Background: Chronic constipation frequently coexists with gallstones in older adults; however, evidence regarding the effectiveness and safety of Traditional Mongolian Medicine (TMM) remains limited.

Main aim: To evaluate the clinical effectiveness and safety of Traditional Mongolian Medicine using Sershi and Digag-3 for the treatment of chronic constipation in an older adult with gallstones. Methods: A one-month prospective case study was conducted between March and April 2026. Before and after treatment, constipation severity was assessed using the PAC-SYM questionnaire, the Rome IV diagnostic criteria, and the Bristol Stool Form Scale. Biochemical tests, complete blood count, urinalysis, and abdominal ultrasonography were also performed. Adverse events were evaluated using the Generic Assessment of Side Effects (GASE) questionnaire. A follow-up assessment was conducted by telephone 25 days after treatment completion using the PAC-SYM questionnaire, the Rome IV criteria, and the Bristol Stool Form Scale to determine the persistence of treatment effects.

Results: After 30 days of treatment, the PAC-SYM score decreased from 0.42 to 0.17, and the Bristol Stool Form Scale improved from Type 2 to Type 3. Symptoms meeting the Rome IV diagnostic criteria for chronic constipation were reduced. Biochemical parameters, complete blood count, and urinalysis remained within normal ranges throughout the study, and abdominal ultrasonography demonstrated no change in the gallstones. No treatment-related adverse events were observed.

Conclusion: This case study suggests that TMM using Sershi and Digag-3 may be an effective and safe therapeutic approach for improving symptoms of chronic constipation in older adults with gallstones.