Overview: When Dean first came in to see Dr Dawn he’d been struggling with a bowel problem for over a decade. He’s been spending a total of 3 hours every day on the loo, answering the call of nature ten or twelve times every single day. Worryingly, he’d also been passing blood every time. After a quick examination, Dawn sent Dean to get a gastroscopy – the inserting of a camera into his stomach in order to investigate the problem. With nothing untoward reported Dean had a similar procedure, this time with the camera inserted anally, followed by an ultrasound. It’s this final test that revealed the root of the problem. A fistula on his anal canal had been disrupting the operation of his sphincter muscle. Rather than going under the knife Dean was referred for a course of biofeedback treatment, designed to retrain his bowels through a series of exercises and dietary improvements, coupled with a course of anti-diarrhoea tablets.