toilet facilities – Clinical Alimentary

January is a time when we start to think about holidays later in the year. However many people who suffer from IBS don’t travel as a consequence of having symptoms. Travelling can be a daunting prospect if you suffer from symptoms of IBS, sitting for too long can make constipation worse or having dreaded diarrhoea and anxiety of not being able to access toilet facilities quickly, can often put people off travelling too far from home. I often find that people tell me that their symptoms can reduce on holiday so, might it be worth the aggravation of getting to your destination to have the symptoms improve once you are there? Here are some tips that might help and this has been posted in time for you to think about arrangements that you might need to make. This post was originally written for Patient UK last year.

1. Ensure you have plenty of time to get to the airport or to your destination if staying in the UK. Don’t rush, try to use travelling as part of the holiday experience. It doesn’t matter if it takes longer to get to your destination, sometimes using A road routes might be a good alternative to motorway travel, you can drive through some stunning scenery in the UK.

Infographic from Hertz https://www.hertz.co.uk/rentacar/misc/index.jsp?targetPage=scenic-drive-in-uk.jsp

2. Before travelling plan toilet stops along the route if driving in the UK – Patient UK have a very useful new app for this and perhaps more importantly, useful for those unplanned panic stops! See the link at the bottom right hand side of the blog.

Work within your symptoms – if they are worse at a particular time of day, plan to travel outside of those times if you can.

3. If flying or travelling by train book you seat in advance as near to the toilet as you feel comfortable – don’t forget your can’t wait card or translation card* have this in your hand luggage (just about as important as your passport!) Do check the train you are planning to travel on (and the station) has toilet facilities.

Chiltern Railways transformed via Thame Gazette. Lets hope that this is not just a superficial attempt at improving toilet provision.

Get up and move around, if you can, during your flight or train journey – this will also help your risk of blood clots!

4. If you suffer from food intolerances book your in-flight meal in advance contact the airline and discuss your needs with them. If you follow the Low FODMAP diet, or exclude any other foods, avoid foods that result in symptoms at least 48 hours prior to travelling.

5. Take some spare clothing, wet wipes or toilet paper in your hand luggage to freshen up and to use in emergencies. Use a discrete bag to store them in your hand luggage so if your bag needs checking at customs you won’t feel too embarrassed.

6. Do some research about the food in the country you are travelling to, sometimes patient organisations available in the country you are travelling to can be helpful if you are intolerant of gluten for example – https://www.coeliac.org.uk/gluten-free-diet-and-lifestyle/holidays-and-travel/

Don’t plan to do too much during your vacation – less is more! You are more likely to enjoy the experience if you choose one or two visits rather than a very packed itinerary.

7. Contact the hotel to discuss food requirements before you travel – or you may wish to go self catering if you have more than one food intolerance and would find it difficult to manage. Often plain food such as rice, chicken & fish are abundant so do think about your dietary needs when planning your holiday.

8. Be aware that toilet facilities abroad may be very different to what we are used too at home, again being prepared for this can help.

How to use a toilet demonstrated in 2012 by Bryce McGowan – Solomon Islands

9. Take some rehydration salts in your first aid pack as you can become dehydrated very quickly in hot climates especially if you experience diarrhoea. Ensure you have plenty of fluids to drink, 8-10 glasses are usually adequate but you may need more, dark coloured urine (wee) is usually a good indication that you are not having enough.

10 Be very aware and follow travel food hygiene advice at your destination, as the last thing you would want is a case of travellers diarrhoea during your holiday http://www.nhs.uk/conditions/Diarrhoea/Pages/Introduction.aspx More information on food safety abroad can be found at http://www.nhs.uk/livewell/travelhealth/pages/travellersillnesses.aspx

*Can’t wait and translation cards are available with the membership package for The IBS Network.

I have to say I find the price of toilets rather expensive and unlike last year when I travelled to London, this year I am going to blog about the problem. My bladder is partly at fault here, because it does not feel the need to empty whilst I am on the train but as soon as I arrive at any railway station I have to go, and usually quickly.

Toilets are a problem for many people with bowel disorders, or lack of them to be precise, many people feel anxious at going out because they need to know where the toilet is, as they can need to go with some urgency. This can increase feelings of anxiety increasing symptoms, making the problem worse. I have recently written an article on IBD and quality of life and the survey (The IMPACT study) I used for the article contests to this very fact in people with this condition. The UK part of the survey revealed that during a flare 97% of IBD sufferers needed to open their bowels urgently, this only dropped to 70% between flares – this therefore represents the majority of responders. Episodes of diarrhoea were 5-10 times per day for 38% during a flare, this level remained at 11% during remission, and this clearly has a major impact on an individual’s ability to travel, work and to function day-to-day. Perhaps not surprisingly this affected the unemployed to a greater extent. One of the primary reasons for work absence is frequency of needing the toilet (38%) and anxiety due to the risks of incontinence (33%).

The British Toilet Association says that the provision of public toilets is a vital service for those people with medical conditions. They campaign for ‘provision of clean, hygienic and safe publicly accessible toilets that are available where and when needed, for all types of users. They request an end to public toilet closures and authorities acceptance that access to safe, discrete toilet facilities are a basic human need. The IBD quality of life study also highlights the need for accessible facilities, unavailability of toilet facilities can increase a persons’ anxiety at going out, which can make symptoms worse. 26% of people with IBD have found they have had to be rude with staff in public areas, whom often do not appreciate the person with IBD’s needs, and have refused to allow people access to staff toilet facilities.

This can lead to an individual being housebound by their symptoms, reducing access to society, friends and family. 81% of people with IBD reported that they are anxious about toilet facilities when travelling somewhere new. Perhaps surprisingly, the Impact survey found that the level of concern about toilet access increased with increasing age, clearly these worries are a very personal and significant problem for people with IBD. I suspect that the same is likely true for people with IBS and other bowel conditions. I do feel that it is the responsibility of the station operators to keep these prices in proportion, particularly when we are having to experience price hikes in other areas and many people who rely on government aid to live, especially those with bowel conditions, whose anxiety at trying to make ends meet can have a direct impact on the symptoms they experience. So come on guys please consider your toilet prices – available toilet facilities are a basic human need, not an excuse for making money.

Can’t wait cards can be purchased from

www.theibsnetwork.org

www.nacc.org.uk

Radar key for disabled toilet facilities and guides are available from

www.radar-shop.org.uk/Detail.aspx?id=44

Read Peter’s blog on toilets and IBD here

http://www.crohnsupport.com/toilet-finder/

The impact study can be downloaded from

http://www.efcca-solutions.net/country.php