Dr Emeran Mayer in the New England Journal of Medicine reported a case study of a woman with IBS who worried that she might soil her clothes when she went out, so spent a long time in the bathroom, and felt anxious and fatiqued as a result of the things she felt she needed to do to ensure her safety. Anxiety and stress can trigger bouts of IBS so working on these worries can be very beneficial.

His report shows that getting a doctor's diagnosis of IBS is very helpful to be sure that there is no underlying disease. Once you have that diagnosis, then you know that there is no physical damage.

In these circumstances, hypnosis and cognitive behavioural therapy have been shown to work, starting on the anxiety and the worries so that you start to feel that you are in control once again. If you have been avoiding going out for fears of embarrassment as a result of IBS, then cognitive behavioural hypnotherapy is well worth a try.

Tried, tested, and successful. Recommended by NICE.

IBS is called a functional disease, because it is a problem of the working of the gut, rather than being caused by the biology of the gut (which is known as organic disease). Of course, as time passes, the gut does become damaged, so there is these days some controversy about the distinction between a functional and an organic disease.

IBS is a syndrome because there are a wide range of symptoms (or a cluster of symptoms) including back pain and chest pain, as well as the more understandable bloating, constipation etc. And not everyone has all the possible symptoms.

This makes diagnosis quite tricky. It involves excluding any organic disease, and then checking to see if the characteristic symptoms are presenting. If diagnosis is not properly conducted, you can end up with painful, unnecessary and possibly damaging internal examinations.

These are the symptoms normally considered to be symptomatic of IBS. They are called the Rome II criteria.

At least 12 weeks, which need not be consecutive, in the

preceding 12 months of abdominal discomfort or pain that

has two of three features:

Relieved with defecation

and/or

Onset associated with a change in frequency of stool

and/or

Onset associated with a change in form (appearance) of stool

Supportive symptoms:

Fewer than three bowel movements per week

More than three bowel movements per day

Hard or lumpy stools

Loose (mushy) stools

Straining during a bowel movement

Urgency

Feeling of incomplete bowel movement

Passing mucus during a bowel movement

Abdominal fullness, bloating or swelling