Assessment of rectal feces storage condition by a point-of-care pocket-size ultrasound device for healthy adult subjects: A preliminary study

Abstract

The aim of this study was to assess rectal feces storage condition by a pocket-size ultrasonography (PUS) in healthy adults so as to define normal rectal defecation desire. Participants were first assessed rectum by PUS imaging immediately after defecation desire (pre-defecation). Nurses checked the amount and quality of the participants' feces using King's Stool Chart and Bristol stool scale. Finally, PUS was performed for defecation with no defecation desire (post-defecation). Pre-defecation PUS detected high echo area in all patients. All of the post-defecation PUS did not detect high echo area (perfectly no recognizable high echo area in 54.5%, high echo line in 36.4%, and low echo of entire circumference in 9.1% of the patients). Average diameter of rectal crescent was 4.22 ± 0.8 cm. Bristol Stool Scale 1 or 2 (indicating hard stool) of pre-defecation PUS indicated high echo area and acoustic shadow in 100% of the patients. This study showed that healthy adult with defecation desire had high average rectal echo area of 4.0 cm in diameter. PUS may be able to define the rectum diameter for defecation desire of elderly people. PUS is capable of assessing fecal retention of the rectum for point-of-care examinations in home care.

Safety and efficacy of a defecation care algorithm based on ultrasonographic bowel observation in Japanese home‐care settings: a single‐case, multiple‐baseline study

“…Furthermore, we confirmed that the said hyperechoic area can be observed in the rectum of patients with functional constipation . Furthermore, we showed that the existence of hard stool can be identified by observing the strong hyperechoic area with acoustic shadow in the rectum using handheld US …”

“…All US observations were carried out by visiting nurses who completed an educational program from February 2018 to April 2018 on colorectal observation by US for the evaluation of functional constipation (under review). US was carried out using the SonoSite iViz handheld US system (FUJIFILM SonoSite, Bothell, WA, USA) with a convex (2–5 MHz) sector probe (1–5 MHz), as reported previously . Gain and image depth were adjusted as necessary.…”

“…suppository, enema, digital disimpaction) is carried out. We reported that rectal fecal retention can be identified from the presence of a hyperechoic area, and that retention of impacted feces might be identified by the presence of a strong hyperechoic area with acoustic shadow on US …”

“…5,6 In healthy adults, a crescent-shaped hyperechoic area was observed when they desired to defecate, and the said hyperechoic area was not observed just after defecation. 7 Thus, fecal retention can be confirmed by observing the hyperechoic area in the rectum. Furthermore, we confirmed that the said hyperechoic area can be observed in the rectum of patients with functional constipation.…”

“…We have reported that Japanese nurses evaluate constipation using US as a physical assessment tool . In healthy adults, a crescent‐shaped hyperechoic area was observed when they desired to defecate, and the said hyperechoic area was not observed just after defecation . Thus, fecal retention can be confirmed by observing the hyperechoic area in the rectum.…”