Mental and emotional problems, which began long before the food intolerance, could make a significant contribution to the symptoms, once the gut has become sensitized and over-reactive. Even quite ordinary forms of stress can have an exaggerated effect on an irritable bowel. A stressful situation, such as having to catch a train or make a speech, might make a normal person’s stomach churn a little, but in the IBS sufferer it can provoke a violent attack of diarrhoea.

During psychotherapy or hypnotherapy, the patient should acquire new insights into his or her own problems, which can help to modify unhealthy ways of thinking and behaving. If the treatment is successful, imbalances between the different arms of the autonomic nervous system – the sympathetic and the parasympathetic – should be corrected. This helps to tone down the bodily reactions to mental stress, and can therefore moderate a symptom such as diarrhoea, even though the primary cause of that diarrhoea is a reaction to food.

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