title: A nation-wide study of prevalence and risk factors for fecal impaction in nursing homes.
abstract: BACKGROUND
  There are no existing studies that provide data regarding the epidemiology of, and risk factors for, fecal impaction, either in the general population or in any sub-group of people.
  
  
  OBJECTIVE
  Estimate the prevalence of and factors associated with fecal impaction on a representative sample of the institutionalized elderly population.
  
  
  METHODS
  Two-phase study. Phase 1: pilot study validating the methodology in which all residents of a single nursing home participated. Phase 2: national multi-center cross-sectional study.
  
  
  METHODS
  34 randomly selected nursing homes.
  
  
  METHODS
  The presence of fecal impaction and associated factors were evaluated using three different tools: data collected from medical records; a self-completion questionnaire filled out by the subjects or a proxy; and a rectal examination.
  
  
  METHODS
  Older subjects living in nursing homes.
  
  
  RESULTS
  The prevalence of chronic constipation was 70.7% (95%CI: 67.3-74.1%), of which 95.9% of patients were properly diagnosed and 43.1% were properly controlled. The prevalence of FI according to patient history was 47.3% (43.6-51.0%) and 6.6% (4.7-8.5%) according to rectal examination. Controlled constipation (OR: 9.8 [5.2-18.4]) and uncontrolled constipation (OR: 37.21 [19.7-70.1]), the number of medications (OR: 1.2 [1.1-1.3]), reduced functional capacity (OR: 0.98 [0.97-0.99]) and the occasional use of NSAIDs were independent risk factors for fecal impaction.
  
  
  CONCLUSIONS
  Constipation affects more than 70% of people living in nursing homes. Although it is properly diagnosed in more than 95% of cases, the disease is only controlled in less than 50%. Constipation, especially when not controlled, is the most significant risk factor leading to fecal impaction, which is prevalent in almost 50% of this population.
authors.affiliation: Division of Digestive Diseases, Hospital Clinico San Carlos, Universidad Complutense, Instituto de Investigacion Sanitaria San Carlos (IdISSC), Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Rey
authors.affiliation: Division of Digestive Diseases, Hospital Clinico San Carlos, Universidad Complutense, Instituto de Investigacion Sanitaria San Carlos (IdISSC), Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Barcelo
authors.affiliation: Centro Valdeluz, Madrid, Spain; Spanish Society of Nursing Homes Physicians (Sociedad Española de Medicos de Residencias - SEMER), Madrid, Spain.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Jiménez Cebrián
authors.affiliation: Division of Digestive Diseases, Hospital Clinico San Carlos, Universidad Complutense, Instituto de Investigacion Sanitaria San Carlos (IdISSC), Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Alvarez-Sanchez
authors.affiliation: Division of Digestive Diseases, Hospital Clinico San Carlos, Universidad Complutense, Instituto de Investigacion Sanitaria San Carlos (IdISSC), Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Diaz-Rubio
authors.affiliation: Spanish Society of Nursing Homes Physicians (Sociedad Española de Medicos de Residencias - SEMER), Madrid, Spain.
authors.forename: Alberto Lopez
authors.initials: AL
authors.lastname: Rocha
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003248:Constipation / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005244:Fecal Impaction / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D008297:Male; D009735:Nursing Homes; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D054368:Laxatives