Fecal properties and associated factors in elderly persons requiring care at a long-term care health facility for the elderly

[Abstract] [Objective] To clarify the current status of fecal properties and factors associated with those properties in elderly persons requiring care at a long-term health care facility for the elderly. [Methods] A questionnaire survey was conducted among 192 persons admitted to the facility, regarding their daily fecal properties over a month, urge to defecate, degree of intestinal peristalsis, frequency (days per month) and condition of defecation, status of defecation care such as drug use and disimpaction, and the nutritional condition. [Results] The mean age of the subjects was 87.4 years. Those at and above care level 3 accounted for 70%, those with dementia for 94%, those under tube feeding for 8.8%, and those using a diaper for defecation for 28%. Fecal properties were identified as soft stool group in 22.5%, and hard stool group in 10.9% of the subjects. Purgatives were used in 63% of the subjects, including laxatives in 27%, stimulant cathartics in 18%, and both in 18%. Antiflatulents and suppositories were used in 4 and 20%, respectively. Disimpaction and enema were performed in 35 and 2%, respectively. Factors associated with soft stools included a lower daily calorie intake, less frequent urge to defecate, a higher daily fiber intake, frequent urinary incontinence, and frequent use of stimulant cathartics. Factors associated with hard stools included less frequent defecation (13 days per month), absence of intestinal peristalsis, and frequent use of suppositories. [Discussion:] As a result of clarifying the fecal properties using the Bristol Stool Scale, an objective index for this purpose, and factors associated with soft stools, stimulant cathartics were suspected to be associated with the soft stools. This study suggested the necessity of using purgatives based on assessment of the fecal properties in each elderly person.