Mother urges national priority for children's continence services after son's near-fatal constipation

A mother whose two-year-old son was left vomiting, losing weight and in severe pain says his chronic constipation was not taken seriously until it reached "crisis point," and she is urging that children's continence services become a national priority.

Elissa Novak said doctors told her that roughly 2kg of her son Ivan's 10kg body weight was estimated to be stool at the worst point. Novak told the BBC that constipation needs to be screened for in every area of healthcare after what she described as a prolonged struggle to get appropriate assessment and treatment.

The number of children aged up to 16 admitted to English hospitals with constipation and related symptoms reached a 10-year high in 2023-24, with more than 44,000 admissions, according to NHS figures. Charities say around 1.5 million children in the UK suffer from constipation and that demand for advice has risen as children return to school, prompting a spike in calls to helplines.

Health advocates and clinicians have highlighted uneven access to dedicated bladder and bowel services across the country. An expert told the BBC that some children are being failed by the absence of such services in parts of the country, leading to delayed diagnosis, insufficient specialist input and avoidable hospital admissions.

Constipation in young children can present with a range of symptoms including abdominal pain, vomiting, reduced appetite and weight loss. In severe cases, impacted stool can cause significant distension and discomfort and may require hospital admission for disimpaction and rehydration.

Novak said her son's symptoms worsened over months before clinicians agreed on the severity of the problem. "My son's constipation wasn't taken seriously until he reached crisis point," she told the BBC, adding that early screening and clearer referral pathways could prevent deterioration and lengthy hospital stays.

Bladder and Bowel UK, a charity that supports families and campaigns for better services, said constipation is widespread among children and that many families face long waits for specialist care. The charity and other campaigners have called for routine evaluation for bladder and bowel problems in primary care, community health services and paediatrics, as well as for the commissioning of dedicated paediatric continence services where they are missing.

Health service leaders caution that presentations can vary and that treatment often requires a combination of medical management, dietary advice and, in some cases, specialist follow-up. However, campaigners and parents say inconsistent recognition of the condition, limited local expertise and barriers to referral contribute to preventable escalation of symptoms.

NHS hospital admission data covering 2023-24 show the spike in admissions for constipation and associated symptoms follows a broader pattern of increasing demand for paediatric services. Health charities say some of the increase may reflect delayed care during the pandemic and subsequent pressures on primary and specialist services.

Clinicians stress that early identification and treatment are usually effective. Standard approaches include oral laxatives, bowel-clearing regimens where impaction is present, behavioural strategies and dietary changes. Where families cannot access a paediatric continence service, community paediatricians, GPs and health visitors are often the first points of contact.

Advocates say a national approach to commissioning continence services for children could help reduce regional variation, speed up referrals and improve outcomes. They are calling for clearer pathways so that children with persistent symptoms are assessed and treated promptly to avoid emergency admissions.

Parents who have experienced prolonged waits for specialist help describe emotional and practical strain, including missed days of childcare or work and ongoing concerns about their child's health. Campaigners say that recognising paediatric bladder and bowel problems as a commissioning priority would help ensure that frontline health professionals have access to training and that families can reach specialist services without prolonged delays.

For many families, early and consistent treatment can prevent complications. The experiences described by Novak and support groups underscore the tensions between clinical guidelines, local service provision and the reality for families seeking care. Charities and clinicians urged health systems to consider routine screening for bowel problems and to review local commissioning arrangements to ensure children have timely access to expertise.

A range of parent support services and charities provide guidance and helplines for families affected by childhood constipation and continence issues. Campaigners say that while these resources are valuable, they cannot replace timely access to specialist clinical services where they are needed.

The calls for action come as clinicians, parents and charities press for clearer pathways and national attention to a condition that is common but in some cases can lead to serious health consequences if not identified and managed promptly.