National Health Impact Campaign

Cost of Constipation

Project details

The Bowel Interest Group (BIG) is a multi-disciplinary group dedicated to raising the profile of bowel management. The group provides evidence driven educational resources to support healthcare professionals treating patients with bowel conditions. E4H provides secretariat services to BIG and its Board.

As part of their work, the Board of primary and secondary healthcare professionals and experts from healthcare and industry, were acutely aware of the alarming number of A&E admission for constipation and wanted to raise awareness of this. E4H worked closely with them to produce a series of regularly updated reports, and accompanying events to understand the cost of constipation on both the NHS and the health and wellbeing of the general public.

Cost of Constipation 

The Bowel Interest Group released its first ‘Cost of Constipation’ report in 2016 and updated it in 2019 and 2020. The report revealed the impact that the taboo subject of constipation has on the UK. E4H worked with Bowel Interest Group Board members to produce the report providing in house research, writing, creative and project management support. E4H also organised and delivered the accompanying virtual events.

Cost of constipation 202 report cover

The 2019 edition of the report undertook significant statistical analysis to understand laxative spend and hospital admission rates across England identifying regional variations and cost per sustainability and transformation partnership area. It identified that poor bowel health and chronic constipation cost the NHS a preventable £71m in unplanned hospital admissions for constipation in 2017/18. However, this cost is likely to be much higher when GP visits, home visits and over the counter laxatives are taken into account. Alongside exploring this significant cost of constipation to the NHS it also highlighted the damaging impact on patient lives. The report was launched via a webinar as part of Bowel Independence Day.

The 2020 update of the Cost of Constipation report included a heatmap showing the cost of admissions per STP. It identified regions that are spending more than others on patients presenting to hospital with constipation. Working with BIG, E4H also produced an Interactive Treatment Pathway. It is an easy reference guide for treating adults with chronic constipation starting at the initial consultation through to third line therapies and when to refer to secondary care. The interactive pathway was developed from the NICE CKS on constipation.


The Cost of Constipation reports have been widely reported on and cited in research literature.

The Lancet Gastroenterology & Hepatology | British Journal of Family Medicine | Independent Nurse | BBC Newsletter | NHS Networks | Primary Health Care | The Huffington Post | Bladder and Bowel UK | Bladder & Bowel Community | Crohn’s & Colitis UK | Pf Magazine | Guidelines | Pharmacy Magazine | CN Magazine | Nursing Times | BBC Radio 4 Woman’s Hour


Digital Expertise

Strategic Partnerships

Production Capability

Medical Education

Medical Publishing

Therapeutic Areas

Omni-Channel Marketing and Communications

Professional Organisation Support

The results


Report Views


Media coverage


NHS Spend on Constipation


Laxative prescription costs

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