The Bowel Interest Group has launched an updated edition of its Interactive Treatment Pathway for chronic constipation that has been developed to improve care and reduce costs associated with chronic constipation in the community.

Constipation is a treatable and manageable condition, but avoidable, unplanned emergency hospital admissions cost the NHS £71 million per year. One on five people are still too embarrassed to talk to their GP about bowel problems, which can cause debilitating physical problems such as chronic pain and urinary tract infections. It can also lead to psychological distress and have a long-term impact on wellbeing and quality of life.  

The pathway constitutes 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. 

It was developed after research shows that lack of information and dedicated bowel management pathways impedes the early escalation of chronic constipation towards effective treatment and improved patient outcomes.

Effective treatment of chronic constipation 

Recognising that this issue is a particularly significant problem in primary care, the guidance is structured pragmatically to allow quick and safe decision making. The first appointment may just cover history and examination. The pathway would then assist by standardising the lifestyle measures which have evidence to support them. The pathway has been developed from the NICE CKS on constipation and is interactive to allow healthcare professionals to click through to the relevant section during patient consultation.

Professor Anton Emmanuel, Consultant Gastroenterologist at UCLH and the National Hospital for Neurology & Neurosurgery, who led the development of the Interactive Pathway, said: “Despite the availability of specific NICE guidance on bowel management, and the pioneering work of some NHS Trusts on the issue, widespread effective treatment of chronic constipation still has some way to go. It is therefore important that BIG have published this Interactive Treatment Pathway which simply and safely leads practitioners through the clinical decision making process, based on the NICE guidance.

"Better treatment of constipation reduces the burden on the NHS while also having a profoundly positive effect on people’s health, quality of life, dignity and requirement for healthcare. This document is a support tool aimed at all clinicians, specialist care professionals, general practitioners and commissioners and can be used in tandem with the other important information on the subject published by the Bowel Interest Group.”