No, I Can't Wait!

While irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), which encompasses Crohn's disease and ulcerative colitis, differ in very significant ways, there's nevertheless a bit of overlap in terms of certain symptoms, pain, and general quality of life, especially when comparing severe cases of IBS with milder cases of IBD. ​

The prognosis and treatment for these two conditions are also very different. In addition, IBS cannot progress into IBD and doesn't increase the risk of colorectal cancer, mucosal inflammation, or the need for surgery, or cause structural damage or other complications the way that IBD can. However, some researchers believe it's possible to have both IBS and IBD simultaneously, although this remains controversial. Also, because a few of the symptoms of these illnesses may parallel each other, IBS and IBD can share similar day-to-day challenges.

One thing all people with IBS and IBD have in common is that their symptoms, triggers, and paths of illness are unique to them: no two people with IBS or IBD will have identical experiences. And that is precisely what can make these conditions so exasperating to live with, diagnose, and treat.

A common symptom both illnesses (especially ulcerative colitis and IBS) often share is an urgent need to use the bathroom. For some individuals with IBS (such as IBS-C and IBS-M), the outcome of urgency may not necessarily be diarrhea; it may be a relatively "normal" bowel movement, but the concern is reaching the toilet before there's a mishap. Because the painful abdominal pressure that precedes a bowel movement for many people with IBS and IBD, it's not always clear beforehand if the end result will be "air, land, or water." And that can be pretty scary, especially if we're out in public and don't know where the nearest restroom is or how available it will be when we're in a crisis situation.

Allyson Bain, a woman from Illinois who has had IBD since childhood, helped write a bill called the Restoom Access Act, also known as Ally's Law, as part of the Americans with Disabilities Act. She lobbied for the bill when she was just fourteen years old, after she was denied access to the bathroom in a retail clothing store and ended up having an accident. The bill was unanimously passed in the Illinois House of Representatives and Senate and signed into law in 2005. The law requires that businesses must allow people with medical conditions or pregnancy to be permitted to use employee-only restroom facilities. The following states currently recognize Ally’s Law:

• Colorado
• Connecticut
• Delaware
• Illinois
• Kentucky
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Ohio
• Oregon
• Tennessee
• Texas
• Washington
• Wisconsin

Under Ally’s Law, people with proper documentation cannot be denied access to a business owner’s private restroom if there is more than one employee present and working. A few small businesses have fought to block the bill in some states, mainly because of staffing concerns.

Some organizations issue "I Can't Wait" cards upon request, but these have been mostly geared toward people with IBD, not IBS. These cards can be presented to the staff at restaurants, retail stores, and other business establishments to help facilitate immediate admission to a private bathroom. The British-based IBS Network has created a card specifically for IBS sufferers, but you need to be a member of the organization to purchase one. Fortunately, the IBS Self Help and Support Group also has created a free card that you can use right on your cell phone:

1. On your phone's browser (Safari on an iPhone or Chrome on Android), go to www.ibsgroup.org/i-cant-wait-card.
2. Turn your phone sideways after loading to see the complete card on the screen.
3. Bookmark this URL in your browser or take a snapshot of the screen so that you have the card available in your photo library.

You could also print out the card and put it in your purse or wallet, if that makes it handier for you to use it in an emergency.

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The "I Can't Wait" cards aren't without controversy, however. Some people have wondered whether the average person would really allow someone with a card to move ahead in a bathroom queue for a public toilet, since everyone in line has a need to use it. Others have stated that IBS is a very personal and embarrassing condition, so advertising it with a card only would only draw attention to something we'd rather not announce. But in terms of quality of life, a card could make the difference between shuttering oneself up at home or getting out and socializing.

Although our illnesses may differ, people with IBS and IBD can benefit equally from the passage of Ally's Law in every state and seeing the Restroom Access Act legislated on the federal level. If you live in a state that recognizes the Restroom Access Act and you have a condition that is covered by that law (the law varies from state to state), you have the right to access a restroom in an emergency. If you are denied access, contact your local law enforcement agency, which may be empowered to issue a citation. If local law enforcement does not enforce the law, contact your mayor, your county executive, your local state house or senate representative, or your other local elected officials. If your state doesn't currently support Ally's Law, petition your elected officials to get the bill enacted.