If you have Irritable Bowel Syndrome (IBS), then you know how daunting the thought of traveling by car, airplane, or train can be. I’ve traveled regularly most of my life, starting with my first airplane trip in a six-seater, one-propeller airplane flown by my father. When I lived for four months in Italy during college I never thought twice about jumping on a train for a one- or even twelve-hour journey. Nor did I think much of making a cross-country road trip. That is, until chronic diarrhea entered my life in 1997 on a trip to the Caribbean. After many months of illness and even more months worth of doctor visits and tests, I was diagnosed not only with IBS but also with Inflammatory Bowel Disease (IBD).
For the first year after these diagnoses I didn’t do much of anything, let alone travel. I spent much of my time regaining my strength, learning how to eat again within the limits of my new restricted diet, and trying to regain some semblance of a normal life. During that first year I was able to discern between stomach troubles caused by the IBD and those caused by the IBS. What I learned was that stress absolutely was a trigger for my IBS. And the thought of leaving the safety of my home or the town I lived in caused a lot of stress. So, at first, it seemed I wouldn’t be traveling much in my post-IBD and -IBS life. But as time moved forward I regained not only my physical strength but also my ability to successfully leave my home, and with that returned my wanderlust and my desire to travel again.
Even though I’ve since figured out how to travel successfully, traveling by airplane can cause me quite a bit of anxiety. The thought of being enclosed in a tin capsule with 200 or more other passengers and only two, four, or six bathrooms has never been a comfort. In fact, in that first year of living with diarrhea, I actually began to feel claustrophobic on airplanes—the kind of feeling where my head whirled, my palms became sweaty while my mouth went dry, and I simply couldn’t sit still. Every ounce of willpower I possessed went to staying in my seat rather than leaping forth and running over anyone who got between me and the exit door. For me, this was an extremely odd phenomenon. I’d never had any fear of flying, and I had never felt claustrophobic at any other time in my life. As I thought about this new phobia I quickly realized the claustrophia was caused by the fact that I didn't have full control over the situation. I had to listen to the pilot and the flight attendants, follow the seatbelt signs, and share the tiny, bumpy, sometimes filthy bathrooms with my fellow passengers. This could also mean standing in a line ten people deep when I had to go to the bathroom now—not in five minutes or even thirty seconds. Flying forced me to combat my worst fear: having an accident in public. (And this did happen to me once, though not on an airplane. And I survived.)
By 1999, two years into living with IBS and IBD, I’d mastered my apprehensions of flying with the possibility of having diarrhea on a travel day. I continue to travel near and far and I travel successfully. Listed here are my airplane travel tips, which can also be used and adapted as needed for traveling by train and automobile.
Traveling by Airplane
- When you book your ticket, request an aisle seat near the bathroom. However, avoid the very last row because generally the seat back won’t recline and these seats are next to the bathroom, so all you’ll hear the whole trip is the flush of the toilet. Also, if you know your gut is most active in the morning, then maybe a 6:30 a.m. flight isn’t your best bet. Book a later flight in this case.
- I try to keep as much stress as possible out of my life before I fly. I know that sounds like an oxymoron, but it can be done—I use meditation, Reiki, self-hypnosis, yoga, and exercise to help me accomplish a more relaxed and less stress-filled life. I have also learned to listen to my mind and my body to help tell me what induces and reduces my stress.
When I was a child, my mom spent weeks before traveling somewhere planning and packing. Even as a child this used to stress me out, and by the time we left I didn’t want to go. I learned a long time ago, however, that I simply cannot spend days or weeks before a trip planning every move—doing so means I am actively thinking about the trip far too much and I risk working myself into a stress-induced tizzy. What works for me is to take one day to book my tickets, hotel, and car and then forget about it until two days before I leave, when I begin with #2 above. Then I pack the day before I leave and that’s that.
- Pack an Emergency Kit. My kit, which is simply a zip-top plastic bag I have in my carry-on bag, includes Imodium® and Pepto-Bismol™, a change of underwear, a change of pants (I only wear dark blue jeans when I travel), baby wipes, any prescription medications I’m taking (never pack these in checked luggage), my doctor’s phone number and e-mail address, Tylenol® (I never take NSAIDs and Tylenol isn’t always easy to find), and a few note cards on which I’ve written, “I have a bowel disease and need to urgently use the bathroom. Thank you for understanding.” I don’t use this card often, but on one or two occasions I have thrust it into the hands of the next person in line for the toilet as I’ve dashed past them to snag the next available stall. This is extremely helpful when there simply isn’t time to chat and ask for permission. And people haven’t been angry at me after reading the card.
- In addition to your Emergency Kit, plan ahead on how you will keep your mind occupied during your trip. Pack your PDA, laptop, books, magazines, meditation tapes. . . whatever makes you feel calm and happy and will keep your mind off your gut. If you are in the airport or on the airplane and start feeling anxious, don’t just sit there: divert your mind by reading a book, listening to music, or taking some deep breaths. Your mind is one of the most important tools you can use to control your gut. Personally, I like to read books about Reiki or listen to meditation music on my iPod when I'm feeling anxious.
- I am also extremely careful about what I eat and drink on the actual travel day. While it is not the healthiest thing to do (and you should check with your doctor to make sure this is okay for you), I tend to go into “just-get-through-the-travel-portion-and-then-you’ll-be-okay” mode. This means eating only rice or applesauce for breakfast. The less I put into my body, the less that comes out. But you don’t want to risk dehydration, so do be sure to eat something every few hours and drink plenty of liquids throughout your day. I drink mainly water, but I also have a bag of powdered Gatorade® in my carry-on to which I can add water to help keep my electrolytes up. I find cutting the Gatorade® 50/50 with water to be easiest on my stomach; otherwise it tends to be too acidic.
If you are traveling on any flight longer than four hours, check ahead on your meal options and choose the one that seems best. Going more than four hours without eating is simply asking for trouble. I usually take the meal they offer and there is almost always something I can eat—bread, crackers, chicken, cheese, and so on. But I also pack snacks that I know I can eat, just in case.
- Finally, if you are traveling and your gut isn’t happy or cooperating, talk to a flight attendant. You don’t have to go into detail about your situation; simply tell them you have a bowel disease and there are times when you urgently need to use a bathroom. Ask if you can call on them to help if there’s a long line for the bathroom. I’ve often had flight attendants let me use the stall in the first-class cabin in an emergency. They’d rather help you than have you not make it to a bathroom on time. However, if you do run into an employee who is less than helpful, nicely remind them that IBD is covered under the Americans with Disabilities Act, and this will usually prompt them into action.
Traveling by Train
My advice for traveling by train is essentially the same as for traveling by airplane. However, before you buy your train ticket, make sure the train has a bathroom. As I discovered in Europe, some trains have bathrooms and some don’t.
When given a choice of where to sit on a train, I like to sit two or three rows away from the bathroom in a seat where I can see the bathroom. This might mean sitting backward, though, which can make some people feel nauseous.
As with air travel, be cautious about what you eat and drink on your travel day—you don’t want to risk aggravating your gut. Even if your train car has a bathroom, if the car is full and people are standing in the aisles, it can be difficult to get to the bathroom quickly no matter where you’re sitting.
Traveling by Automobile
My advice for traveling by automobile is pretty much the same as for planes and trains but with a few additions.
- Whenever possible, I like to do as much of the driving as possible. It helps to take my mind off my gut and I can control when we stop. Over the years, my husband has become very good at knowing that when I say, “I need to find a bathroom,” I mean now, not five miles down the road. But, with other friends, family, or clients I do best if I drive. Or, on shorter drives, I simply take my own car and meet them at the location.
- If you are on a long road trip and you have to use the bathroom but there is no hope of making it to a rest stop here is a piece of advice I came across nine years ago: pick a place where you can pull your car off the road, as far as possible from traffic. Have all other passengers exit the car and go for a walk in the opposite direction—preferably across the road. Then, open both the front passenger door and the back passenger door and use them as shields. Essentially, you’re making a three-sided bathroom stall. Then, squat and do your business. It’s not pretty and a bit gross, but truly desperate times can lead to truly desperate measures. I always keep some baby wipes in the glove compartment or the door pocket for such situations. I've only used this suggestion once but it was very helpful.
- Also, if you are traveling with people who don’t live with you on a day-to-day basis and don’t understand what living and traveling with IBS and IBD can mean, it’s best to be honest and upfront with them before you finalize your plans. You don’t have to get too graphic or detailed, but do let them know that you may have to change, or adjust, your plans, or make an unplanned stop or two. I find that informing my travel mates of my potential problems ahead of time takes some pressure off me and allows them to know what they’re getting into. I prefer to know if they can’t handle. Their frustration would cause me stress and stomach issues.
The most important thing to remember when living with IBS or IBD is to keep living. Travel, see this country, see other countries, but don’t let either illness keep you from doing what you want to do. I travel extensively and fly at least four times each year—at least one of those trips is international. I do have to consider my destinations carefully and there are places that I don’t travel to because the food or water would simply be too risky for me and my gut. I’ve had my share of setbacks and problems during a trip, but I’ve never had to cancel and, when I cull through my memories, it’s the good times I remember, not how many bathroom calls I made.
If I can travel successfully, then so can you!
You can read more about my trips, how I travel, and how I live successfully with IBD and IBS in my book, Living with IBD & IBS: A Personal Journey of Success.