This is a real & common entity. Its cause is not well understood. There appears to be an altered & abnormal, sometimes paradoxical, working of the stomach & intestines, a real effect & not just your imagination. There is no mechanical defect or visible disease. Although it is a terrible nuisance & burden to the sufferer, it is not serious in that your health is not jeopardised & it is not associated with, nor does it cause cancer. It is usually intermittent, i.e. it comes and goes, it can often without any apparent reason, quickly resolve. Certain foods & stress or emotion can bring on the symptoms or make them worse.

To help minimise its unpleasant effects:

• Take a high residue diet. If constipation is your predominant problem then you should take Natural Bran, which can be obtained, from Boots Chemists, Health Food shops & some other food stores such as Safeway's & Sainsburys. Take 3 tablespoonfuls (i.e. 3 large spoonfuls) every day. Natural Bran is very dry & should be taken mixed with or sprinkled over moist foods or fluids. For example sprinkle 3 tablespoonfuls of Natural Bran over your cornflakes & milk or porridge during breakfast. You should drink plenty of fluids when taking Natural Bran. If despite this you remain constipated, in addition take the medication Lactulose (which can be obtained without a prescription), up to 10mls (2 teaspoonfuls) 3 times a day. To supplement your high residue diet, eat wholemeal bread (e.g. Allinson’s Stoneground) instead of white bread. If diarrhoea is your predominant problem you should take preparations containing Ispaghula husk e.g. Fybogel or Regulan, 1 or 2 sachets daily, these can be obtained without prescription.
  

• Avoid any food, which upsets you or disagrees with you. You may need some time to find out what foods you can eat without problems. It is not possible to generalise & give you a list of the foods to avoid as each person may be affected differently. If you wish, you can go on a special exclusion diet for 2 weeks to find out whether or not food intolerance is the cause of your problem, & thereafter add one type of food to your diet every 2 weeks, to try to identify the offending food. This exclusion diet, the various types of food & all the necessary instructions together with numerous recipes are clearly explained in the book entitled The Allergy Diet by John Hunter (published by Optima, ISBN number 0-3561-4458-5, cost £5.99). This book is available from most bookstores, e.g. Dillons, 82 Gower Street, London WC1E 6EG.

Tel: 0020 7636 1577. If you are overweight, diet sensibly to reduce weight.

• If you think you are under mental stress, take whatever measures you can to reduce this as far as possible.
  

• Live a physically healthy life as far as it is practicable.
  

• In addition you may be prescribed medication for your symptoms. In this condition, medication should be kept to a minimum.