Constipation is one of the most common gastrointestinal conditions for which treatment is sought and tens of millions are spent every year in hospital admissions, with many people coming in as emergencies. Aside from cost, the effect on quality of life for people who experience constipation is significant. It can cause psychological and physical distress, serious pain and embarrassment. Individuals with long-term neurological conditions, such as Parkinson's disease, multiple sclerosis, spina bifida, spinal cord injury and dementia, often experience constipation as a symptom or side effect, but its management can be poor. An examination of hospital episode data reveals surprising hidden costs and shows that better preventive care in the community can bring savings.