Toilets - General & Specific

There are a number of apps to find toilets. Try https://pee.place/en/l/Italy/Apulia/Barletta-Andria-Trani/Barletta to get started. Good luck!

I have never seen a Regional train with no toilets and, before reading your message, I admit I have never thought of the possibility of a train where people are forced to hold it for hours. It would be quite funny to see all these people keep quite while trying not to... is it common in your country's train system? The final crackdown on train picnics, at last!

The Circumvesuviana to Pompeii has no toilets, but it's like an overground metro that stops every 5 minutes. Same for the old FSE trains departing from the back tracks at Bari Centrale, toilets were always out of service, but those old trains have been all scrapped now.

Bring wet wipes, toilets will be dirty by the end of the journey

We will be travelling Barletta - Napoli via Caserta.

The Barletta-Caserta leg is served by 5 daily Intercity and Freccia trains, there are no Regionale trains making that route You'll take a Regionale from Caserta to Naples.

Dario, some of us live in areas where there is literally NO passenger train service, so we don't know what to expect.

Jane, I’ll add that not only does Amtrack not go near Phoenix, but freeway rest stops are an hour apart if they are open. With IBS that can be disastrous.

I had brought my family to Venice and we were walking the city at night. I had no idea that my diet affected my bowls :-)
It was very hard for me to find a WC.
You, at least, know "what's up" and there are apps to help.
Blessings on you.

Specific to your situation, some thoughts:

Trains: As mentioned, nearly all trains have some type of toilet, except for some commuter lines. Stations, except for the very smallest ones maybe, have toilets. As was suggested, carry wipes and hand cleaner with you, as well as change, in case they are pay toilets or have an attendant (Can't recall if this is prevalent in Italy).

General about town: Museums are dependable toilets, but I recall few public toilets in general areas. Most businesses restrict use to customers, just asking may yield permission, if the place is busy, acting like you belong there lets you waltz right in, stopping for a coffee or drink would get you toilet rights.

Basically, planning out your timing of availability, making stops for breaks, mixing in museums, should give you enough windows of "opportunity" to manage. While maybe not something you use now, considering wearing one of the products available for incontinence, might be considered a back-up. One thing to consider, is that most people suffer some disruption to their digestive system when travelling, from new bacteria to just time difference, it may take a few days to figure out how you will be affected.

Especially in Italy, always carry toilet paper with you. It is often missing from public toilets. Many seem to be stocked in the morning and ignored for the rest of the day. There is often no way to dry ones hands, which leads some people to use toilet paper for that purpose, which no doubt contributes to the problem.

Not being a coffee drinker (usually the cheapest available drink) and always having my own water bottle with me, I have sometimes stepped into a bar, placed a 1-euro coin on the counter, and asked, "Toilet?". If that didn't work I'd just buy a bottle of cold water.

I used to have your problem for a couple of years when I started eating Greek yogurt daily sometimes multiple times a day (I stopped that practice once I discovered it was the cause of my problem). For the couple of years I suffered that condition before I discovered the cause, traveling to Europe was a big problem, but not on the trains. Actually that was a time of relief, because all train cars have two restrooms, on each side of the car (front and back), and you can easily walk from train car to train car, therefore there will be no place where you’ll have so much choice of restrooms. A typical high speed train (12 cars) will therefore have 24 restrooms. A European train is truly an intestinal paradise.
My problem was actually airplanes, because airplanes have few bathrooms and often busy enough that you have to wait in line.
Another issue might be while you sightsee around town. Public restrooms are not always easily available, therefore you need to always be aware of the closest coffee bar, they are ubiquitous in Italy and as long as you buy something, even a glass of miners water, they’ll let you use it.
Another resource are hotels, especially large ones. If you are in a museum, they’ll have facilities, often in better condition than most places.
Of course always have extra tissues/paper and also wet wipes with you.

I just wanted to add that if you use any kind of OTC meds in addition to your prescription meds, be sure to bring a generous supply. They do not allow the sale of PeptoBismol and Immodium is very hard to find (not sure if that is not within EU regulations either).

My SIL got (I suspect) norovirus on the plane on our first trip to Italy and went thru all my brother's small stash of Immodium and my Pepto so now I take enough for about 3 people, lol.

Have a wonderful time!

This last trip to Italy, in September; I was very pleased to see more toilet paper and paper towels....and soap!!.. in nearly every bathroom we came across.
More than in previous years, that is.
But I would still carry TP or tissues, and hand sanitiser or wipes with me at all times, just in case.
If you are prepared, you will be just fine.
In cafes/bars: just buy a bottle of water first, then ask to use their toilet.
If you don't want to drink the water, you can at least use it to wash your hands with!

They do not allow the sale of PeptoBismol and Immodium is very hard to find

"They" may have no idea of what PeptoBismol is, but any Pharmacy will sell you Bismuto and Loperamide Cloridrato (aka Imodium). Next time note down the name of the medicine and the active substance it contains and give it to the pharmacist. Different pronunciation and names may have been the problem, but Imodium is sold in Supermarkets as Imodium these days.

Thanks Dario, I'm sorry I gave wrong information. When my SIL was sick in 2013 in Rome our RS tour guide said Pepto-Bismol was not an allowed medicine. My brother took the box with him to the local pharmacy, then the guide went back with him to help translate and he could not get either for his wife. They did have an herbal liquid they sold him for her but we were not successful in getting her to try it.

It wasn't a pharmacy, the herbal reference makes me think at some homeopathic herbalist. Really Bismuto and Imodium are two medicines that can be freely sold without prescription at any pharmacy.

Medicines containing Bismuto Subcitrato (Aka the strong stuff inside PeptoBismol) are seen as jurassic in the EU and may be "prescription only" like Allergan's Pylera, but not Imodium. Imodium can be easily bought also online: https://www.efarma.com/catalogsearch/result/?q=imodium

I'm in Italy right now. To get specific for someone with IBS (I have a dear friend with same): Some of the regionale trains that I've been on only have three cars and there is only one toilet. Do bring not only your own tp, but also a supply of paper toilet seat covers if you will want to actually sit down. You may need them for some bars and restaurants, too. (All such establishments will have toilets, but not all toilets will actually have plastic or wooden seats on the ceramic basin.)

I always find astonishing that Americans think wood and plastic to be more hygienic than porcelain. Restaurants do not substitute broken plastic seats because nobody uses them.

Have always been mystified bu the idea of covering the loo seat, cant for the life of me work out what it achives.

As has been stated, Immodium is widely available but also are the supermarket brands that contain exactly the same ingredients but at a fraction of the price. You won't find Pepto-Bismol but you will find more palatable alternatives that are just as effective.

IBS can be managed when travelling on Italian trains albeit not an ideal experience.

It has been a while since I traveled on Italian trains. But it is not a silly question. In France I have been on many trains where the loos are locked. on the long haul TGVs there are always toilets but on trains that are regional and may have trips as far as an hour or two, there are often no available toilets. I discovered this on a trip where we were. a bit late to the station and I thought 'oh i'll just go on the train' -- and then discovered no toilet available for an hour train ride. When we arrived at the small station, there was no available toilet at the station. The one loo was locked and 'broken' and I was headed for the woods when we finally spotted a cafe.

If you need frequent toilet access it is best to be proactive and yes always carry OTC meds. In Italy you can go into any cafe/bar and use the head -- it is expected you will purchase something.

You've received excellent information and advice here. The links provided should be very helpful.

As a person who has lived with IBD ( Crohn's Disease/Ulcerative Colitis) for about 40 years, I definitely can relate to your concerns. In spite of 2 surgeries and only having about 3 feet of colon, my IBD is well-controlled with a very expensive, not yet generic drug.

Essentially, I function normally. But I still take the smallest bottle of Pepto Bismol pills I can buy on every trip. Even people with normal guts can get out of sorts by the time change, different water (not bad, just different) or food that may be a little off. I've actually only used the Pepto twice in over 315 days of European travel since 2009, but I was sure glad I had it those 2 times.

Based on my experience, trains are not the major thing to worry about. Access to toilets on buses and when out and about can be a bigger issue.

Many have given advice as to how to deal with that. Mine is that anytime a toilet is available, use it! That's even if you don't think you need to. You never know if one will be nearby when you really, really need it.

Unlike Roberto, I eat yogurt every day to try to keep my gut happy, Greek at home, whatever's available in Europe. That might or might not work for you.

About the toilets themselves:

Although not so common these days, you could still occasionally encounter squat toilets. On my first trip to Europe in 1977, I always chose those because there was never any line. At 74 this month, my ability to use them is long past.

And I agree with the person up thread who prefers plain porcelain to any other option. It may not be as comfortable, but at least people don't line it, then not make sure that the liner flushes. Pet peeve here, in the US and Europe.