Irritable Bowel Syndrome (IBS) and a Debate on “Can’t Wait” Cards

Earlier this week, an anonymous blogger, who apparently has IBS, posted a thought-provoking entry entitled “The IBS Card– Good or Bad Concept?” Such cards are also popularly known as “can’t wait” cards and are sometimes offered to members by organizations representing various medical conditions that frequently cause an unpredictable, urgent need to use a toilet. The design of the cards varies with the individual organization, but generally, such cards state that the person has a medical condition and politely asks others to allow him or her to use the restroom or washroom immediately. While they do not confer legal protections in most localities, the cards are meant to assist people with relevant medical conditions who carry one to communicate their need quickly and courteously, perhaps forestalling lengthy public explanations. Because these cards also usually have the logo and/or contact information of the issuing organization, presumably those who are shown a card may perceive a bit more legitimacy to the request, and it becomes an awareness tool as well. In the IBS community, “can’t wait” cards are known to be offered by the IBS Network in the United Kingdom and the Irritable Bowel Information and Support Association in Australia (IBIS). To IBS Impact’s knowledge, they are not currently available through IBS organizations in the United States or Canada, though the concept is widely used by various inflammatory bowel disease (IBD) organizations and also the Interstitial Cystitis Association in the U.S. Interstitial cystitis is a chronic, painful bladder condition that is among several conditions commonly known to overlap with IBS.

The author of the post in question appears to believe that “can’t wait” cards are not a good idea for IBS, wondering if the average person would really allow someone with a card to move ahead in a line or queue for a public toilet, as everyone in line has a need to use it. He or she also states,”IBS is generally a very personal and embarrassing condition, thus advertising it with a card seems peculiar.” Later in the post, the blogger writes, “Without doubt many people would think the IBS card a good idea,  although it does sound as though it was created by people who thought it would be a good idea, but did not consult sufferers.”

Julie Thompson,  registered dietician and advisor to the IBS Network who writes the Clinical Alimentary blog and is also known by the online handle Jules_GastroRD, left a comment on this blog entry which offers a counterpoint. She states that using a “can’t wait” card, if available, is a personal choice, and that such cards may help people with IBS gain access to toilet facilities usually restricted to staff. She also notes that other organizations offer these cards with apparent success, as mentioned above, and asks if the anonymous blogger knows for a fact that people with IBS were not consulted regarding this issue.

From IBS Impact’s own interactions and advocacy in the IBS community over time, it is clear that, as with almost everything concerning IBS, responses vary greatly among individuals. The question of why “can’t wait” cards specific to IBS are not available in the U.S. or Canada comes up periodically in other  IBS forums and in incoming searches and inquiries to this blog and the main IBS Impact site. This blog’s posts on the Restroom Access Act, also known as Ally’s Law, which address medical conditions and employee-only restrooms in thirteen U.S. states, are among those that generate relatively high numbers of hits. (See February 21, 2012, August 20, 2012 and November 2, 2012) Yet, we have also received feedback from some people that they do not know if they would use such a card, or that they have one for another condition or in a country where IBS-specific cards are available, but rarely or never actually use it. When IBS Impact has raised the issue in the past of if members or supporters would be interested in having cards made available in more countries,  as of yet, there has never been a critical mass of responses one way or another. But this small debate between bloggers is the impetus to ask some questions of our own and to consult our peers with IBS, as suggested by the original blogger.

What do you think? Is the concept good or bad?  Do you or would you choose to use a “can’t wait” card?  If not, why not?  Is IBS truly different from or more embarrassing than other medical conditions with “bathroom issues?” Readers are invited to comment on this post. As always, you do not need to leave your name, although you are encouraged to do so if you wish. First-time commenters are automatically moderated to reduce the spam and hoaxes commonly received by blogs, but varying opinions from real IBSers are always welcome.

14 Responses to Irritable Bowel Syndrome (IBS) and a Debate on “Can’t Wait” Cards

  1. I carry mine and find it helps when faced in situations where I am usually in a state of panic that I come across as a little manic and therefore cant communicate well! Immigration lines, TSA lines are examples where I have used it. It offers legitimate proof of a concern and though I haven’t had to use it to jump to the head of a line of a ladies restroom, it provides just that little bit of comfort in this debilitating condition.
    I’ve had it for many years and have improved my ibs greatly through fixing my gut brain axis, sibo, parasites, diet and stress management. It is now my profession and I help other high achieving women.

    • Angaston says:

      I think it is a great idea and I will be using one of these cards in the future. I have had, what I would describe as terrifying moments when I have been in the middle shopping at a large supermarket and having no warning what-is-ever and having to beg a shop assistant to use the loo. This has happened many times and my worst nightmare is not making it in time because I would be forced to look elsewhere and therefore having an extremely embarrassing “accident” in front of everyone. My condition can be set off with just the movement of the car… It’s just horrible & it makes it very hard to join in socially out of the home… So I think the “can’t wait card” is a yes from me.

  2. Laura says:

    I need one, I’ve found myself not going out in fears of getting sick. It’s miserable and there are so many places downtown in my area where they only have employee bathrooms.

    • ibsimpact says:

      Some of the U.S. states with Restroom Access Acts/Ally’s Law regarding employee bathrooms accept doctor’s notes to the same effect. See the link for the February 21, 2012 post in the post above.

  3. Kathleen zumbach says:

    I’m looking for can’t wait card

    • ibsimpact says:

      As of May 2014, the IBS Network in the UK and IBIS in Australia offer these to their paid members. No IBS organization in the U.S. or Canada offers one, although IBSGroup.org online support group based in Canada but reaching readers worldwide, offers a smartphone download. Crohn’s and colitis organizations and the Interstitial Cystitis Association in the U.S. offer them if one has one of those conditions. Finally, several U.S. states with “Ally’s Law”/Restroom Access Acts will accept a doctor’s note for this purpose.

  4. Tori says:

    I don’t have IBS. I have IBD. I have Crohn’s disease. I’ve been hospitalized 19 times in just a few years and faced multiple emergency surgeries.

    I find it amusing that this person believes that showing the card to help people understand why you MUST cut in front of them is more embarrassing than having bloody poop run down your legs in public.

    If I need to get into the bathroom… I’m going to cut. The card helps people to see that I have a medical problem and not just an urgent need for a bathroom like everyone standing in line does. The CCFA card is great. It motivates compassion and understanding vs judgment.

    Apparently the writer of the blog who thinks the card is embarrassing isn’t really struggling all that much.

    • That was the same thought I had had. I don’t understand how showing a card and jumping a line is more embarrassing than having an “accident” (and in my case likely a panic attack)… or just succumbing to the only other ‘solution’ – never going out! I think the card makes all the sense in the world. I’ve often thought of having one of those medical bracelets like they have for allergies, that could just be waved. Even if I never used one, I think having one would be worth it, just for the peace of mind it would bring!

  5. Anonymous says:

    hi just wondering where to get these “CANT WAIT CARDS” i’m in australia and i suffer from ibs???

  6. rpsabq2014rpsabq says:

    “Ally’s Law” like many of the “Named Laws” is as a result of a very rare, unfortunate situation. We can’t legislate human decency. Creating laws over such instances only causes needles panic and suggests that it is a common occurrence. I personally have never had a problem with being allowed access to a restroom. The only reason why such access is not automatic is because of OTHER laws that require expensive ADA compliance and cleanliness standards of Public Restrooms – punishable by fines. So we really get ourselves in the way of each other when we try to legislate human decency. Usually i am not so panicked that I can’t muster a low-voiced “Hello, I urgently need to use your restroom.” If I need to use it so bad that i don’t have time to actually ask, I just go right in. Asking, it seems to me, takes less time than showing some strange card that takes time to first identify and then read. I mean, i’m not mute, i just have to really use the restroom NOW. Maybe the card would be good if the person were on the phone or helping someone else, but again if that is the issue, i just go on and go in. I’ll explain and get yelled at later.

    • ibsimpact says:

      Thank you for your comment. If there has always been an immediately visible, accessible and unlocked restroom available for you to “just go right in” any time you have had urgent needs, then you are indeed fortunate. Although this particular post was published about 4 1/2 years ago, it and several other posts on restroom access issues have remained in the top 10 posts every year since, so it appears denial of immediate access to a restroom is not a “very rare and unfortunate situation.” For additional context, this blog reaches over 130 different countries and territories, and in most of them, there are no known laws mirroring the original Ally’s law in the U.S. state of Illinois, and as of this writing, in February 2017, there are similar laws in a only about a third of U.S. states. Although most were modeled on the Illinois law originally spearheaded by Ally Bain, each was a decentralized effort by advocates in each separate state over many years, so this was not Ms. Bain’s issue alone.

      There is no known evidence that refusals of business owners to grant access to restrooms to people with medical urgency (which includes a wide variety of bowel and bladder conditions, not just IBS, or IBD, as Ms. Bain and most public advocates for these laws have) are the result of backlash against the Americans With Disabilities Act (ADA). The ADA actually does not address anything relating to the public’s use of employee restrooms as the restroom access act laws do. The relevant ADA requirements on public restrooms involve architectural access. However, other provisions of the ADA, such as employment, access to public services and public accommodations could apply to people with disabling degrees of IBS in other contexts. According to the ADA Amendments Act of 2008, clarifying language was added to specify that the ADA can apply to disabling conditions that come and go intermittently, include disorders of bodily function like digestion, and that mitigation by medication or other means do not disqualify one as disabled. Several people involved with IBS Impact over the years have or had other disabilities or medical conditions in addition to IBS, and IBS Impact unequivocally supports the ADA and similar disability rights/equal access laws or advocacy in other nations.

      As for Can’t Wait cards, the IBS Network in the United Kingdom, and the recently defunct Irritable Bowel Information and Support Association in Australia have provided cards to their members for many years. U.S. laws such as the Restroom Access Act laws and the ADA do not apply in other nations. In the U.S, Can’t Wait cards are not in wide use in the IBS community as this is not a service that organizations that cover IBS provide at this time. Such cards are known to be issued by inflammatory bowel disease organizations and some organizations for bladder disorders in the U.S. for people with those conditions, which some people with IBS may also have.

  7. Lisa says:

    I have had IBS for over thirty years and three years ago had my gall bladder removed. I have very little notice when I need to go to the toilet. I have experience so many embarrassing incidents when I have had literally ran out of time locating a toilet let alone found one and it was closed for one reason or another. I was not aware of this card but I will be getting one and will be happy to carry and use when I know that on a very bad day the alternative is a panic attack followed by a deeply embarrassing situation.

  8. Karen says:

    I am thinking of getting an “I can’t wait card” as I have IBS and sometimes have barley made it, I do panic where the nearest toilet is and sometimes when shopping know there are staff toilets but no public ones, I hope not to have to use it but it will be there in an emergency

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