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: I have had pain in the right lower part of my belly for three months. The pain often goes to the back, but I have no loss of weight or appetite. What could cause such a pain?
There are a wide range of conditions that can cause such a pain, and you will need a wide range of investigations to discover its cause.
The first step is a detailed physical examination and history by your general practitioner. This will be followed by one or more of the following tests:
— Blood tests to check liver, kidney, pancreas, to find any infection, and assess your general health.
— Urine test to check bladder and kidney.
— Ultrasound scan of ovaries, uterus and other pelvic organs. —X-ray of back, bowel and/or kidney.
— CT scan of abdomen.
— Colonoscopy (a flexible tube passed up your back passage) to check the bowel.
— Laparoscopy (tube put through your belly button) to directly look around inside your belly.
A few of the many possible causes could include an ovarian cyst, an abscess from appendicitis, endometriosis, back arthritis, kidney stone, aneurysm (swelling) of the aorta, arterial thrombosis (clot), irritable bowel syndrome, tube infection, hernia, Crohn’s disease, cancer and many more.
I can only guess at a diagnosis. Your GP and the specialists s/he may refer you to, should be able to come to a definite diagnosis that can then be treated appropriately.