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The commonest cause of recurrent abdominal pain is what is called the spastic colon or the irritable bowel syndrome.

Exactly why it occurs is unknown although it is believed to be due to anxiety. Apparently the muscles in the wall of the large bowel are overactive, and go into cramp-like spasms which cause pain and either diarrhoea or constipation.

Treatment consists first in making the diagnosis and so relieving the patient’s anxiety that the symptoms might be due to cancer. Drugs which reduce the spasm in the muscles have been of value, as have tranquillisers and a diet high in fibre content.

Some researchers are not at all convinced that the irritable bowel syndrome is due to nervous tension. They think that only those with a high level of anxiety go to the doctor to complain about their abdominal pain; the rest simply put up with it.

If it is not due to anxiety, what does cause it? Food allergy is often suspected; the modern highly refined diet low in bulk is another possibility.

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There are now some blood tests (RAST tests) which can determine specific allergens. There is still some doubt about their accuracy. Other blood tests show a rise in the amount of globulin, the blood protein concerned with immunity.

Treatment of asthma will depend on its severity. There is no cure but control is possible. Mild or occasional asthma will only require treatment for the acute attack.

Many drugs are used and are designed to dilate the constricted bronchial tubes. They can be taken by mouth, by suppository (absorbed through the rectum), by injection into the muscles or directly into a vein, or inhaled into the lungs.

Most are related to adrenalin and tend to make the heart beat faster and the person feel jumpy.

Children often vomit with asthma and so, in an acute attack, cannot take medicine by mouth.

The development of the metered spray has made treatment so much better and drugs can be delivered in small doses directly to the target tissue.

Some of these bronchodilator medicines are used not only for an acute attack but also on a regular basis for prevention.

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