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You’ve finally figured out the secret sauce to pooping on the regular. You’ve got your routine down pat…you know what to eat and what supplements you need to take, and you’ve got your toileting positioning down. And then it happens - you have an upcoming trip scheduled, the wheels start turning, and the panic and anxiety set in.
What will I eat? What if I’m doubled over in pain and can’t make it to the dinner or a family function? What if my gas is so bad while I’m in an all-day meeting? What if there isn’t a bathroom when I need one? You try to focus on the positive, but you keep returning to the “what-ifs” in your head.
We don’t want to poo-poo your concerns (hehe); we know that traveling with IBS induces anxiety. But here’s the deal - you’ll most likely not poop as you do at home, and this is completely normal!
In fact, one study found that 40% of its participants had either traveler’s diarrhea or other GI symptoms that interrupted their planned trip activities. Another small study found that 46% of its subjects believed that their bowel habits changed during the trip, with 38% reporting that they experienced constipation and 8% reporting diarrhea. The researchers noted that this was most likely a result of altered eating, fluids, and physical activity habits, anxiety around public/shared bathrooms other than the ones you're used to, and jet lag (disruptions in our circadian rhythms) and its effects on the gut-brain axis.
If people with a so-called “normal gut” have problems with pooping when traveling, how are you, someone with IBS, supposed to deal with this?
Where do you even start with such an extensive plan? Read on for some of our travel suggestions to keep you pooping like a pro when you’re away from home.
As we mentioned above, traveler’s constipation and diarrhea are real things, and if you combine this with IBS, you could be heading for trouble. Bring your supplements and any prescribed medications with you, and if traveling by plane, pack them in your carry-on bag. Try to keep whatever regimen you have going at home, and make sure you try to do the same when you’re away. And if you don’t normally need these at home, it’s not a bad idea to bring some of these supplements and medications with you. They can provide a gentle-ish push for when you just can’t seem to go, help you out if you have urgency, provide pain relief, and reassurance for when you don’t have control over what you’re eating.
As with all medications and supplements, always consult with your physician or a licensed healthcare professional before starting any supplement, especially if you are pregnant or have pre-existing medical conditions.
There are two types of over-the-counter laxatives that are available for purchase: osmotic and stimulant laxatives. Osmotic laxatives like Miralax, Milk of Magnesia, or magnesium supplements draw water into the colon, soften stool, and help to speed up transit time. They should be taken before bed as they take about 8-12 hours to work. Stimulant laxatives like senna or Dulcolax work by making the intestines contract more. They will usually cause a bowel movement within a few hours; however, we also suggest taking them overnight.
Antidiarrheals like Imodium can be useful if you experience anxiety-induced urgency, overflow diarrhea, or if you have to travel and can’t stop going. These medicines work by slowing digestion time and intestinal contractions. They also increase the reabsorption of fluids and electrolytes, which results in a more formed stool.
Encapsulated peppermint (IBGard) is an antispasmodic that can act as a smooth muscle relaxant and may decrease visceral sensation, the heightened feelings that are so often experienced when you have IBS. It may also help to reduce your bloat, belly pain and discomfort, and any urgency that you may experience.
It’s nearly impossible to control everything that you eat when you’re away and eating out. Enzymes that contain lactase, alpha-galactosidase, and xylose isomerase may help decrease symptoms like gas and bloat if you’re sensitive to FODMAPs. Some brands we like and our patients find helpful are Fodzyme, Fodmate, and Beanzyme.
Fiber supplements (Citrucel, psyllium, partially hydrolyzed guar gum) can be taken when you know you're not going to meet your fiber needs through food. These soluble fibers form a gel in the intestines and help to soften stool, making it easier for you to go. If you are not used to consuming fiber supplements, make sure you take it with plenty of fluids and always start with about a quarter of the recommended dosage to get the body used to it and then increase your dosage over time.
Most Americans are not meeting their fiber needs on a daily basis, and this is especially true when away from home. The food at airports, fast food restaurants, convenience stores, and hotels aren’t always the most nutritious or fiber-packed, and holiday meals aren’t known to be the most gut-friendly. That’s why we recommend that you bring fiber add-ins. Plus, our guts need to eat regularly to be able to work their best! Keeping snacks on hand will ensure that you have something to feed your gut, maintain your energy levels, and prevent hangry moments.
Chia seeds, ground flaxseed, nuts, and oats can be packed in plastic or reusable baggies. They can be added to smoothies, yogurt, shakes, soups, and salads to boost fiber and the vitamin/mineral content of your food.
Granola bars and trail mix travel well and can be thrown into any bag. Look for ones without inulin, chicory root, or sugar alcohols. Fody Foods and BelliWelli are two brands that offer Monash-certified low-FODMAP options. Go Macro and 88 Acres are two other brands we often recommend that are made without filler ingredients.
Eat known tolerated fruits and vegetables when you can get them in. Mandarins and clementines are easy to throw in a bag and eat throughout the trip. Bananas (often green) can be found at airports and even gas stations. Kiwis can be picked up from a local store and help with constipation. Order salads with lemon and olive oil and steamed veggies or sauteed in light oil at restaurants to increase your intake while away.
The active ingredient in ginger, gingerol, has been shown to help with nausea. It may also have antispasmodic and muscle-relaxant effects. Ginger tea is warming and could help if you feel bloated or nauseated.
Peppermint tea is cooling and is also anecdotally known to help with nausea. It also might help relieve some abdominal pain. Peppermint tea is not the same thing as encapsulated peppermint oil; however, peppermint tea might help those with functional dyspepsia.
Tea bags can be packed in a plastic pouch and hardly take up any room in your carry-on or suitcase. Plus, a warm cup of tea can be calming and soothing, especially after a day of meetings or a hectic family event. Taking the time for yourself to enjoy a cup of warm tea can also reduce your anxiety and stress.
Proper hydration is vital for digestion and maintaining normal bowel movements. Drinking water throughout the day often gets overlooked when traveling, so setting yourself up for success is key.
As one of the studies mentioned above, one reason that we may become constipated when traveling is a lack of physical activity (Sitting on planes, trains, in cars, and meetings). All muscle groups benefit from movement, which is true for the muscles in the gut. Exercise brings blood to the muscles and organs, can stimulate gastrointestinal motility, and can help to regulate bowel movements. Below are our suggestions for planning physical activity when you’re out of town.
Diaphragmatic Breathing, also known as belly breathing or box breathing, helps the body to relax and is shown to reduce blood pressure, muscle tension, and stress hormones. It can also help provide a gentle massage to the intestines and stomach. Diaphragmatic breathing can be used during any moments of stress, before and after eating, and while on the toilet to help relax the bowels.
Toileting position (how you hold yourself on the toilet) can either help or hinder stool evacuation. You want your knees to be above your hips to allow for the rectum to release its contents completely. How can you do this if you’re in a hotel or staying with family?
Traveling and being away from home can be stressful for anyone, but it can increase fear and anxiety if you have IBS or another disorder of the gut-brain interaction. And while constipation and diarrhea can be common outcomes, knowing that you’re prepared can help reduce some of the negative feelings that you might associate with travel. If you’d like more guidance or if you’re still feeling scared about your upcoming travel, we can help you manage your symptoms and give you personalized advice that will help you to keep pooping like a pro!