives or enemas. Furthermore, the use of tools such as the King's Stool Chart and Bristol Stool Chart can augment the findings of the colonic US in order to gain a more holistic view.

What are the broader implications of using colonic ultrasonography in long-term care facilities?

The use of colonic ultrasonography (US) in long-term care (LTC) facilities has several implications for the care and well-being of elderly residents. First, it can improve the accuracy of constipation diagnosis and management, leading to more effective relief and reduced discomfort for patients. Second, it can help prevent complications such as fecal impaction or bowel perforation, which can have serious health consequences. Third, colonic US offers a safe and cost-effective alternative to more invasive diagnostic procedures like colonoscopy or abdominal radiography, reducing the burden on both patients and healthcare systems. Finally, the application of colonic US aligns with the principles of personalized medical care, recognizing that each patient's needs and circumstances are unique.

What assessment tools and data analysis methods were used?

The study employed the Rome III criteria for functional constipation to define the patient population. Additionally, the King's Stool Chart and Bristol Stool Chart were used to assess stool consistency and quantity after defecation. Statistical analysis was performed to determine correlations between fecal retention, nutrition management methods, stool characteristics, and bowel movement frequency. These tools and methods are crucial for standardizing the research process, ensuring the reliability and validity of the findings, and facilitating comparisons across different studies and clinical settings.