Abstract: Objective To investigate the efficacy of linaclotide combined with electrostatic physical therapy in the treatment of elderly patients with irritable bowel syndrome with constipation (IBS-C) and its impact on colonic transit function. Methods A total of 120 elderly IBS-C patients admitted to the Geriatric Hospital of Nanjing Medical University from April 2022 to March 2024 were selected and randomly divided into two groups, of 60 patients in each, using a random number table. The control group received conventional treatment, while the intervention group received a combination therapy of linaclotide and electrostatic physical therapy on this basis. After the 4-week treatment, the therapeutic efficacy was compared between the two groups. Changes in Gastrointestinal Symptom Rating Scale (GSRS), colon transit test markers, vasoactive intestinal peptide (VIP), motilin, 5-hydroxytryptamine (5-HT), and quality of life were recorded before and after the 4-week treatment. Results The total effective rate of the intervention group was 96.67%, significantly higher than the 83.33% of the control group (P ＜ 0.05). After 4 weeks of treatment, the GSRS scores and retention of colonic transport test markers in both groups were lower or less than before treatment (P ＜ 0.05). After 4 weeks of treatment, VIP and 5-HT levels in both groups were significantly lower than before treatment, while motilin levels were higher than before treatment (P ＜ 0.05). After 4 weeks of treatment, the levels of restlessness, health anxiety, dietary control, social reactions, and family relationship scores in both groups were significantly higher than before treatment (P ＜ 0.05). After 4 weeks of treatment, the above indicators in the intervention group were better than those in the control group (P ＜ 0.05). Conclusion The combination of linaclotide and electrostatic physical therapy demonstrates significant therapeutic effects on elderly patients with IBS-C, markedly improving clinical symptoms, gastrointestinal function, and quality of life.