Travelling with ibd

If you have ulcerative colitis or Crohn’s disease you may be worried about travelling with the disease. You may be worried about being in a car or plane for a long period or how you will get about in an unfamiliar foreign place with unfamiliar foods.

When you are in remission, travelling is not an issue with inflammatory bowel disease (IBD). However, if you are experiencing a flare-up, there are a few things you need to plan for; whether you’re getting on a bus to the city or flying to the other side of the world.

Even though you may have inflammatory bowel disease, there are a number of things you can do to help you with your travel plans. 

Planning Ahead

Medication

• Bring enough medication to last throughout your trip. Filling a prescription abroad can be complicated
• If you have medication that needs to be refrigerated, store it in a small cool bag that you can buy at the pharmacy before you go
• It is a good idea to take along a copy of your prescription (including generic names – as the brand names can be different from country to country) just in case you need further supplies
• Keep your medication in its original container so it is easy to identify
• Take a supply of over-the-counter medications such as anti-diarrhoeals, anti-spasmodics, rehydration sachets and pain killers. Speak to your IBD specialist before buying or taking these medications
• Use pillboxes to carry small amounts needed during the course of a day, so you always have your medication with you
• If you are travelling by air, store your medication in your hand luggage, in case your baggage is lost. With current restrictions on hand luggage, you will need to show a letter from your IBD specialist stating your medical need. It is best to check with the airline when booking your tickets and ask about any rules they have regarding carrying medications in hand luggage

From your doctor

• Obtain a letter from your doctor with your medical history and the drugs you are taking. This will be helpful if customs officials question you or if an emergency arises. This can also be very helpful to show a doctor abroad, if you need to see one. It may be worth having this information translated into the language(s) of your destination country(ies)
• Ask your doctor for a written plan of action in case your condition worsens while you’re travelling
• Keep your doctor’s phone number and your insurance card in your wallet

Transportation and getting around

• Find out in advance whether buses and trains you are using have toilets. When making airline reservations, request an aisle seat near a bathroom
• Give the airline advance notice so it can accommodate your diet needs, or bring a snack of your own
• Carry a number of snacks and simple foods you can eat if the local food does not agree with you
• Consult the web and see if there is any local information or any tips from other sufferers that can help you (see below)

Security checks

With added security on planes, boarding ships and even railway stations, you may be concerned about whether you can take your medication on board with you. You should be ready to show your pillboxes and other medicines, also any medical appliances.

If you have a body search, your stoma bags and added sanitary protection may be felt. A letter from your doctor explaining your condition and medication and any appliances you may need will help to explain your situation.

Be aware of your rights to ask for a qualified person to be available in case of need.

Are there places I shouldn’t go?

If you’re planning to travel to developing countries, a consultation with a travel medicine specialist may be worthwhile. Then speak with your IBD specialist before making a final decision about visiting those locations.

What day-to-day issues do I need to think about while I am travelling?

Experiencing a flare-up of your ulcerative colitis and Crohn’s disease does not mean you can’t leave the hotel, but it helps if you do some practical planning.

• Find out where public toilets are located. You can use the internet to help you and if you have a smart phone, some of these may be available as an app
• In some countries you can get a special “Can’t Wait” card, which gives you access to public toilets and disabled toilets without having to queue
• Take extra toilet tissue or clothing with you in case of an accident

Vaccinations

As with any travel plans, always make sure that you have the relevant vaccinations and malaria medication.

Always speak to your doctor in good time (about 4-6 weeks before the planned journey). If you decide to use an independent travel clinic, always tell the doctor about your condition.  If you being treated for IBD, you may also need vaccination against the following diseases, depending on the destination of your journey:

• Yellow fever
• Hepatitis A
• Hepatitis B
• Cholera
• Rabies
• Meningococcal encephalitis
•  Japanese encephalitis
• Tuberculosis

If you are using steroids, immunomodulators or biologic therapies for your ulcerative colitis or Crohn’s disease, you should avoid some vaccines (against yellow fever, cholera and tuberculosis) as these medicines may affect the ability to react to the vaccines. Always consult your doctor to find out what vaccines will be suitable for you.

If you are going on a long distance trip – speak to your doctor or travel clinical specialist about whether you need an injection to prevent deep vein thrombosis (DVT).

Be careful what you eat

Always be watchful and pay attention to what you eat. Be extra careful with drinking water, and always use bottled water (even for brushing teeth) and be careful not to drink it by accident when you are taking a bath or shower. Avoid sushi, raw vegetables (including salads), ice-cream and ice lollies. Remember to ask for drinks without ice, unless the ice is prepared using bottled water.

Cooked vegetables and meat from reputable and clean establishments should be fine to eat, but avoid roadside and street foods. Always peel fruit before eating.

Travel insurance  

Before you travel, ensure that your travel policy is adequate and will cover your IBD-related problems. Unfortunately, many insurance policies exclude cover arising from pre-existing illnesses and will probably refuse claims. So make sure that your travel policy offers full cover. You may also have to confirm that you are not travelling against your doctor’s advice.