<p>Bowel problems can be common in people with learning disabilities. Paxton et al (2001) found that almost half (48 per cent) of the clients with Down syndrome who received a health screen had bowel problems. Indeed, an earlier study found that a similar proportion of clients with a learning disability who were screened took laxatives (Paxton and Taylor 1998). Bowel problems can be influenced by a number of factors. These include congenital abnormalities such as Hirsprung’s disease (Rogers 1998), food sensitivity and allergies (Oliver 1986), inadequate diet management and a lack of a structured toileting routine (Nabors and Morgan 1995, Smith 1990). For some individuals with associated physical disabilities, limited mobility can also be a factor in bowel problems.</p>