{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:11Z","timestamp":1785544991491,"version":"3.56.0"},"reference-count":33,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n In older adults with chronic constipation, symptoms of defecation difficulty often persist despite improvements in bowel movement frequency. However, constipation-related symptoms have rarely been examined as independent outcomes.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The objective of this study is to explore factors associated with constipation-related symptoms, less than 3 spontaneous bowel movements per week, straining during bowel movements, a sensation of incomplete evacuation, and a sensation of anorectal obstruction or blockage.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional web-based survey was conducted to collect patient-reported data. Constipation-related symptoms were defined according to the Rome IV criteria. Each symptom was treated as a binary variable in the analyses. Multivariable logistic regression analyses were used to examine associations between stool characteristics and medication, treatment processes, and lifestyle-related factors. Stool characteristics were classified using the Bristol Stool Form Scale, with hard stools defined as types 1 and 2.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We enrolled 546 participants and investigated the following constipation symptoms: less than 3 spontaneous bowel movements per week (n=226, 41.4%), straining (n=330, 60.4%), sensation of incomplete evacuation (n=344, 63.0%), and sensation of anorectal obstruction or blockage (n=242, 44.3%). Multivariable logistic regression analyses for these outcome variables showed that hard stool was consistently and independently associated with all constipation-related symptoms (odds ratio [OR] 1.86\u20104.66). Symptom-specific associations that remained significant after false discovery rate adjustment included lower physical activity with less than 3 spontaneous bowel movements per week (OR 0.86, 95% CI 0.77\u20100.96), stimulant laxative use with the sensation of incomplete evacuation (OR 2.01, 95% CI 1.22\u20103.31), and lower adherence to the prescribed dosage with the sensation of anorectal obstruction or blockage (OR 0.87, 95% CI 0.78\u20100.97). In contrast, the experience of adverse effects was associated with a higher probability of less than 3 spontaneous bowel movements per week and the sensation of anorectal obstruction or blockage.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In older adults with chronic constipation, different constipation-related symptoms showed distinct patterns of association, while hard stool consistency emerged as a common factor across symptoms. These exploratory findings may support symptom-oriented assessment and help inform individualized management approaches using electronically collected patient-reported outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/93531","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T20:51:49Z","timestamp":1783716709000},"page":"e93531-e93531","source":"Crossref","is-referenced-by-count":0,"title":["Symptom-Specific Factors Associated With Chronic Constipation in Older Adults: Cross-Sectional Survey of Patient-Reported Outcomes"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0527-3713","authenticated-orcid":false,"given":"Michinobu","family":"Takenaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3397-0158","authenticated-orcid":false,"given":"Toshinari","family":"Mitsuoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7660-2874","authenticated-orcid":false,"given":"Hidehiko","family":"Sakurai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1053\/j.gastro.2012.10.028","article-title":"American Gastroenterological Association technical review on constipation","volume":"144","author":"Bharucha","journal-title":"Gastroenterology"},{"issue":"6","key":"R2","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.bpg.2009.09.001","article-title":"Constipation in old age","volume":"23","author":"Gallagher","journal-title":"Best Pract Res Clin Gastroenterol"},{"issue":"1","key":"R3","first-page":"19","volume":"91","author":"Talley","journal-title":"Am J Gastroenterol"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-015-0366-3","article-title":"Chronic constipation in the elderly: a primer for the gastroenterologist","volume":"15","author":"De Giorgio","journal-title":"BMC Gastroenterol"},{"key":"R5","unstructured":"Rome IV. 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