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.

We all know about gut flora and their impact on digestive transit these days! All new words explained by the probiotic manufacturers.

Research shows that gut flora, those millions of tiny bacteria in the gut, are essential for maintaining the health of our intestines.

When the microbes are in the wrong balance or insufficient numbers, then we can get all sorts of problems - slowness, inflammation etc.

What can cause this? Change in diet (one of the reasons for constipation on holiday), food poisoning, taking antibiotics, for example, can change the balance of your gut.

So what to do? Probiotics can help as long as you take them regularly so that they build up a colony. They come in the tiny bottles or as capsules from health food shops. Eating a wide range of food helps. Most of us don't eat enough fruit and veg. If you like spicy foods, you may find adding more veg tIntroduce new foods slowly to let your insides develop the "skills" in the form of microbes to digest them. Drink plenty. At least one litre of non-alcoholic fluid a day so that you have plenty of water to slosh around in your gut. Alcohol is a diuretic so you pee it out. If your pee is dark, you need more fluid.

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 the most common gastrointestinal diagnosis. The symptoms of irritable bowel syndrome are similar to those of small intestinal bacterial overgrowth. A study by Dr Mark Pimentel and colleagues  set out to see whether overgrowth is associated with irritable bowel syndrome and whether treatment of overgrowth reduces patient's intestinal complaints.

They found that after treatment with antibiotics, half of IBS sufferers from both IBS and overgrowth, the IBS symptoms disappeared. The overgrowth test can be done in doctors' surgeries.

Dr Roland Valori, editor of Frontline Gastroenterology, said of the first 100 of his patients treated, symptoms improved significantly for nine in 10. mptoms stopped completely in four in ten cases with typical IBS. He says in a further five in 10 cases patients reported feeling more in control of their symptoms and were therefore much less troubled by them.

"It is pretty clear to me that it has an amazing effect," he said. Read more here!

Dr Rona Moss-Morris, a gastroenterologist who did a survey of 620 patients suggests: “Patients who have ongoing IBS symptoms might benefit from a simple, early intervention of CBT, a means of changing thought processes from negative to positive that has been shown to be helpful.”

EArly intervention works well for many illnesses. Cognitive behavioural therapy (CBT) helps you to identify some of your negative and unhelpful thinking, and then to change the way you commonly talk to yourself. For example, some of us catastrophise our symptoms, telling ourselves that we just can't stand the pain. This only  makes things worse, and can often cause further anxiety, as you worry about whether or not you can cope. CBT helps you cope better. And hypnosis has been shown to directly improve the symptoms.

The cognitive behavioural hypnotherapy that I practice allows you to take control of your symptoms and improves your ability to cope. Not all pain involves suffering. If you have IBS, then consider CBT and hypnotherapy. The sooner the better.

Two bits of recent research show that a bout of food poisoning is a major independent risk factor for developing IBS.

Spanish researchers Luis A García Rodríguez and Ana Ruigómez found that in the general population the rate of classic IBS (as determined by the modified Rome criteria) was 0.3% and in those who had suffered gastroenteritis, the rate was much higher at 4.4%. This is about the same as the rate of 7% found by Keith R Neal, John Hebden and Robin Spiller of the Department of Gastroenterology Queens Medical Centre Nottingham. They also found that 25% had some digestive problems 6 months on.

If you get a serious gastric infection, be sure to get it properly treated by your GP.

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.

IBS is one of the causes of bloating. But it can also be caused by insufficient bile, so that fats are not properly digested. Or if you are eating new foods, your body has not developed sufficient enzymes to digest these newcomers, so the food hangs around in the gut for overlong and gases develop.

You may have tried probiotics. But according to the Glenn Gibson, professor of microbiology at Reading University, nearly 50 per cent of the probiotic yoghurts, powders and capsules sold in their millions every year simply do not have the minimum of 10 million bacteria per dose necessary to have any impact on our digestive systems.

There are a number of reasons. IBS is just one of the causes. Other sufferers may lack digestive enzymes, so the stomach doesn't empty fast enough. "You might notice that you're always bloated after eating one type of food, and this suggests that you aren't producing enough of the appropriate enzyme for that food," according to Dr Sarah Brewer in the Daily Telegraph. If you are not used to a particular food, you may well not have developed sufficient enzymes for that food. Soon however your body will be habituated and the bloating would stop. Dr Brewer considers that overeating is a main cause of bloating. That aside, lack of bile, which helps digest fats, can also be a problem. High levels of the hormone progesterone slow down the action of the bowel, which why premenstrual and pregnant women can suffer terrible constipation and bloating.

Some of us have tried probiotics. But according to Glenn Gibson, a professor of food microbiology at Reading University, nearly half the probiotic yoghurts, powders and capsules sold in their millions every year simply do not have the minimum of 10 million bacteria per dose necessary to have any impact on our digestive systems.