Travel and Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a term mainly used to describe two long-term conditions that involve inflammation of the gut: ulcerative colitis and Crohn's disease. There are other less common types of IBD, for further information view the Crohn's and Colitis UK website.
If you have IBD, you may be concerned about:
- a flare-up during travel
- toilet facilities both on transport and at destination
- the effect of changes to your usual diet
- enteral nutrition
- your risk of travellers diarrhoea and associated dehydration
- travelling with medications and medical supplies including:
- possible restrictions on required medications
- maintaining sufficient supplies in the event of loss or delays
- deep vein thrombosis due to increased risk for those with IBD
Crohn's and Colitis UK have produced a comprehensive information sheet detailing common challenges travellers with IBD may experience and management strategies:
If you have IBD you may have recently had surgery or been in hospital, or you may need help with planning how to manage a flare-up during travel. It is therefore sensible to consult your own doctor or IBD team before arranging your trip.
Taking a summary of your condition, medical history and any known allergies, as well as a plan for what to do if you have a flare-up may prove useful. It is possible to translate this information into the language of your destination; this may prove useful if you are travelling to a country where English is not commonly understood. There are many free translation services available online, such as Google Translate, which instantly translates words and phrases between English and over 100 other languages.
Some travel-related illness, for example travellers diarrhoea, may be more severe and have an increased risk of complications in those with IBD.
Many of the drugs used to help control IBD are drugs that weaken the immune system including:
- steroids such as prednisone, budesonide, hydrocortisone
- immunosuppressants such as azathioprine, methotrexate and ciclosporin
- biological such as infliximab and adalimumab
If your immune system is compromised then you may be more susceptible to travel-related illnesses and you may be at a higher risk of related complication than someone with a competent immune system. Ideally you should consult a travel healthcare practitioner 6-8 weeks in advance of travel for advice about advisable vaccinations and malaria tablets, and risk management advice about:
- food and water safety, accident prevention, care with sun exposure, avoiding insect bites and animal bites, and practicing good respiratory hygiene
Travelling with medication should be planned in advance of your departure because there may be country specific restrictions on the type or quantity of medication that you need. Counterfeit medicines are a growing problem throughout the world, you should therefore consider ongoing supply of your medications and how you would replace your medication if you lost it.
With careful planning, having a stoma can be managed throughout travel:
- Ensure ample stoma supplies are taken – some advise twice as much as usual
- If travelling by air ensure supplies are in hand luggage
- Before a long journey, food or drink that cause excessive wind should be avoided
- Advice from a stoma nurse can be sought beforehand.
Medical treatment abroad can result in significant financial burden on travellers and potentially be a barrier to receiving the treatment you require. It is therefore essential that you obtain appropriate travel insurance.
You may find it more difficult or expensive to get appropriate travel insurance, for example, if you have recently had surgery or are awaiting results of tests or investigations. In some cases, the insurance company may agree to provide cover but exclude any health issues related to your IBD.
- insurance policies are only as good as the medical facilities available
- check your cover includes emergency medical treatment, medical evacuation and repatriation
- disclose all your medical conditions and medications (including over-the-counter)to your travel insurer, failure to do so may nullify your cover
- medical care abroad often requires payment at point of service; regardless of whether insurance cover is in place
- keep all receipts associated with any medical treatment, including things like transport costs to hospital or medical centre
See the travel insurance page for detailed information on purchasing appropriate travel insurance.
Crohn's and Colitis UK
0300 222 5700