Why South Africa Is the Best Country to Visit If You Have Digestive Issues
Katie Jackson poses in front of Lion's Head mountain in Cape Town, South Africa.
Katie Jackson
Crohn's disease may be a life sentence, but I haven't let my diagnosis rule my life. If anything, getting diagnosed with a chronic condition was the catalyst I needed to realize I couldn't count on tomorrow. When it comes to travel, as long as I'm in remission, today is the day. In the last four months, I've zip-lined in Costa Rica, logged 20,000-step days in Paris, skied in the Italian Alps, swam with manta rays in the Maldives, and spent a week on a wine farm in South Africa—which I consider the best country to visit if you have a digestive disorder. In fact, I've traveled to South Africa so often in the past 10 years that immigration is starting to give me some serious side-eye. I even convinced my mom, who also has Crohn's disease but hates to travel, to spend two weeks with me in Cape Town and Kruger National Park. She loved it. That's because out of all 70-something countries I've visited, no country welcomes Crohnies—or anyone with IBD—quite like the Rainbow Nation.
Where to find toilets
South Africa can swallow nearly three Californias. When I talk about the country, I'm referring to Cape Town and Johannesburg, as well as safari camps, wine country, and other traveler-friendly destinations. The first thing I love about South Africa is I've never had to pay to use a public toilet. Meanwhile, in Norway, I averaged at least $20 a day on bathroom breaks at public toilets that only opened with a credit card swipe. I did just read that a Durban shopping center is implementing a new restroom fee but it's just 2 ZAR (about 10 cents). I don't know of any Cape Town shopping centers or malls that charge. Plus, the city maintains more than 75 public restrooms, mostly found along the promenade and in tourist areas. That said, I usually just duck into a shopping center, a petrol station if I'm road-tripping, or a restaurant where I know there will be toilet paper and soap. Currently, the US dollar remains strong in South Africa, and I can afford to patronize eateries multiple times per day just to use their facilities.
The Picnickery at Spier Wine Farm provides picnic blankets and baskets brimming with curated treats that accommodate a wide range of dietary preferences.
Spier
What to eat (and drink)
Food is also inexpensive, and it's easy to find gut-friendly options. I'd trade a kidney for the recipe for the homemade gluten-free, dairy-free chocolate brownies sold in the Picnickery at Spier Wine Farm. Yes, South Africa is so idyllic they have picnickeries where you can purchase freshly baked bread (some made with 'celiac-certified flour'), vegan cheese you'd never guess was made from nuts, and organic Sauvignon Blanc. Although she doesn't condone drinking, my gastroenterologist says dry wines, which are low in residual sugars, are best for people with irritable bowel diseases like ulcerative colitis and Crohn's.
For fast food, I hit up Kauai, a wellness-themed franchise featuring burgers, wraps, bowls, and salads. Look for the flagship locations, because they have make-your-own menus where you can customize your meal. That said, I've never had a waiter give me side-eye in South Africa when I asked for a substitution. And unlike in some cultures, where it's considered rude to decline food offered to you by a local, here they don't get too offended. For example, I like to support the country's ethical township tours, which bring visitors to settlements formed under the apartheid government to enforce segregation. But I usually don't eat the food offered to me. As tempting as it may be, I just can't afford to take any chances while on the road.
In case of an emergency
I won't sugarcoat it: I've gotten sick in South Africa. I was there in 2021 when Omicron was discovered. But every time I've had to see a doctor there, I've been pleasantly surprised. Private hospitals and clinics offer good health care at great prices. While I pay $200 for a consultation with a gastroenterologist and $8,000 for a colonoscopy stateside, I can get the same service and procedure for just $100 and $800, respectively, in Cape Town. I've also found a family-owned pharmacy in Sea Point willing to refill my prescriptions when I run out, and the plastic surgeon who gives me Botox in Green Point is happy to write a prescription for metronidazole, an antibiotic that treats both bacteria and parasitic infections when I can't outrun the runs.
Built atop a former grain silo, the Silo Hotel is a unique property with stunning views of Cape Town.
The Silo
Loos with views
If you're going on safari in South Africa, there's no need to worry about the bathroom situation. 'Watering a tree' is a rite of passage on any game drive. If nature's call requires going number two, simply use a 'wag bag,' a portable toilet in a pocket-size pouch you can buy on Amazon and at most outdoor retailers. Usually, your guide will check behind the tree (and up in it) first to make sure there are no dangerous animals enjoying its shade. Safari camps also pride themselves on offering guests a loo with a view. At Royal Malewane, in the Limpopo Province, I watched giraffes and baboons from my porcelain throne. And at its sister property, The Silo Hotel, floor-to-ceiling pillowed-glass windows in the bathroom boast panoramic vistas of Table Mountain's iconic peaks and the dramatic Atlantic coastline.
Cape Town International Airport's best-kept secret, meanwhile, is this unisex corner stall in the business lounge, where you can watch planes land and take off while taking your time on the toilet. Can the pilots or passengers on the planes see you? I'm not sure. But even if they can, why feel embarrassed? No one gets through life without going number two. Just sit back, relax, and enjoy the view.
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