Toiletry Advice for Crohns
People living with Crohn’s disease may use colostomy bags on a daily basis. A colostomy is a surgical procedure that brings one end of the large intestine out through the abdominal wall to create a stoma and to which a pouch is attached to collect your faeces (https://en.wikipedia.org/wiki/Colostomy). Following this procedure, great care is needed to make sure that you have the right toiletries with you whether you are travelling on holidays or carrying out your normal day-to-day activities.
- Always have your Urgent Can’t Wait card with you for use at any toilet. Issued by your stoma nurse, this is a card designed to help you gain access to a toilet without embarrassment or confusion. The card is small enough to fit discreetly into your purse or wallet, and it is available in a number of different languages.
- Having the correct toiletry items with you is key to living with Crohn’s disease.
- Identify locations where you can change.
- Be familiar with the correct signs for toilets when you are travelling abroad (e.g. WC, toilet, lavatory, lav, washrooms, restrooms, loo).
- Make sure to have the following items with you: wipes for cleaning; small bags (nappy bags) for discarding your stoma colostomy pouch; sanitary gel to clean your hands; and your medication blister pack(s).
- If you are a colostomy user, you should have whatever products you use to hand. Many people use a small leather purse to carry these items, while some of the major colostomy companies supply carrier bags. Ideally you should be able to fit the full range of toiletries you need into these bags. Therefore, it is important to try to source a bag that will store exactly what you need, with enough space to hold a few stoma bags, nappy bags, some wipes and some air freshener.
Your Crohns Disease Emergency Kit
People living with Crohn’s disease can have a toilet emergency at any time. If this happens, it is really important not to be caught off guard. By having your toiletries on hand to respond immediately can mean the difference between experiencing a minor inconvenience as opposed to your day turning into a complete disaster. These are some key items that you should store in your emergency kit:
- A change of clothes
- A bag to store your clothes in case they are soiled
- Water to make sure you self-hydrate
- Ostomy essentials
- Someone you know that you can rely on to collect you, in the case of an emergency
How To Avoid Travellers’ Diarrohea
These are some tips to try to prevent an unpleasant bout of diarrohea occurring when you are travelling:
- Avoid non-carbonated drinks e.g. fresh juices
- Avoid ice-cream, raw vegetables and salads, uncooked meats and shellfish
- Avoid dairy products, unless you know for certain that they have been pasteurised
- Stay away from food vendor counters
- Never eat prepared foods, such as potato salad or canapes
Remedies for Travellers’ Diarrohea
Anyone with Crohn’s disease who is thinking of travelling should:
- Drink plenty of fluids to make sure to keep your body hydrated, preferably lukewarm, weak tea, making sure to boil all water first
- Avoid ice-cold beverages, sodas or citrus drinks, which could aggravate diarrohea
- Take extra salt to prevent dehydration
- Avoid foods that you know will cause you to have loose bowels or diarrohea – remember you know the way Crohn’s affects you better than anyone else
- Consider taking anti-diarrohea medication, such as Imodium® – they are travellers with Crohn’s best friend for dealing with diarrohea – or large amounts of Pepto Bismol® may also be effective. However, always consult your doctor first before taking them: https://www.imodium.com/
Location of Bathrooms
(WC, toilets, lavatory, lav, washrooms, restroom, loos)
Having the best toiletry kit is no good if you do not know where the toilets are located. People living with Crohn’s disease tend to be good at memorising maps of toilets and building this knowledge into their daily routines. The same should apply when you are travelling to a place you have never visited before. Always consult your local planning guides and rest stops to find where toilets are located on the route that you are taking. Always have toilet paper in you toiletry kit, as many toilets or restrooms are not always well supplied with these items.
Travelling Without Fear with Crohn’s Disease
In addition to your Urgent Can’t Wait card, your toiletry bag should contain a letter from your doctor to alert security personnel at airports. If you have a colostomy bag, it is important to alert the airport staff, as they are trained to respond to medical needs, screen people living with Crohn’s who are travelling and to make sure that you pass through checkpoints without any inconvenience, while also safeguarding your privacy. If for any reason you are asked to step aside to show your ostomy, you should ask that medical personnel carry out this screening process in a private room.
Most airports provide bracelets which are available at the airport reception desk. Wearing them helps airport staff to identify that you have additional needs. If you feel worried or anxious about going through an airport checkpoint, you can ask for assistance 48 hours in advance of your flight. This will help to ensure that your request to be searched in the presence of a medical professional can be met, as they are not always on standby and you could miss your flight if arrangements have not been put in place in advance.
Always sit down and plan your day in advance, whether it is a trip to the shops or going out with friends. Make out a list of all the toiletries that you could need in a Crohn’s disease emergency and include these items in your travel bag.
Remember, including simple toiletry products in a SMALL bag can a BIG difference to your life. It can help you to build the confidence you need to be able to do more things in life, travel more and take part in sports. By doing so, you will become a role model for others to follow your example. You will feel the benefits of taking these simple steps, as they will help you to avoid any mishaps that could potentially happen on your travels when living with Crohn’s disease.
Get Your Gut Back On Track!
An estimated 110,000 people consume antibiotics daily in Ireland, between December/March. (Source: Health Protection Surveillance Centre).
We asked Nutritional Therapist Rosanna Davison for her Top Tips to get your gut back on track after an illness.
1. Take time out
Don’t push yourself too quickly. Remember your body needs time to rebuild its reserves and regain strength.
Take more rest than usual. If you need to sleep longer, go to bed earlier.
Cut back on non-essential activities; they can wait until you are feeling 100%.
- Embrace fibre-rich foods full of protective nutrients
Fresh vegetables and fruits are rich in dietary fibre, vitamins and antioxidants. Try eating seven to nine portions over the course of each day. Choose different colours so that you nourish your body with a variety of phytonutrients.
Eat a portion of complete protein at each meal, such as poultry, fish, eggs, beans, pulses or tofu.
Consume essential omega-3 fatty acids daily. Avocados, seeds (flax, chia) and oily fish (mackerel, wild and organic salmon), are naturally rich in anti-inflammatory fats.
- Go ‘fermented’
Fermented foods are rich in ‘friendly’ bacteria. Sauerkraut is simple to make at home or buy kefir or kimchi in your local health store.
- Reduce or eliminate sugary foods
Processed foods often contain refined sugars to enhance taste. Excess refined sugar and processed foods may encourage the growth of ‘unfriendly’ bacteria, so aim to buy and eat fresh food.
If you have a sweet tooth, try eating berries (strawberries, blackberries, blueberries, raspberries). They are rich in antioxidants and naturally low in sugar.
If you need a sweetener, try Stevia which is extracted from plant leaves and doesn’t impact blood sugar levels.
Do vegans need to take supplements?
A varied, wholesome vegan diet provides almost all essential nutrients in sufficient quantities. I hear you shouting ‘Noooo! It provides absolutely everything we need!’ and you may be right, but only if you regularly eat certain fortified foods. The sad truth is that modern food production systems and lifestyles make it more difficult for everyone – vegans or not – to get all they need from diet alone. It doesn’t mean a vegan diet is unnatural or unhealthy, in fact the opposite is true. It means that how we grow, produce and consume food has changed and, with an ever-growing population, the demands on the systems that produce our food are so high that certain nutrients become harder to obtain.
I get a lot of questions about supplements and understand why people are confused. Over the years, I’ve worked on many vegan research projects and as science and population studies reveal ever more data, the guidelines and recommendations change and evolve. Hence, what we were told 10 years ago may no longer be up-to-date and that’s why different opinions arise, depending on where and when we got our information. It’s my job to keep up-to-date, so hopefully I can bring some clarity to the supplement discussion!
So what’s needed? The trio of nutrients to keep a close eye on are vitamin B12, vitamin D and iodine. You may not need to supplement with all these, all year long, but it depends on several factors. Read on…
Vitamin B12 naturally comes from bacteria in the soil and both people and animals would traditionally have got it from eating unwashed plants. However, we not only wash vegetables before we eat them (and for good reasons), but food production is now so sanitised that most vegetables are washed in chlorine, or other sterilising solutions, so there’s not a trace of B12 left.
People are not generally aware that most farmed animals are given B12 supplements and this is how the vitamin eventually ends up in their flesh. So, the argument that meat is a natural source of B12 doesn’t really stack up as meat-eaters essentially consume B12 supplements recycled by the animals that were given them!
It is absolutely necessary that we have a reliable source of vitamin B12 for our bodies. We need it to make red blood cells, for a healthy heart and circulation, and it’s essential for the nervous system. It takes years to develop a B12 deficiency, so on one hand, you don’t need to worry about not having taken B12 for a while. On the other hand, you do need to pay attention, as when symptoms develop, it’s usually serious.
To ensure adequate intake, you should have at least 5µg (micrograms) daily from supplements or fortified foods. The B12 used in both foods and supplements is produced commercially by growing bacterial cultures in large vats – and it’s always suitable for vegans.
There are two forms of B12 in supplements – cyanocobalamin (cheap) and methylcobalamin (expensive). Cyanocobalamin is the stable ‘inactive,’ form of B12 and is used in supplements and to fortify foods and drinks. Once ingested, it’s activated by your body so it can be used. Methylcobalamin is the ‘active’ form of vitamin B12 as it does not require any metabolic reactions to be activated. It costs more and is not so stable.
So which one to choose? Unless you’re a heavy smoker, have kidney failure or any other serious condition affecting your metabolism, cyanocobalamin – the cheap form of B12 – is perfectly fine. Intakes up to 2,000µg a day are safe and you can take either a lower dose daily or a higher dose a couple of times a week.
We need vitamin D for healthy bones, teeth and muscles and it also performs other essential functions in our metabolism. It is produced in the skin when exposed to sunlight and this is the main source of vitamin D for most people. However, if you always use sun-block, cover most of your skin or live in a country, like the UK, where we don’t get enough sunlight over the winter, you need a supplement, whether you’re vegan or not.
The UK Government now recommends that we all take a supplement from October to April and, if you protect your skin ferociously over the sunnier spring and summer months, you should take a supplement all year long. Otherwise, just 20 minutes of sunlight on the face and arms is all that is required by the body to manufacture sufficient vitamin D.
Fortified breakfast cereals, bread, plant milks and vegan margarines can be useful sources if exposure to sunlight is not practicable, but may not be enough. When it comes to supplements, there are two types and your body can use both, but it’s advisable to check the source – vitamin D2 is always vegan, but vitamin D3 can be of animal origin. Many vegan foods are fortified with vitamin D2 and labelled so, but if not specified, especially on cereal products, vitamin D tends to be of animal origin. If you choose to supplement your diet, there’s a range of quality and affordable vegan supplements with vitamin D2. There are also those made from algae or mushrooms that contain D3 and these are recommended if you need a higher dose. When deciding on your dosage, 10µg per day is enough and you shouldn’t go above 25µg.
Iodine has been a hot topic lately, especially with plenty of tabloid ‘experts’ warning that vegans are missing out. This mineral is necessary for thyroid function and helps to regulate how energy is produced and used in the body.
The amount of iodine in plants depends upon the iodine content of the soil in/on which they are grown. The closer to the sea, the more iodine and therefore vegans can get enough from plant foods, but there’s no guarantee. Seaweed, which of course grows in seawater, is always a good source and includes nori, laver, dulse and the kelp family (kombu, arame, wakame). But be warned – kelp absorbs far more than other seaweeds and you can get too much iodine from it. So, while seaweed consumption is encouraged, kelp should be used only sparingly.
It’s best to use a kelp supplement so you know exactly how much iodine you’re taking – it’s cheap, reliable and you don’t have to worry about taking too much. The recommended daily intake is 140µg and intakes up to 500µg are considered safe. In many countries, iodised salt is commonly used to ensure iodine intake, but it’s not the norm in the UK.
The dairy industry has been boasting about the iodine content of cow’s milk. What they don’t tell you is that it’s not a natural component of milk, but comes from iodinated cattle feed, supplements, iodophor medication, iodine-containing sterilisers of milking equipment, teat dips and udder washes. Cow’s milk is neither a natural nor the best source of iodine, so we can happily leave all that dairy out of our diet.
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