About 1 in 10 people in the UK - mostly women - suffer from IBS. The University of Southampton shows that there is a link with perfectionist tendencies.

Dr Rona Moss-Morris, who led the research, said: "We found people's beliefs about their symptoms, how anxious they got and their behaviour were all important".

She added: "These are people who have high expectations of always doing the right thing - and going off work goes against their beliefs."  Such people try to remain active and may go back to work too soon, she said.

Cognitive behavioural therapy helps people to manage unachievable expectations, such as perfectionism, where failure feels such a disaster. CBT is the gold standard treatment for anxiety and is recommended by the National Institute for Clinical Excellence. And CBT with hypnosis works to reduce the severity of IBS symptoms, and to help you to manage pain and your feelings about your pain. Not all pain involves suffering. Click here to link to the International Foundation for Functional Gastrointestinal Disorders, who have lots of useful advice.

Foods and drinks that may cause or worsen symptoms include

• fatty foods (most takeaway foods are fatty)
  
• milk
  
• chocolate
• alcohol
• caffeine - coffee, Red Bull
  
• fizzy drinks
  

Some things are helpful. Fibre from fruit and vegetables is helpful, and if you want to take extra fibre, then Psyllium husk is the one to choose. If you haven't been eating fruit or veg much, then start slowly. New foods need new enzymes to digest them, and your body needs time to build them up.

The gut has its own complex nervous system (the enteric nervous system), which links through to the sympathetic nervous system (as well as the rest of the nervous system). When you become anxious, stress hormones are released into your body, and these can be picked up by the gut. These can cause the colon to spasm, instead of calmly working on your digestion. You already know that your gut responds to your mood – such as butterflies in your tummy. We talk about feeling things “in my gut”, having a “gut response”. And in Japanese culture, the gut was the location of the soul, thus when commiting ritual suicide, the warrior cut his belly open. The expression “hara ga suwaru” – literally “the gut is settled” – means to be calm and without anxiety.

Once the nerves of the gut have made the link with the stress hormones, the colon becomes sensitised and responds quickly and intensely. And we are generally very sensitive to stress, and we associate these painful IBS symptoms with suffering.

Hypnotherapy can help because it is tried and tested for controlling stress. With hypnotherapy you can learn to calm down quickly when you feel the onset of stress, and also learn how to change your personal circumstances to reduce your overall risk of stress.

Dr Mark Porter on BBC Radio 4’s Case Notes, presented a really good programme about Constipation. The programme suggested that the main reasons for constipation are:

• diet low in fibre such as fruit and veg
• IBS
• sluggish bowel with slow transit,
• those who have trouble emptying their rectum even if the rest of the gut is working well
• neurological problems – pelvic surgery or back injuries for example

The programme reminded us that there is a close link between the gut and brain. For example, they said, the rectum sends a message to the brain to say that you are ready to empty your bowel, and also to tell you the consistency of the poo, and whether it is just wind.

The urge  is strong in the morning, because the bowel switches off at night and gets woken up by the brain in the morning. The bowel contracts after eating a meal and so the sensation of urge can be strongest after a meal.  The rectum is very sensitive to being stretched and this stretch makes us feel the urge sensation. We learn to respond to this urge by going to the loo – this is what potty training is.

The programme recommended the best way to go to the loo. Crouching, as the French did on their old-fashioned outdoor loos is the goal - like babies sitting on potties. You can mimic this by putting a child’s loo step or a pile of books in front of the loo and put your feet on there. Your knees are high up by your waist. Lean forward and rest your elbows on your knees.

Rather than straining from your shoulders and going red in the face, we need to be relaxed. Take a nice relaxed deep breath in, then a deep breath out pushing your belly out and bigger, to open the general abominal area. Relax our muscles in the pelvic floor. Consciously relax the anal sphincter. This opens all those low down muscles. One interesting technique which I learned with having babies, is to open your mouthIt is a technique to learn and practice.

If we don’t recognise the urge sensations or we leave it too long, the squeeze muscles in the bowel can become too limp and weak to expel stool from the rectum. Persistent strainers might end up with a swollen bowel lining and this gives a feeling of a need to go to the loo, which can result in further straining and long-term damage to the rectum.

The programme discussed different sorts of laxative. There has not been a lot of research on which type is best for which sort of constipation but this is what the programme suggested.

• bulking agents such as psyllium husk, for runny stools
• stool softeners make the stool moist and make it easier to pass the stool. These are currently being advertised on the telly.
• osmotic laxatives for hard stools. They retain fluid inside the colon to make the stool mushy – Milk of Magnesia and lactulose are well known and there is a new one, Movicol.
• Stimulant laxatives – use for slow transit constipation or for codeine induced constipation – sennakot for example. These should not be used on a regular basis as they would damage your gut and upset your potassium balance.
  

This is not a subject much talked about, but very important. I applaud them for dealing with this tricky subject.