Chronic constipation is highly prevalent in nursing homes and not well controlled, leading to a high likelihood that residents develop fecal impaction, according to findings from a first-of-its kind study.

Nearly 71% of the participants from 34 Spanish nursing homes had chronic constipation, the investigators determined. Fecal impaction was “prevalent” in nearly half of these residents, suggesting that while chronic constipation is almost always correctly diagnosed, it is not well controlled.

“This is the first study specifically designed to evaluate the prevalence of both constipation and fecal impaction in a sample representative of the nursing home population,” the authors emphasized. The prevalence of constipation in nursing homes previously has been calculated through “indirect data” such as the rate of laxative use, they noted.

For the Spanish study, the researchers analyzed clinical data and administered questionnaires to participants, and a physician conducted a rectal examination on all consenting residents.

Their results suggest that laxatives are not as effective for nursing home residents as for other patient populations, or that effectiveness is not monitored well after the medication is prescribed, the authors noted.

The investigators cited several studies from the United States that support their findings and suggest the issue is of similarly large scope in nursing home populations outside Spain.

The authors were affiliated with several institutions, including the Division of Digestive Diseases, Hospital Clinico San Carlos, Universidad Complutense, Instituto de Investigacion Sanitaria San Carlos in Madrid. Full findings are published in PLOS ONE.