Oh, Crap!

Adventure is a State of Mind

Travel and Bowel Problems

Crap. Shit. Poop. Shite. Feces. Excrement. Number two. No matter what you call it, we all do it. But no one wants to talk about it. Luckily, I have a good friend and frequent travel companion, Shelley LeValley, who is brave enough to join me in discussing this messy (pun intended) topic.

It Happens to the Best of Us

Travel changes us. Anyone who has traveled to a new place can attest to the fact that they are different for having been there. Travel brings us new experiences and helps us to view the world differently. But it’s not just our minds and personalities that are impacted by travel. It’s also our guts. It can happen to any of us, and likely will happen to all of us. Even if you have the healthiest and most regular bathroom schedule of anyone on the planet, travel is likely to have an impact on when and how you go.

When our bowels aren’t working optimally, they can change in one of two ways – they can slow down or speed up. It’s possible that you could experience both during a single trip, but most of us have a tendency to experience one or the other. Shelley and I have had different experiences, so that’s why we thought it would be useful to share both sides.

Sandi’s Story

I have no idea why, but when my insides are unhappy, they tend to slow down. This results in constipation. Constipation can occur for many reasons, but the most common causes when you’re traveling are changes in diet, not drinking enough water, and changes in physical activity.

Travel can create all of these scenarios for me. When I’m traveling, I love to try new foods, but not everything is always going to agree with my system. Sometimes the problem isn’t eating foods that bother me. Instead, I may be eating less of some foods that I’m used to eating when I’m home. For example, I tend to eat a lot of fruits and vegetables on a daily basis at home, but if I’m traveling somewhere where I’m concerned about the quality of the water, I’m going to avoid eating any foods that aren’t cooked. That means a major change to my intestinal system.

Sometimes the change is related to timing. Obviously, changing time zones can have an impact on how my entire body is operating, but even as I adjust to the new time zone, different cultures eat their meals at different times. Or when we’re traveling, many of us get off schedule from when we tend to use the toilet at home. We might even need to ignore the urge when it hits us because we’re out and about and can’t find a restroom immediately, and then our system really gets confused.

Not allowing yourself to go when you feel the urge can also result from being uncomfortable with the bathroom situation, such as dealing with a squat toilet – these are toilets that are essentially holes in the floor, with or without the ability to flush them. People often think of them as a third-world option, but I’ve come across them in a restaurant in the heart of Paris, and they are common throughout Asia, including in Japan where large rest stops will often have both squat toilets and Western seat toilets.

I really struggle with squat toilets (more on them later) and have become an expert at holding it all in for a looooong time until I can find a toilet with a seat. (Maybe not the healthiest thing to do to my bowels and bladder, but we all have our issues we need to work on, don’t we?)

Other changes that likely impact me include physical activity – I’ve observed I have more problems on days that I’m not very active, which includes days when I spend a majority of my time sitting on a plane or train.

Decreased water consumption is also a problem on some days when I’m busy traveling and don’t take the time to slow down and make sure I get enough to drink, or if I’m out and about in hot weather and forget I need to drink more.

Any and all of these have, on multiple occasions, resulted in the physical discomfort of constipation. There are times that this has also resulted in the embarrassment of stopping up a toilet in the hotel or wherever I’ve been staying. (Be honest, it’s probably happened to a lot of you too! We’re just all too embarrassed to talk about it.)

Travel broadens the mind and loosens the bowels.

Sherwood L. Gorbach

Shelley’s Story

Then there is the other “end” of the story. I’ve been in some desperate situations, but not due to constipation. I have had the experience of (as my daughter-in-law would say) “emergency evacuation.”

Due to the urgency of some bowel situations, I’ve had to go in some interesting places. Often there’s not a convenient place, but one still must be found. If you’re dealing with urgency or diarrhea, stay aware of signs and be sure you know the proper name for “bathroom” in the local language. (Having grown up out in the boondocks, I fortunately know how to “pop a squat” when desperate and have also learned to look for a nice bush or vegetation to provide cover.) Sometimes there’s even some entertainment in watching for those signs – we have seen some really fun ones in our travels.

A very important tip for some countries is to also have plenty of change with you and a small package of tissues – for example, in Guatemala, there were attendants at public toilets who required payment for a few squares of toilet paper. In this case, both money and usually more tissue was required to have a successful experience. In China, there was no toilet tissue in public bathrooms, so we were on our own to provide what we needed.

Back to the emergency evacuations – travel diarrhea is usually caused by eating or drinking something that is contaminated with bacteria, viruses, or parasites. A lot of travelers know not to drink the water in some parts of the world, unless it is bottled or boiled, but they don’t realize that also means not eating things that were rinsed in that water (such as the lettuce and other vegetables in a salad), drinking a cold drink with ice cubes made from that water, or brushing their teeth with that water. Additionally, there is a potential for problems when eating undercooked meat or fish or consuming unpasteurized milk, cheese, yogurt, or ice cream.

What to Do to Avoid and Treat Travel Constipation

Sandi here again. If you can identify what has changed in your daily schedule while you are traveling, try to address those issues first. For example, I mentioned how I often do not drink as much water and do not consume as much fiber as I do when I’m at home. An easy remedy is to be conscious of these problems and make a point to drink more fluids and eat more fruits and vegetables.

Another solution is to identify how your internal clock may have been thrown off by traveling to a new time zone, and listen to what your body needs and wants. For example, I know some individuals who are able to have a bowel movement like clockwork…lucky you! But if you’re used to using the toilet every morning after breakfast in the central time zone of the U.S., your body might be ready to get things moving when you’re getting ready to go to bed in Tokyo, Japan. If you can, paying attention to this and respecting your body’s needs can prevent the development of problems.

If you’ve been experiencing problems before you leave home, make plans to do what works for you while you’re on your travel adventure. For example, if you use a fiber supplement on a daily basis, plan to take some with you. I recently discovered that Metamucil makes on-the-go packets, which is a travel-friendly way to add fiber to your diet with minimal muss and fuss.

It also never hurts to talk to your doctor before you travel and develop a plan for any problems you anticipate. For example, if you know you’re like me and tend toward constipation, discuss with your doctor whether it might be a good idea to take an over-the-counter laxative with you in your suitcase… just in case.

What to Do to Avoid and Treat Travel Diarrhea

This is Shelley again. To avoid travel diarrhea, check before you travel to learn about water safety where you are going. If it is questionable, stick to bottled water, and always double check the seal. Or, the more eco-friendly option is to use an in-bottle water filter. Avoid fresh fruits and vegetables unless they’re washed with a disinfectant like iodine or a fruit and vegetable cleaner, and don’t eat peeled fruit unless you peel it yourself.

In places with questionable water, you should even brush your teeth with purified water. One of the first things we do in places where water is a concern is stop at a convenience store and get gallons of drinking water.

Even if you do all of the above, problems can still develop. Come prepared! Many of you have heard of Immodium, and yes, Imodium works, so it’s usually a good idea to travel with it. Do not overdo Imodium, though, or you can end up in Sandi’s situation.

A less intense remedy, however, might be bismuth subsalicylate tablets (commonly known at Pepto-Bismol). A doctor I previously worked with suggested traveling with tablets, breaking them in half and swallowing whole so they actually dissolve in the stomach, not the esophagus. He felt you had better results that way and they are so much easier and less messy than liquid.

Before you travel to an area known to have contaminated water and/or to frequently create problems for travelers, talk to your doctor about possibly traveling with a dose of antibiotics that you can take if your symptoms persist longer than three days. Your doctor will be able to tell you whether this is a healthy plan for you.

A big health risk with diarrhea is becoming dehydrated, so it’s important that you continue to drink fluids. Water – clean, clean, water! If your diarrhea is accompanied by nausea, try sips – approximately one tablespoon every 10 to 15 minutes. Diarrhea makes your gut need a rest, so clear liquids for about 24 hours is ideal, though not very practical while traveling. A cheeseburger and fries is NOT recommended as a recovery meal.

When to See a Doctor

This article is informational in nature and not intended to identify, diagnose, or treat any specific physical illness. You should always check with your doctor or medical provider if you think you may have health concerns. The information presented on this site are opinions and should not be taken as medical advice.

Hopefully any constipation or diarrhea problems you experience while traveling are temporary and will resolve themselves with time or with some of the common-sense remedies we’ve suggested. You may also have other strategies that you use when you have problems at home. There are times, however, when it’s important that you seek medical attention.

If your symptoms are worsening and you experience severe pain, if there is blood in your stool, or if you begin experiencing a fever, seek immediate medical help!

Other Bathroom Tips

Throughout the world, bathroom customs differ greatly. Both of us have observed that outside of the U.S., it is far more common to pay to use a public restroom than what we are used to doing. Often that payment is expected to be made with the exact change. Both of us have had the experience of pooling resources with our travel companions (sometimes that has been each other) to come up with the right combination of change. For that reason, we’ve learned to keep an assortment of the local coins when we are traveling.

There are other toilet customs that can differ from country to country, so it’s helpful to do a little research before you travel to a new area. For example, earlier we mentioned the squat toilet, also known in some parts of the world as a “Turkish toilet.” Because Sandi has such an aversion to them (yes, it’s bordering on a phobia), we’ll let Shelley provide some advice:

Another tip for squat toilets – wear tight legged pants and high heels!!!! In China,while standing in a toilet line, people looked at me, snickered and tee-heed and pointed at my loose legged yoga pants and Chaco sandals. I quickly learned to roll up the pant legs above the knee and step gingerly. I never did figure out whether you were to provide a frontal or rear view while squatting. Occasionally, a side view was available and that felt a bit more comfortable. In some countries you just have to let all modesty drop away and do your thing, no matter how it’s coming out.

Oh, and beware if you have bad knees… or poor balance. There are no grab bars!

A Last Thought From Us Both

Just remember, wherever you are, people poop. And sometimes (and more often than we’d like) people get diarrhea or constipation. A pro travel tip – it’s usually a good idea to carry a spare pair of underwear. Shit happens. (Sorry. We couldn’t help ourselves.) Just be prepared – bring tissues, some change, and an extra set of underwear.