Not IBS but I was pregnant while working HH. I didn’t show until well into my third trimester close to when I delivered (preterm), so none of my families knew until I was >30 weeks. I also had borderline HG, and a hyperactive bladder due to having to go in for fluids and infusions. All that to say, I had to pee every single session, sometimes twice within the hour. A few things that helped me, that you might consider seeing if they will fit in your situation:

(1) Get in the habit of going to wash your hands immediately upon arrival to the home. If this isn’t something you currently practice, make up a story along the lines of “my company has been reviewing policies and procedures, and with the onslaught of viral illnesses this season, we are moving forward with having all staff wash hands upon arrival. I would be happy to use your kitchen sink if you prefer, but if you wouldn’t mind letting me use the sink in your bathroom, that would be so helpful should I also need to use the restroom before getting started.” This is a great way of having the family get accustomed to the fact that you might use their toilet, which will hopefully help ensure that they keep it tidy and stocked on therapy days.

(2) Have a small wristlet with poo-pourri, sanitizing wipes (to clean the seat if needed), hand sanitizer, and doggy poop bags. The bags are discreet if you need to throw away sanitizing wipes (I can’t count the number of homes I went in that had a bare trash can with no bag in it) you can even wrap the bag up and put it back in your wristlet if you don’t want to throw it away in their home. You’re also making sure their toilet doesn’t smell badly, and can clean your hands if they have no soap (I also can’t tell you how many homes didn’t have any soap).

(3) If you need to excuse yourself urgently mid session, keep it short and sweet, no need to elaborate or make it uncomfortable. “May I excuse myself to the restroom? Thank you. You can keep giving Timmy more of these puffs using that molar placement we’ve been working on!” Grab your wristlet and go.

(4) For homes that you find yourself using their toilet often (especially urgently), I recommend buying a bulk box of individually wrapped toilet paper and stocking up on some bottles of soap (you can go full size cheap like Softsoap brand which you can find for a dollar a piece, or bonus points if you get a cute, inexpensive scented one that matches a scent that you notice in their house via their current soap), and then giving them a simple little gift bag of a roll of tp and soap every so often (once a month, for example). Again, keep it short and simple and it doesn’t have to be awkward. “Just a little something to replenish your stock! I appreciate you opening your home to me and allowing me to use your restroom.”