Although concealed abuse of cathartic laxatives is probably an unusual cause of severe longstanding diarrhoea, nevertheless, it is presumably a more frequent cause of such diarrhoea than are endocrine pancreatic tumours. The patient often undergoes extensive and expensive investigations before the diagnosis can be reached if indeed it ever is. The condition is almost exclusive to women, often those employed in medical care. A psychiatric background is usual, frequently with anorectic traits. The abuse often continues even after 'disclosure' and commonly defies psychotherapy.