Gastroenterology Today Autumn 2020

NEWS
Bowel Interest Group
launches updated Interactive
Treatment Pathway for
chronic constipation patients
(Letchworth, 18 June 2020)
Research has shown that chronic
constipation is costing the NHS £71 million/
year in avoidable, unplanned emergency
hospital admissions. Bowel complaints carry
an enormous stigma, with one on five too
embarrassed to talk to their GP – the same
level of embarrassment associated with
erectile dysfunction. Even more importantly,
there is a long-term impact on wellbeing
and quality of life. Chronic constipation can
cause debilitating physical and psychological
distress, especially as it can cause other
issues, such as chronic pain and urinary
tract infections (UTIs). Yet constipation is
a treatable and manageable condition,
so earlier and improved treatment would
alleviate an unnecessary burden on the NHS.
Data shows that lack of information and
dedicated bowel management pathways is
impeding the early escalation of chronic
constipation towards effective treatment
and improved patient outcomes. To assist
healthcare professionals in both primary
and acute sectors, the Bowel Interest
Group has launched an updated edition
of its Interactive Treatment Pathway for
chronic constipation.
The pathway constitutes an easy reference
guide for treating adults with chronic
constipation. The interactive treatment
pathway starts at the initial consultation
through to third line therapies and when
to refer to secondary care. It has been
specifically developed to improve care
and reduce costs associated with chronic
constipation in the community.
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, comments:
“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.”
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GASTROENTEROLOGY TODAY - AUTUMN 2020
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