Charities supporting people with gastrointestinal issues have praised Transport for London’s new funding for public toilets, but say more needs to be done to raise awareness of these conditions.

In October, TFL unveiled the first phase of their plan to introduce more free-to-use and accessible toilets, in addition to the refurbishment of existing facilities.

Camden Road, Clapton, New Cross Gate, South Tottenham and White Hart Lane Overground stations are all due to be refurbished in the first round of changes.

Toilets in Morden and Hammersmith Underground stations will be upgraded in the same phase.

TFL are also planning on making current facilities within its tube network to be more accessible.

Toilets at Amersham, Green Park, Seven Sisters and Sudbury Hill stations will be changed within the first phase of the project.

They say they are “committed to making toilets more accessible for everyone”, aiming to ensure that passengers and staff are always within 20 minutes of facilities.

Public toilet on a busy street in Kensington.
Public toilets in many London boroughs were not refurbished when their life expectancy ended in 2023

For those with gastrointestinal conditions (GI conditions), this announcement is a welcome one.

Charities call for a ‘complete rethink’ on public toilets

Travelling away from home can massively affect those suffering with conditions like irritable bowel syndrome (IBS), Crohn’s, ulcerative colitis and people living with a stoma.

Alison Reid of The IBS Network says that a “complete rethink” of toilets outside homes is needed.

She represents people with IBS, a chronic digestive condition that causes a variety of symptoms that are often hard to manage while travelling away from home.

Anxiety around public toilets is an added stress. Geraldine Cooper, presenter of Crohn’s and Colitis UK: The Podcast says that nine out of ten people with GI conditions plan journeys based on public toilets available, often increasing fear and isolation among the community.

70,000 Londoners live with inflammatory bowel disease (IBD), with many needing to use public transport each day, which can often lead to stress.

Lack of awareness among businesses to help those with GI issues

The charities who spoke to City News said they issue an ‘I can’t wait’ card that can be shown to businesses to use toilets that may not be available to the public. But a lack of awareness of this pass can mean that individuals aren’t able to access toilets quickly.

Another element of this anxiety is the urgency experienced by those with GI conditions often meaning toilets need to be used quickly.

Giovanni Cinque from Colostomy UK says “signposting is key”.

“Its not only just having [toilets] but its really good signposting and its clarity of where people can use these toilets”

Giovanni Cinque, Colostomy UK

Symptoms of IBS can be worsened by anxiety, creating a vicious circle of discomfort for sufferers, says Alison Reid from The IBS Network.

She adds that this “trigger” can result in a reluctance for those with IBS to go anywhere new or leave home.

“[People] can be reluctant sometimes to leave their own home, and their job and social life [means] their life gets smaller”

Alison Reid, The IBS Network

Fears over using public toilets

Social exclusion is huge concern for GI charities.

Colostomy UK report that 62% of respondents to their survey are impacted by a lack of public facilities in their everyday life.

But one in four people living with a stoma who were surveyed admitted to not wanting to use accessible toilets, fearing the judgement or aggression from people for not appearing to be disabled.

“That’s another reason that [this can] stop people from going out because they don’t want to use an accessible toilet. That’s over 50,000 people [living with a stoma] who don’t want to use an accessible toilet because of the attitudes of other people”

Giovanni Cinque, Colostomy UK

Colostomy UK hope that these new toilets will ease this problem, but has called on the government to introduce new legislation. Currently, local councils have no statutory requirement to provide any public toilets.

“There needs to be… in the planning legislation…a space put aside for public toilets in all large new buildings in and around every major city and town”

Alison Reid, The IBS Network

a sign from tower hamlets council saying that cafe toilets are free for all the public to access
Campaigners say that businesses should be encouraged to open their facilities to the public, especially those who suffer with a gastrointestinal condition.

All four charities that City News spoke to said that a general decline in available toilets, both public and those within local businesses, is detrimental to those with GI conditions.

Crohn’s & Colitis UK said that TFL’s plans not only benefit not just their members but everyone, especially the elderly, pregnant women and those with children.

“I use London Transport all the time, I have colitis and I know it can be really, really challenging. I think more toilet provision, and more accessible toilets can only be a really positive thing”

Geraldine Cooper, Crohn’s & Colitis UK

Charities say that a “lack of awareness”, coupled with increasing closures of public toilets and a lack of willingness from businesses to allow visitors to use facilities, means that many people with a variety of GI conditions can be left isolated, shameful and anxious.

Alison adds that we need to start having “adult conversations” about GI conditions, rather than being embarrassed about them.

For support, or to learn more about bowel conditions, visit these charities’ websites:

The IBS Network

Crohn’s & Colitis UK

Colostomy UK

Guts UK