The evaluation of stored feces in elderly patients by ultrasonography: Three case studies

Masaru Matsumoto, Shiho Tanaka, Koichi Yabunaka, Mikako Yoshida, Yuka Miura, Takuya Tsutaoka, Mayumi Handa, Gojiro Nakagami, Shingo Okada, Hideki Ota, Junko Sugama, Hiromi Sanada

Research output: Contribution to journalArticlepeer-review

Abstract

Providing defecation care can be challenging because bowel movements cannot be directly observed in home-care settings, and the objective evaluation of constipation symptoms is difficult, particularly for elderly patients with cognitive impairment. We evaluated the use of rectal ultrasonography (US) to assess the properties and volume of feces in three cases with different fecal properties. Case 1: In a 94-year-old man with normal feces (Bristol stool score: BS type 4), rectal US revealed a crescent-shaped high-echo area without acoustic shadow that was present until the next defecation. Case 2: In a 92-year-old woman with hard stool (BS type 1), rectal US showed a crescent-shaped strong-echo area with acoustic shadow that was present until the next defecation. The length of the high-echo area gradually increased during the observation period and decreased after defecation in Cases 1 and 2. Case 3: In a 67-year-old man with watery stool (BS type 7), rectal US revealed a low-peripheral-frequency-echo area without acoustic shadow. Rectal ultrasonography was able to demonstrate the presence or absence of hard stool, which was observed as a crescent-shaped a strong, high-echo area with acoustic shadow; the presence or absence of hard stool may be evaluated based on these findings. Furthermore, the fecal volume may be able to be evaluated based on the long diameter of the crescent-shaped high-echo area. Determining the best course of defecation care based on the fecal properties/volume evaluated using rectal US will likely be possible in the future.

Original languageEnglish
Pages (from-to)657-662
Number of pages6
JournalJapanese Journal of Geriatrics
Volume55
Issue number4
DOIs
Publication statusPublished - 2018
Externally publishedYes

Keywords

  • Constipation
  • Elderly
  • Rectum
  • Ultrasonography

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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