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Why constipation must be taken more seriously

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Dr Benjamin Disney Dr Benjamin Disney

Constipation is a treatable and manageable condition and yet thousands of people are admitted to A&E with constipation each year. The Bowel Interest Group’s latest report on the cost of constipation strikes home the extent of the problem and makes it clear that more can be done at a primary level to alleviate suffering before more intensive treatment is required. The economic burden on the NHS is significant. Unplanned admissions resulting from constipation cost the NHS £71 million in 2017/18. In total, £162 million was spent by NHS England on treating constipation over this period, equivalent to the cost of funding 7,043 newly-qualified nurses for a year. This figure is likely to be much higher if GP visits, home visits and prescriptions are taken into account.

The impact of this seemingly innocuous condition is far-reaching and extends to mental as well as physical health. Often, the first challenge is speaking up to a health professional; nearly one in five people feel embarrassed talking to their GP about constipation. There is a lack of awareness of what is ‘normal’ when it comes to bowel health so a frank discussion with a clinician can go a long way in preventing aggravation of the symptoms. When it is not properly managed, constipation can seriously affect quality of life, with 40% of sufferers experiencing an anxiety disorder. Chronic constipation can cause on-going pain and urinary tract infections (UTIs), resulting from urine retention and bacterial growth. Failure to deal with it promptly can lead to complex problems such as haemorrhoids, anal fissures or rectal prolapse.

For those with existing health problems, constipation is a further cause of distress, making early support doubly crucial. Patients with nerve-related health conditions often suffer from neurogenic constipation; in fact, approximately 68% of people with Multiple Sclerosis (MS) develop bowel problems. Meanwhile, older adults are more likely to suffer from constipation: in patients aged 65 and older, approximately 26% of men and 34% of women complain of constipation. The causes may be easily addressed, such as increasing physical activity and fluid intake. However, in some cases patients may need further investigation.

With so many patients suffering needlessly as a result of constipation, opening up conversations and equipping patients with the correct advice and treatments can reduce the cost to the NHS while also improving the wellbeing of those affected. Please find the full report, Cost of Constipation, here: https://bowelinterestgroup.co.uk/cost-of-constipation-report-2019-hcps/

Dr Benjamin Disney, Consultant Gastroenterologist, University Hospitals Coventry and Warwickshire NHS Trust

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