A 45 year old businessman presents at your clinic with a 2 year history of recurrent abdominal pain, associated with frequent bouts of diarrhoea. The pain is relieved by defaecation, but there is often a feeling of incomplete evacuation. Between these episodes he is often constipated, with infrequent bowel motions characterised by hard stools. During stressful situations, symptoms get worse and are associated with abdominal bloating and increased flatulence. He researched his problem on the internet and thinks he might have Irritable Bowel Syndrome.peer-reviewe
