May present with pain, chronic diarrhoea or constipation. It is important to investigate for and exclude organic pathology.

Reassurance and explanation are essential

A high fibre diet is the mainstay of treatment.

For relief of pain:

Hyoscine butyl bromide (O) 20 mg four times a day

Or

Diazepam (O) 5-10 mg three times a day.

Give short and infrequent courses only, in order to avoid dependance.

If constipation prominent

Magnesium trisilicate (O) 20 ml mixture three times a day.

Explore psychosocial factors in resistant cases.

Consider referral to clinical psychologist.

Prolonged use of anti-diarrhoeal drugs may exacerbate the condition, therefore avoid.