How I survived traveling through Italy with an IBD
By: Nikole Kost
If you know me at all, you know that I have Crohn’s disease. I was diagnosed at 16 and long story short, I have some major issues.
Here’s the back-story:
You may know Crohn’s disease (if you know what it is at all), as the disease where you have an insane amount of bowel movements a day. Yes, that’s completely true for me; however, every case is different.
Crohn’s disease is a chronic inflammatory condition of the gastrointestinal, called the G.I. tract, according to the Crohn’s and Colitis Foundation website. About 780,000 Americans are diagnosed with Crohn’s Disease.
Men and women are equally likely to be affected, and while the disease can occur at any age, Crohn’s is more prevalent among adolescents and young adults between the ages of 15 and 35,” according to the Crohn’s and Colitis Foundation website.
Crohn’s disease is not the same thing as ulcerative colitis, another type of IBD. The symptoms of these two illnesses are quite similar, but the areas affected in the G.I. tract are different, according to the Crohn’s and Colitis Foundation website. Crohn’s can attack any part of your digestive system while Ulcerative colitis is limited to the colon.
I personally struggle with frequent bathroom breaks, cramping, fatigue, loss of appetite, extreme weight loss, joint pain, dehydration and acid reflex the most. I’ve learned ways to cope and minimize these symptoms. The most influential thing to minimize these symptoms besides medicine is my diet. Food is my worst enemy.
My everyday diet includes:
Breakfast: Toast, fruit, yogurt and a sugary juice
Snack: Protein bar, saltine crackers
Lunch: Sandwich, fruit and saltine crackers
Snack: Granola Bar, saltine crackers
Dinner: Chicken or Fish, steamed veggies and rice
Snack: Saltine crackers
I eat just about the same things every day because diving head first into trigger foods has given me crippling anxiety for months.
Of course I have cheat days but only in places where I’m comfortable and know I have easy access to the restroom.
Red sauce, spices, dairy and grease are my triggers to having a flare up. Pretty much anything that isn’t bland gives me a toilet sentence.
Alcohol is known to be a trigger for many Crohn’s suffers. Myself, I don’t usually have any issues with drinking unless I’m flared or I don’t eat.
A flare-up usually lands me bathroom written, bedridden or in the hospital. I have been hospitalized six times in the past four years, which leaves me in there for about a week at a time. My initial diagnosis left me in the hospital for over three weeks.
I’ve passed on so many opportunities due to my disease, and going to Italy was the opportunity that I refused to pass up.
I’ve been saving money for this trip for about a year. I’ve been getting my health in check for the same amount of time.
Preparation
Exactly one year ago, I was being discharged from the hospital after a double colonoscopy and endoscopy along with a small reconstructive surgery of my colon.
It took about five months to fully recover, but I still had some issues that would stop me from traveling abroad. I’ve been discussing this trip with my gastroenterologist for months now.
We’ve been doing trial and error runs with different medications and treatments and finally found what works best for me right now. I say for right now because over time with these kinds of medications, your body gets immune to it over time.
A month before I left I made sure not to have any cheat days. I stuck to a strict diet that is high in white meats and fish. I made sure to stay away from red meat because it causes inflammation. I also made sure to drink eight cups of water a day, too, if not even more.
Another very important thing I did before I left was just to take it easy. Stress is a huge trigger for me, so staying stress free and relaxing helped a lot with maintaining my health. It also helped me keep my fatigue little to none.
On the planes
I made sure everyone on the trip was aware I have Crohn’s. I personally do this with anyone I meet in case I have any unexpected symptoms. It’s easier just to acknowledge the elephant in the room than trying to hide it. There’s nothing to be ashamed of at all. If anyone isn’t OK with it, then that’s someone you don’t need to have in your life.
I had to be at the airport to catch my flight to JFK at 8 in the morning. I had a hard time sleeping because of the excitement, so I definitely recommend anyone else who struggles with the same symptoms to take a sleeping aid so you have a good amount of sleep while you can. Chances are, you won’t sleep on the plane for long.
At the airport, I started getting those nervous/excitement butterflies in my stomach, which kept sending me to the restroom. As always with the typical “Chronie” (a nickname in the IBD world of someone struggling with Crohn’s disease), spot your restrooms everywhere you go. Get your friends on board with it too. It’s just like “Where’s Waldo?”
I made sure not to really eat at the airport too heavy so I wouldn’t have to go to the bathroom on the plane. I didn’t eat any unhealthy snacks or fried foods. Luckily, I made it through both plane rides without any issues.
Culture shock
When we landed, we immediately met up with our tour guide, Matteo Troiani, who immediately took us on a walking tour through Rome. Everyone was extremely jetlagged, but the tip is to stay up the entire day to get through the jet lag.
One thing we take for granted here is that we are free to use public restrooms. In Italy, you have to pay to use public restrooms. The price is usually 50 cents or 1 euro. I always made sure to have coins on me for that reason.
Restaurants or businesses will not let you use their restroom unless you are a paying customer. Any time you are a paying customer somewhere, whether a Crohn’s sufferer or not, ask to use the restroom whether you have to go at the time or not. Chances are you will still go.
Food
Italy is most known for their pasta, pizza, gelato and coffee … all foods that are major triggers for me.
I just want to say that I ate so much of everything, and I was completely fine. I’m not really sure how, but I believe the freshness of the food was a huge factor.
Everything was made fresh, and I believe, and that’s what saved me. I also made sure to take my medication on an exact schedule.
I was just careful with my portions as well. I don’t really eat much as it is, so going from that to multiple coursed meals was tough. If I couldn’t finish my dish, then I didn’t.
Fatigue
Our schedule was so jam-packed. We had no time to waste.
I got about six or seven hours of sleep a night along with multiple power naps through the day.
I napped anywhere I could: on the bus, trains and lobbies mostly. When we went city to city, we had about a three-hour bus ride at a time, which everyone took to his or her advantage. If we had a media visit and were waiting in the lobby, I napped.
Power naps will get you through the day. So will espresso.
The unexpected
As I said earlier, alcohol isn’t often a trigger for me. This time, it was.
I casually and socially drank in Italy. I had no problems until the last night in Rome. We went to a cooking class where we made our own pasta and at the end, we ate it as a group dinner.
When we were served, we didn’t get a large portion. To be honest, the cream sauce upset my stomach, but I drank wine anyway. We were served limoncello at the end, but I didn’t drink it because I do not like it.
From there, we all went out to a bar as a group to drink. I ended up drinking a couple drinks and began violently vomiting after leaving the bar to the point where an ambulance was called. Then I woke up in an Italian hospital.
In the hospital, the doctor said it was due to my Crohn’s and gave me some fluids because I was extremely dehydrated.
They said it could have been a combination of bacteria from everyone touching the pasta, the sauce upsetting my stomach, not enough food, mixing alcohol, medications with the alcohol, and my body just needed to get rid of everything.
It was weird because I casually and socially drink just like this any other time. My friends said I drank more than what I remembered, so the alcohol hit me a lot more than it usually does.
I was released in a couple hours, but I was out of it for two days. I didn’t really drink much of the rest of the trip because I was scared of that happening again. Just like anything that upsets me, I treat it with humor.
I’m just really grateful for the amount of love my friends gave me and how much they cared. Specifically, I’m very thankful for Casey Hoolahan coming with me to the hospital and Matteo, our tour guide, for meeting her there. Everything was in Italian so without Matteo, we wouldn’t be able to communicate effectively.
Luckily, I was fine and was able to finish out the trip.
Top 5 tips:
- Buy traveler’s insurance.
– Just in case. Anything can happen. Thankfully, Point Park covers us with full travel insurance on these trips.
- Always have a change of clothes with you.
– Accidents happen.
- If you don’t feel good, tell someone. Don’t try to hide your symptoms.
- Always find restrooms before doing anything else.
- Bring a water bottle.
– Staying hydrated is a major factor with digestion.