man constipated holding stomach near the toilet

Cost of constipation still rising in most English regions, reveals new report from the independent Bowel Interest Group.

Newly released data from the Bowel Interest Group – published in the 2020 edition of its Cost of Constipation report – has revealed that the cost of avoidable emergency admissions to hospital because of constipation is rising year-on-year in most regions of England. Just six regions have seen a drop in the cost and/or number of admissions for constipation compared to two years prior. This comes at a time when the NHS is already under stress and is dealing with the backlog of patients with chronic conditions who have had their treatments delayed because of the coronavirus pandemic.

The Cost of Constipation report reveals the impact that constipation has on patients’ quality of life, the significant cost of constipation to the NHS as well as how this varies by region. Nationally, the cost per 100,000 population of avoidable constipation-related emergency admissions was over £158,000 in 2018/19. This represents a 15% rise compared with 2016/17 (around £137,000). Regional variations were marked, ranging from around £106,000 per 100,000 in Bristol, North Somerset & South Gloucestershire, through to £244,000 per 100,000 in Humber, Coast & Vale. This level of variation underlines the importance of establishing and implementing best practice bowel management across the country.

At a national level, the report shows that poor bowel health and chronic constipation, which are debilitating for hundreds and thousands of people in the UK, cost the NHS £81 million per year in admissions to A&E for constipation. This cost is likely to be much higher when GP visits, home visits and over the counter laxatives are taken into account. Other key figures include:

  • £168 million was spent treating constipation in 2018/19. This includes avoidable admissions to A&E for constipation (£81 million) and prescription laxative costs (£87 million).
  • The cost of treating constipation in 2018/19 is equivalent to funding 7304 newly-qualified nurses for a year.
  • Only 6 out of 42 regions (STPs or ICSs as applicable) in England have seen a decrease in the number and/or cost of avoidable emergency admissions for constipation.

Some leading NHS Trusts in England have established formal Bowel Management Pathways and these pioneering initiatives are starting to offer empirical proof of their value, both in transforming patients’ lives and reducing the cost burden on the NHS. The Bowel Interest Group publicises clinical best practice on its website, and further information from the National Institute for Health and Care Excellence also offers further guidance for practitioners[1].

Dr Ben Disney, Consultant Gastroenterologist at Coventry and Warwickshire University Hospitals Trust and Bowel Interest Group board member, comments, “This latest output from the Bowel Interest Group should make everyone sit up and take notice. Not only does chronic constipation ruin people’s lives, it also is causing the NHS unnecessary costs, largely because dedicated Bowel Management Pathways are not yet standard best practice. Pioneering work in this area has clearly shown a strong return on investment from such pathways, both in terms of patient outcomes and cost reduction. At a time when our NHS is under such pressure, failing to establish these pathways would seem poor practice. Modern healthcare is not simply about treating the escalating rise in chronic conditions, but also taking pre-emptive action to create more ‘well societies’. Effective bowel management is just one of the initiatives that help foster healthier populations that consume less healthcare.”

The Bowel Interest Group is an independent multidisciplinary organisation dedicated to improving bowel care for patients.

You can download the full report free of charge by visiting:


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