Inflammatory bowel disease is a diarrhoeal illness and even people with
the strongest guts may suffer diarrhoea on holiday. It is therefore most
important to select a destination wisely when considering a holiday.
Listed below are some helpful tips on things to consider before going
on holiday and how to ensure you remain well once you arrive.
1. Select a Suitable Destination
Choosing a suitable destination could mean the difference between a
disastrous holiday and perfect heaven. Choosong unwisely could also prove
extremely expensive in terms of a holiday wasted and possible medical
Holidays in UK may generally pose few problems as relatively little
is changed environmentally. However, holidays abroad are very different
and destinations that are renowned to have poor hygiene are generally
not recommended. If you must travel to these places ensure that the accommodation
is of the highest possible standard.
2. Travel Insurance
that you have a comprehensive travel insurance policy before you travel
abroad, and that pre-existing medical conditions are
• Do not travel against the doctor's advice as this may make the policy
void. A letter from the doctor would be helpful.
• Be familiar with the procedure for obtaining medical treatment or making
an insurance claim. Free emergency medical treatment can be obtained
in EU countries.
• Health advice for travellers and the E111 form can be obtained from the
Post Office. This should be completed by you and stamped by the Postmaster
before you travel and should be taken on holiday with you.
• Shop around for the most suitable and least expensive policy - some companies
will be more sympathetic than others towards chronic illnesses.
3. Mode of Transport
This is very important in terms of availability and accessibility of
Some long-distance coaches have toilet facilities on board and this is
worth checking prior to booking. Coaches used in transportation from
the airport to your resort destination generally may not have these
facilities so check transfer time from the airport when deciding on
It is usually possible to book a seat near to the toilet when travelling
by train. Check that this is possible if travelling abroad.
Information giving details of toilet facilities at ports and on board
ships is available from the reservations office of ferry companies.
Stena Sealink has produced advice leaflets containing these details
for all of its routes.
Air travel can cause difficulty in gaining quick and easy access to the
toilet. It is possible to pre-book a seat which is near the toilet.
Most airports have information services and booklets giving details
of medical centres and location of toilets.
There is a system which enables drivers who hold a special key to have
access to toilets not available to other people and therefore the chances
are that you will not have to wait, (they are also less likely to be
vandalised and are cleaner). To purchase or hire one of these keys
contact: The Royal Association for Disability and Rehabilitation or
RADAR. Tel: 020 7250 3222.
Ensure that you take all your current medicines with you and in good
supply as these may not be available if you run out. These should be
kept in hand luggage for easy availability. Your doctor will be able
to give you advice on the use of short-term anti-diarrhoea tablets to
avoid accidents whilst travelling. (The regular use of such medications
is generally not recommended as they can cause complications of the disease).
Instructions may also be given on taking steroids should you experience
a flare-up whilst abroad.
4. Food and Drink
A change in environment may change your tolerance to foods and so you
should be extra vigilant whilst abroad. The general rule is not to eat
anything that you would not eat at home. Exotic and highly spiced foods
may cause the bowel to be upset.
General recommendations include:
• Increase the fluid and salt intake in hot climates to avoid dehydration.
• Check if the local water is safe to drink, if not use bottled water for
drinking and cleaning the teeth. Fizzy water is safer as some unscrupulous
proprietors may decant their tap water into empty water bottles and re-cap
• Choose fully cooked food whenever possible and avoid cold foods. Salads
and fruits should be washed in bottled water if self catering.
• Avoid ice cubes (frozen local water!) and ice cream.
• Peel all fresh fruit yourself.
• Ensure that you have a supply of anti-diarrhoea tablets such as Immodium,
should diarrhoea occur.
• If your IBD is being treated by diet, ensure that you have a supply of
elemental diet with you.
Prophylaxis and Travel Abroad
Although most people can enjoy foreign travel today, in order to remain
healthy it may be necessary for you to take precautions against conditions
which have a particular prevalence in certain countries, i.e. you may
require vaccinations before you travel or need to take anti-malaria tablets.
Your GP will be able to advise you about which vaccinations to have,
or if you will need to take anti-malaria tablets.
Special precautions need to be considered if you are taking medications
which lower the immune response of the body, e.g.corticosteroids, 5-ASA
preparations (mesalazine, olsalazine, salazopyrin) or azathioprine (imuran).
A patient would be considered immunosuppressed if steroids have been
taken at a dose of 40mg per day for more than one week or lower doses
of steroids or other immuno-suppressants have been given for long periods
Patients who are immuno-suppressed should not receive live vaccines
until at least three months after treatment has stopped, or three months
after levels have been reached which are not associated with immuno-suppression.
If dead vaccines are administered to patients who are immuno-suppressed
the antibody response may not be sufficient to provide protection against
Many patients with inflammatory bowel disease are also upset by taking
anti-malarial tablets. Unfortunately, these must continue as there would
be a risk of contracting malaria if stopped.
General considerations when travelling abroad
* Before travelling, you need to be aware of the risks involved in entering
certain regions and, although most vaccines are only recommended rather
than compulsory, make sure you are aware of the risks of not being vaccinated.
* Immuno-compromised patients should carry a letter detailing their condition
and treatment and, ideally, a contact number of the physician in charge
* It is advisable that travel insurance covers medical evacuation to
the nearest region with adequate medical facilities should you be unfortunate
enough to fall ill abroad.