Japan and IBD

I recently spent 3 weeks in Japan, and I wanted to write about my experiences in case it'd help anyone else with IBD who is thinking of travelling to Japan. I should note that I was mainly in Tokyo, Kyoto, and I also spent a bit of time in (rural) Ibaraki prefecture, so I can only attest to what I experienced in those areas.

The toilet situation

There are two types of toilets in Japan. There are the western-style sit-down style toilet that we're all used to. These are very good - the vast majority of them have a lot of nice features such as heated seats, heated bidets with multiple settings, and will play the sound of rushing water to cover up any sounds you make in the bathroom. The heated seats and bidets were just plain wonderful and I am now shopping around for a heated seat for my home toilet.

Unfortunately though, there are also the squat toilets. (I'm a female, so I'm not quite sure what the situation is in the men's room when it comes to toilets.) The squat toilets are horrible. It's basically a trough in the ground that you squat over and do your business. Some of them have the rushing water sound but no bidet and obviously no seat! Also, we women don't exactly have the ability to aim our urine streams, so as a result, the floor in the squat toilet stalls was sticky and wet and disgusting. I did have to use a few squat toilets, and mainly I tried not thinking about standing in strangers' pee while I also tried to not pee on my own shoes. It was not a fun time.

Sometimes squat toilets are your only option, so be prepared to have to squat a few times if you visit Japan - if you have joint issues, keep that in mind as it may be a painful or downright impossible time. In particular, the Kyoto train station, which was large and modern, only seemed to have squat toilets which was surprising to me. Typically the more modern places will have western-style toilets, but not always.

I should also mention the soap and paper towel situation. As in, many public bathrooms do not have soap and almost none of them have paper towels. Some will have hot air hand dryers but a lot don't. And the lack of soap was just plain distressing. There were sinks in every bathroom so you can at least rinse your hands, and I just started bringing soap with me because I hate not being able to properly wash my hands. I would find myself very happy if I lucked into finding a public bathroom that actually had soap and it was like winning the lottery if it had both soap and paper towels! Get used to drying your hands on your pants, and carry soap or hand sanitizer with you.

Oh, and the toilet paper situation is the other thing I should mention here. They apparently only have extremely thin, flimsy, not soft, 1-ply toilet paper in Japan. I presume that the thinking must be, that since many of the toilets have bidets, that they don't really need nice toilet paper. If you like nice toilet paper, though, you may want to bring your own with you from home. When I got back to the US, I nearly shed a tear when I used the bathroom in the Chicago airport and the TP was so much nicer than anything I had used the entire time that I was in Japan.

Long story short - western toilets good, squat toilets bad. Bring soap. Japanese TP bad.

The food situation

I travelled to Japan with my mother. She and I each have different food issues so that was interesting (I mainly don't do red meat or much dairy - she is gluten-free and she also avoids soy, and it turns out she also has an allergy to raw fish).

Japanese food was very easy for me but very difficult for my mother. I was able to do a lot of things without any trouble - I had a lot of sushi, tempura, noodles, rice. All of it was very easy on my digestive system.

My mother, on the other hand, had a very difficult time finding foods she could eat. It turns out that gluten is added to most restaurant foods in Japan (even things like rice balls had added gluten which is perplexing, and soy sauce is added to many foods as well). The one reliably safe gluten-free food that she could have was sushi, as long as it was cooked AND soy-free. This meant mainly cooked shrimp sushi. She ate a lot of cooked shrimp sushi just because it was safe and easy to come by.

We also found that, if your hotel has a fridge, then a grocery store might be better than a restaurant. My mom was able to get things like hardboiled eggs and fruit from convenience stores, and salads without dressing from grocery stores. If your hotel has a kitchenette with a microwave or stove, even better. My mom had brought herself some safe gluten-free instant oatmeal packets from home, and she had those for breakfast many days when we had access to a microwave.

If you speak/read Japanese or are travelling with someone who does, then things should be much easier for you. We met up with an old friend of mine from high school who now lives in Japan and he is fluent in the language. He found us a restaurant for dinner which had vegan, gluten-free, soy-free "ramen" (I say ramen in quotes because it was pretty far removed from actual ramen, but my mom said it was delicious anyway - I had standard, actual ramen). Having someone who can actually read Japanese and can read the menu was a huge benefit, but unfortunately we only had one day to hang out with my friend as he had to work. If you're not fluent in Japanese and you can't do gluten, you're going to have some challenging times finding food you can eat. If that's the case, make sure to bring yourself some safe snacks, and seek out sushi bars or grocery stores whenever possible.

But if you're like me and gluten isn't an issue, then Japanese food should be great! I really loved everything I ate and it all sat very well with me.

Walking

If you go to Japan, be prepared to walk a lot. The trains will take you to most places that you want to go, but you will have to walk to and from the train stations and to and from your destinations. We ended up averaging about 8 to 10 miles of walking per day, even in Tokyo where trains are plentiful and frequent. If you have joint issues and/or aren't able to walk a lot, Japan may not be the destination for you.

Also, be prepared to stand on the trains a lot, particularly when you're in the larger cities and/or during the busy times of day (rush hour). It's not easy to find an open seat on the trains especially during the busy times, so you may need to stand the entire time that you're on the train. Sitting turns out to be something of a luxury in Japan.

Accessibility

Japan has a lot of accessibility when it comes to blindness. There are bumps on the sidewalk for the blind to feel with their feet, and the "walk" signal and train stations make noises intended to signal blind people to walk or enter the train station.

But for some reason, Japan does not have a lot of accessibility when it comes to wheelchairs or mobility issues. There are many stairs and there isn't always a ramp or an elevator. I'm not in a wheelchair (I have mild arthritis in my hips but most of the time I can get around fine without my cane), but even so, I was hauling around a heavy wheeled suitcase at times, and I would have to lug that big heavy thing up and down stairs fairly often. If you are in a wheelchair or cannot do a lot of stairs, you might want to look into destinations other than Japan. In particular, there are many ancient temples which have very steep stairs and no ramps. If you want to visit temples or shrines, be prepared to walk up and down a lot of stairs.

Final Thoughts

I loved Japan and I'm so glad I went. I really loved the food. The people of Japan are very friendly and polite, many of them speak at least some English and they are generally extremely helpful and kind. The atmosphere was also wonderful - we went during cherry blossom season which was beautiful, and we went to many parks and gardens which were gorgeous. I loved Tokyo and Kyoto. But, if you have mobility issues or need to avoid gluten, Japan might be a challenge. I'm fortunate that my own specific health issues didn't get in the way too much during my trip, and as a result I was able to have a wonderful time. I would definitely go again if I had the chance.

Thank you for taking the time to share so much info. My husbands company is based Japan and he keeps hinting that there's a possibility we could do a 6-12 month stint there. Gah!

Nancye50, I hope you have a wonderful time if you do end up living there for awhile! I really did enjoy it in spite of the few challenges I encountered. The language barrier is daunting for sure, but hopefully if you end up living there then you'll quickly pick up some of the spoken side of Japanese (I definitely picked up a few new words just from being there for 3 weeks). And hopefully living there means you'll have a normal western-style toilet at your residence and can avoid the icky squat toilets!

My parents are going on a 3 week trip to Japan. They leave early next month. I'll pass on the bathroom warnings!

Beach, I hope they have fun on their trip! If they don't already know, "Toire wa doko desu ka?" is how to ask "where is the bathroom?" in Japanese. It was my experience that most Japanese people spoke at least some English, though, so your parents should be okay even if they don't speak any Japanese.

Awesome!