Question: After I have anything more than a snack to eat, I have to rush to the toilet to pass a motion. It’s getting embarrassing! How can I stop this?
In all animals there is a reflex known as the gastro-colic reflex. This acts so that when the stomach becomes distended by food, the rectum (last part of the gut) contracts to move out faeces. This reflex is easily seen in animals such as cattle and horses. In humans, the reflex is better controlled, for obvious social reasons, but it is still easier and better to go to the toilet after the main meal of the day than at other times.
Some unlucky people have an overactive gastro-colic reflex. This may be due to some disease or chronic irritation of the lower part of the gut, and it would be essential for you to see a doctor for a large bowel examination to exclude any problems in this area.
Colonoscopy involves passing a flexible tube into your back passage. Through this, the inside of your gut can be easily seen and any diseases identified. If nothing is found, exercises to improve your bowel control may be tried, dietary modification may be useful, and as a last resort medications can be prescribed to help your problem.

Question: Whenever we go away I suffer constipation and dreadful wind pains. I don’t like to use public toilets and can’t go away for more than a few days because I can’t go to the toilet until I get home.
Your self-diagnosis of a psychological problem is obviously correct, but these problems are not silly, and can seriously affect the lives of some people. The solution is to be taught to use public toilets and other facilities away from home. It is worth keeping in mind that even the Queen has to go to the toilet— a point many royalists who worship the Queen would never even consider! Arrange through your general pracritioner to see a good behavioural psychologist or a psychiatrist who has an interest in behavioural problems. Over a period of several weeks you will be taught how to cope with your fear, and in due course you will be able to enjoy long holidays away from home.
Fear of almost anything can be overcome by using appropriate techniques, and your fear of strange toilets is no worse than another person’s fear of heights, fear of spiders, or a fear of confined spaces. Don’t delay seeking help—a wide world away from home is waiting to be explored. A light-hearted paperback called ‘London’s Distinguished Dunnies’ (or something similar) is available for your perusal should you venture that far afield!

Question: What is appendicitis, and how do people get this problem? My sister has just had hers removed at age 38.
Appendicitis is an infection of the appendix, which is a narrow dead end tube about 12 cm long that attaches to the caecum (first part of the large intestine). It is an almost unknown condition in poorer countries for dietary reasons, and the lack of fiber in Western diets is often blamed, although its incidence is steadily falling due to better dietary education. In other mammals, particularly those that eat grass, the appendix is an important structure which aids in the digestion of cellulose, but in humans it serves no useful purpose.
If the narrow tube of the appendix becomes blocked by faeces, food, mucus or some foreign body, bacteria start breeding in the closed-off area behind the blockage. When a patient develops appendicitis, pain develops around the navel and soon moves to the lower right side of the abdomen just above the pelvic bone and steadily worsens. It is often associated with loss of appetite, slight diarrhea and a mild fever. There is no specific diagnostic test, but blood and urine rests are done to exclude other causes of pain. Once removed, the appendix will be sent to a pathologist to confirm the diagnosis.
The only effective treatment is surgical removal of the appendix in a simple operation (appendectomy) which takes about 20 minutes. The usual hospital stay is only two days, and patients return to work in seven to ten days. The operation is sometimes done through laparoscopes (1 cm diameter tubes). The surgeon looks through one and operates through two others, leaving only three tiny scars scattered across the belly. This speeds recovery so that sometimes only a single night is required in hospital. If left untreated, the appendix becomes steadily more infected, full of pus, and eventually bursts to cause peritonitis. Most patients get very good results from treatment.