Recognising constipation in older residents with colostomies: practical guidance for nursing and residential care staff

Constipation is a common but often under-recognised problem among older adults living in residential and nursing care settings. A persistent misconception exists that people with a colostomy cannot become constipated because faecal output is diverted through a stoma. In reality, constipation remains a significant risk and may contribute to abdominal discomfort, reduced appetite, dehydration, hospital admission and functional decline. Care home residents are particularly vulnerable because of frailty, multimorbidity, reduced mobility, polypharmacy and cognitive impairment. Constipation should also be considered among the potentially reversible factors contributing to acute deterioration, confusion and delirium in older adults. Early recognition is important because symptoms may be overlooked or attributed to ageing, dementia or other comorbidities. This article examines the recognition, prevention and management of constipation in care home residents with colostomies and provides practical guidance for nurses and care staff.