Synopsis : Essential travel information for people with Crohn's disease, Irritable Bowel Syndrome, Ulcerative colitis and/or Inflammatory bowel disease.
Check your medication and doctor visit schedules when picking a date.
If traveling to exotic or developing countries, all travelers are at risk for GI/bowel problems.
Inflammatory Bowel Disease (IBD) and travel can sometimes be like ketchup and chocolate cake: they just don't go well together.
Well, I love international travel - and I have Crohn's disease.
Crohn's disease, also known as Crohn syndrome and regional enteritis, is a type of inflammatory bowel disease (IBD) that may affect any part of the gastrointestinal tract from mouth to anus. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, and weight loss. Other complications may occur outside the gastrointestinal tract and include anemia, skin rashes, arthritis, inflammation of the eye, and tiredness - Learn more about Crohn's disease.
In the 10 years that I've lived with the joys of Crohn's disease Crohn's has not stopped me from the following:
3 months in Belize (at age 19 within a year of being diagnosed)
Study abroad in Costa Rica (1 semester)
1, 2, 6, and 10-week trips to Costa Rica, sometimes leading groups
6 weeks in Italy
Three short trips to Mexico
Side trips to Panama and Nicaragua (2nd poorest country in the Western Hemisphere)
My Crohn's hasn't been exactly dormant either. I've always had flare-us 1-3x per year, and have even had one in Italy and in Costa Rica. There is a lot I have learned in these experiences, some through doing it right, others from doing it wrong (8 hours bus ride with 1 stop and no onboard bathroom made me nervous). The most important thing I can say is that we should do everything we can to not let IBS impede us.
It is my theory that we are extra prone to becoming sick abroad because of a combination of subtle stresses we put on our body that can add up and may include:
A woman wearing a skirt with her back to the camera studies the arrivals and departures board at an airport.
Change of climate
Shocking our system with different water and foods that it's not accustomed to (not that they're necessarily contaminated)
Drinking more alcohol than usual
Stress of trip planning / interpersonal conflict
Stress of being out of one's comfort zone / experiencing culture shock
Stress of worrying about getting sick (at some point you just have to have fun)
Each person's experience with IBD is unique; the following are tips that will apply to some but not to others.
Research your destination
Have a simple understanding of the medical system.
Example: In Costa Rica, the pharmacy is generally the first stop when people are sick. The pharmacists are trained to treat minor ailments and provide medications without prescriptions. Every town has one or two.
The bathroom situation:
Are there many (or any) public bathrooms? Do you typically need your own toilet paper
Know how to ask where a bathroom is in the host county's language.
Any guide book for the country you're going to should give you this info, otherwise ask the receptionist at your hotel.
Low Stress Itinerary
Get flights with good connections and departure time.
Consider a tour or package deal from a reputable company.
Reconsider renting a car - this can lead to many stressful situation.
Give yourself time to decompress at home before going back to work.
Contact Your Health Insurance Provider
What are coverage rules abroad?
Will they reimburse?
What are their limitations?
Buy travel insurance. It should cover:
Emergency evacuation (i.e. send you home on MedVac).
Emergency reunion (i.e. pay for you to have a visitor if hospitalized).
Medical expenses (just in case your HMO gives you surprises).
Check your medication and doctor visit schedules when picking a date. Be sure to not only have enough pills for your trip, but also for when you return. Try to travel between scheduled appointments.
Contact Your Doctor
Ask about taking anti-motility medication before you leave home.
Ask about treating traveler's diarrhea should you develop it while traveling.
Have written, back-up copies of all prescriptions.
Have a written statement summarizing your medical history and medications.
For a list of physicians in the cities you plan to visit.
Ask for a written plan of action for you, in case your condition worsens.
Ask if the climate at your destination will affect your medications (such as lots of sun).
Visit a travel clinic:
For valuable information on staying healthy in the host country
For necessary medications and shots.
What to Bring
Needed documents and medications.
Your doctor's phone number and your health insurance card in your wallet.
Medications in their original pharmacy bottles.
Enough medications for a few extra days in case of surprises.
Pack a "bathroom kit" and carry it with you.
Include extra underwear, tissues, antibacterial hand wash, plastic bags and anything else you may need if you encounter a lavatory that is not clean or properly stocked.
Know how and when to find a doctor.
Have a Strategy for Each Mode of Travel
Be sure to be extra healthy the weeks leading up to your trip, if possible. Get exercise, sleep and eat well, take your meds.
Allow plenty of time to pack for trip so you're not stressed before you've even left.
Get plenty of sleep the night before departure.
During Your Trip
Communicate your concerns to the flight attendants. They may:
Change your seat to be near a bathroom.
Invite you to use the first class bathroom if the coach one is occupied.
Allow you to use the bathroom during fasten-seat belt times.
Allow you to get up and walk around if necessary.
If traveling to exotic or developing countries, all travelers are at risk for GI/bowel problems. People with Crohn's disease need to be especially careful.
Be Extra Cautious with Food and Water
Sticking to bottled water
Avoiding non-carbonated beverages such as ice tea and fresh juices. Skip the ice cubes. Don't swallow water when swimming and showering.
Avoiding raw vegetables or salads.
Never eating prepared food, such as potato salad and canape.
Note: Local food is an important part of an international experience. Consider your own health condition, recommendations from guide books, and, well, your gut feeling.
Eat and Drink Healthy Food
Be cautious of drinking more alcohol than usual.
Be aware of your new diet while abroad compared to what you normally eat at home. Are you eating more roughage, processed foods, meats, etc
Drink plenty of water
Becoming dehydrated stresses the body. When traveling to a new destination and new climate, it's easy to forget to drink water as we are out of our normal routine
Contact a physician immediately if you experience any of these symptoms:
High fever, and shaking chills.
Profuse bloody diarrhea.
Severe abdominal pain and/or abdominal distension, especially with abdominal tenderness or nausea and vomiting.
Fainting or dizziness when standing up.
Marked decrease in urine.
Be Extra Aware of Where Bathrooms Are Located
Although you're probably used to this at home, there may be much fewer bathrooms and you may have to deal with language barriers
It may seem like a lot, but any international trip requires extra planning, and most people need to do much of this for one ailment or another anyway. International travel is a true joy and provides so many lifetime memories.
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