The note was written during UN summit talks

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But when you are the US president, at a gathering of more than 150 world leaders, it is even more tricky.

While talk at the UN world summit was focused on terrorism and internal reform, George W Bush appeared to have been caught short.

And, he is said to have turned to Secretary of State Condoleezza Rice for advice.

"I think I may need a bathroom break? Is this possible?" a Reuters news agency photographer caught him writing in a note to Ms Rice.

The photograph, and Mr Bush's apparent request for permission to pee, has been the subject of discussion on a number of satirical websites.

President Bush was among monarchs, presidents and prime ministers for the opening of the three-day summit, marking the 60th anniversary of the UN.

In a speech, he urged the UN to pursue meaningful reforms to allow it to meet modern challenges and said the US was committed to helping overcome poverty.