Travel related morbidity is high in foreign travel for
people with IBD. A study published in Frontline
Gastroenterology found that not many IBD patients seek information for
travel-associated risks. Several healthcare providers also are not confident
enough in providing this information.
Inflammatory bowel disease
(IBD) refers to chronic inflammation of all or a part of digestive tract. The
most common IBD conditions are ulcerative colitis and Crohn's disease
. In Crohn's disease (CD),
the inflammation affects entire digestive tract, whereas in ulcerative colitis
(UC), only the large intestine is affected. Both the conditions affect quality
of life and cause severe diarrhea, abdominal pain, fatigue and weight loss.
In the US, as per current
estimates about 1-1.3 million people suffer from IBD. UC is slightly more
common in males, while CD is more frequent in females.
A study surveyed 132 IBD
patients which included 67 patients with Crohn's disease and 65 patients with
. It revealed
that most patients were affected during travel owing to IBD. However, only
around 23% patients actually contacted their physicians for pre-travel advice. Nearly
half of the patients who were taking immunomodulator therapy (drugs that affect
immunity) were not aware of any need of avoiding live vaccines. To make matters
worse, only 40% patients had travel insurance.
The study also obtained
responses to questionnaires from health care providers. They found around 27%
of health care providers were not confident in providing travel-related
information to patients of IBD. Aspects that most healthcare providers were
unsure of were related to vaccination, healthcare insurance and healthcare
The study thus emphasizes
the need for greater IBD-specific travel education and awareness for both
patients with IBD and healthcare professionals dealing with these patients.
for Travel with IBD
Traveling with IBD can be
daunting task. A change in climate, water, or food can upset bowels. But, with
careful planning and seeking professional advice would ease out and make travel
possible to most places.
Locating a doctor:
Ask your doctor for names
of physician in cities you plan to travel to.
Insurance should be taken if
traveling to countries that do not have healthcare agreements with your
country. Check with your insurance carrier if it covers foreign travel, as well
as previously diagnosed chronic conditions.
For IBD patients on drugs
that can weaken immune system, live vaccination should be avoided. However, an
appropriate letter needs to be sought from your doctor regarding avoiding
- Enough prescription drugs
should be carried as filling prescription abroad can be complicated.
traveling by air, always carry your medication on the plane.
your medicines in their original containers. Carry enough medicines for entire
- If traveling to malaria-prone area, anti-malaria medication needs to be
taken. Anti-malaria medicines can affect IBD, so a specialist has to be
consulted before their use.
- Typed statement from physician
that describes your medical history and drugs being taken should be sought to
avoid hassles in a foreign country.
- Copies of
prescriptions, including foreign brand names or generic names have to be
If traveling by air, a long
flight can upset bowels as cabin air is very dry. Therefore taking an
anti-diarrhoeal beforehand can be considered and alcohol and caffeine need to
be avoided, so as to prevent dehydration.
Traveling with Stoma:
If ileostomy or colostomy
has been done recently, then ample of stoma supplies need to be taken.
Emergency travel kit:
Packing an emergency kit or
first aid box is useful for any accident during travel.
doctor's phone number and insurance card in your wallet so that you can access
them at all times.
Hot weather can make you
dehydrated. Drink plenty of non-alcoholic liquids (at least 8-10 average
glasses) to eliminate dehydration.
Protection from sun is important if you are on immunosuppressive drugs
such as azathioprine
, mercaptopurine and methotrexate
for IBD treatment. Include high sun screen protector (SPF 25 or above) for
Avoid traveler's diarrhea:
Take the following steps
during your trip to avoid traveler's diarrhea.
water than normal water.
mineral water even to brush your teeth.
Do not swallow
water when swimming in fresh water, swimming pools as they may be polluted.
non-carbonated beverages such as iced tea and fresh juices.
ice and ice-cream, raw vegetables and salads, raw or
uncooked meat, fish, or shellfish, uncooked dairy foods (unless confirmed for
pasteurization and sterility), food from vendor carts, prepared food (potato
salad and canapés), and food that is allowed to sit at room temperature.
all fruits and egg shells completely by self.