Authors (including presenting author) :
Tong MH (1), Chan LM (1), Lee LS (1), Luk WY (1), Choi PS(1), Bonny CY (1), CHIM CK (1), Au KM (1), Angela Kwok ML (2) , Maria Leung KW (3) , Maria Tang WS (4)
Affiliation :
(1) Community Outreach Services Team, Prince of Wales Hospital (PWH)
(2) Central Nursing Department, (PWH)
(3) Family Medicine, NTEC
(4) Medicine & Geriatric Department, Shatin Hospital & Shatin Cheshire Home
Introduction :
Introduction:
Constipation is common among the elderly due to weaken intestinal peristalsis because of inadequate water and fiber intake, immobility as well as having multiple
co-morbidities. It may lead to abdominal discomfort; some even intestinal obstruction causing emergency admission. Per-rectal digital examination is a usual practice to identify constipation but it induces great discomfort to patients.
The Community Geriatric Assessment Team(CGAT) of New Territories East Cluster(NTEC) piloted to use the non-invasive handheld ultrasound bowel scan for early detection of constipation among the elderly for timely management from Oct, 2024 to December 2024.
Objectives :
Objectives:
1. To have early identification of constipated residents by using non-invasive ultrasound scanning
2. To provide early intervention
3. To avoid AED attendance and admission due to constipation and related problems
Methodology :
Methodology:
CGAT nurses are trained to use non-invasive handheld scan.
Cognitive impaired elderly was recruited with inclusion criteria, including persistent abdominal distention, or passing loose stool or watery stool; or no bowel opening for at least 3 days.
Each recruited patient would have scan for three times on Day 1, Day 7 and Day 14 in order to evaluate patients’ constipation condition, to provide treatment as needed and to evaluate treatment effectiveness.
Result & Outcome :
Results:
29 residents were recruited from October to December 2024.
100% (N=29) of residents were diagnosed with moderate to severe constipation at the first ultrasound scanning. 31%(N=9) was detected with impacted hard stool associated with abdominal distention. All of patients required medical intervention including prescription /titration of laxatives.
After intervention, 84%(N=24) residents had significant improvement in terms of subsided abdominal distension; and stool noted to become soft on Day 7. 17 % (N=5) resident with fecal impaction & abdominal distention were resolved after stepped up treatment.
100%(N=29) residents’ constipation condition were noted having improvement on Day 14.
No patient needed attending AED or hospital admission due to constipation or related problems within this period.
