IBD Diet and Travelling
Last Updated: 20/10/2021
Whether you suffer from IBD or not, everyone is at increased risk of experiencing diarrhoea when travelling abroad due to consuming food and water that contains bacteria, parasites or viruses which are different to those you are used to. The risk of contracting a diarrhoea bug will depend on the destination of your visit, how developed the country is and the sanitation.
It is a good idea to stick to the diet you usually follow at home as much as you can, unless you feel confident about trying something new. Generally foreign and spicy foods should not make your IBD worse but you should be more careful about hygiene, particularly in developing countries. As a rule of thumb, diet will not lead to a flare but could temporarily upset your well-being. Also remember that you might not be able to tolerate the same foods you were able to tolerate prior to your diagnosis.
To minimise the risk of getting a diarrhoea bug when travelling the following precautions can be taken:
- Tap water is often safe to drink and cook with but you might want to check with the locals. If you are in a rural location they may use tank/rain water which may make you more susceptible as it will not be treated (boil water before use if unsure).
- Do not use water from streams, rivers and lakes for drinking or cooking as the water can be contaminated.
- If in doubt, stick to bottled drinks or cans and avoid draught drinks (beer/lager is the exception here), and drinks which need water to dilute them, such as cordials, syrups or powders.
- Avoid ice cubes, as frozen water is probably made using local supplies
- Avoid water-containing foods, such as ice cream
- Peel fruits or wash them in bottled water.
- Most food venders in New Zealand are generally safe but this might not be the case abroad.
- Avoid uncooked dairy products unless you are certain that they have been pasteurized and prepared under sterile conditions.
- Avoid food that has been kept at room temperature.
- Dishes containing raw or undercooked eggs, such as home-made mayonnaise, some sauces and some desserts (e.g. mousse) may be dangerous.
Should you develop diarrhoea, or an increase in stool frequency, it is important to remain hydrated, so take care to drink enough fluids. Further information regarding travellers' diarrhoea and avoiding dehydration can be found in on our managing travellers’ diarrhoea page.
To make managing your dietary requirements easier when travelling, a personalised dietary alert card available in 18 different languages can be purchased from the Dietary card website http://www.dietarycard.com/
Advice from a Dietician may help with many aspects of IBD and also when planning to travel, when your diet may not been the same as usual for a period of time. This useful nutritionist resource can give you a few handy tips regarding diet. Comprehensive diet and inflammatory Bowel Disease information can also be found on the Crohn's and Colitis UK website.
Parenteral/ enteral nutrition when traveling abroad
Always ensure you contact your nutrition team before booking any holiday to ensure your health needs can be managed adequate plans are in place before your trip
You may be receiving artificial nutrition via a feeding tube (enteral nutrition) into your intestine/stomach or via a line, e.g. Hickman or PICC line (parenteral nutrition) into your vein. This should not stop you from travelling but there are extra factors that you will need to consider before your trip.
**Check out this useful Blog from Sara Ringer, Author of Inflamed and Untamed, for helpful tips for travelling with TPN**
Allow at least 6 weeks before your departure date to plan the logistics of travelling with your feed. The homecare company that delivers your feed can deliver to many overseas destinations. Exceptions to this are developing countries and those in war conflict or where delivery is not possible due to customs restrictions. Contact your feed delivery company before you book your trip to ensure delivery is possible. You may need to stick to visiting the main centres at your destination for logistical reasons.
Obtain a letter from your specialist outlining your medical history, medication and an explanation of why you need enteral/ parenteral nutrition. A sample clinician letter for patients travelling with IV or tube feeds that can be edited can be found at The Oley foundation website http://www.oley.org/Travel_letters.html.
Ensure you have a written plan from your specialist of what to do in an emergency
A complication chart, and travel pack which covers the symptoms and steps to take for common problems related to parenteral or tube feeding nutrition and an essential supply inventory list plus useful tips for travel can be obtained from the Oley Foundation
Inform the travel agent or airline of any special needs you have or facilities you may require. You may need a medical certificate from your specialist confirming your fitness to travel.
Inform the airline that you will be carrying essential medical supplies with you. You will need an excess baggage waiver and will have to provide the airline with details of the contents, weight and dimensions of the excess baggage containing your feed equipment. You may be charged extra for this depending on the airline.
At the airport – you can request special assistance for pre-boarding, immigration and baggage reclaim.
Most pumps and feeds are safe to go through airport security x-ray but it is a good idea to check with your specialist or feed manufacturer and obtain a letter from them confirming this.
Transport your pump and at least one nights’ supply of feeds (better two to three nights) and medication in your hand luggage. You will need a supporting letter and a copy of your prescription from the hospital or feed company to do this.
Request your feed and pumps to be hand loaded onto the aircraft to avoid damage or spillage. This can be done with prior arrangement via ‘special handling’.
Ensure you know what products you can take onto the plane and what should go in the hold.
Consider the length of your trip- you will have to carry adequate medical supplies and equipment for the duration of your trip plus any additional supplies in case of delays.
What will the temperature be like at the destination? Hot, humid counties run the risk of causing dehydration, meaning you may have to take extra fluids.
Accommodation facilities- What type of accommodation? What facilities do they offer? Does it have a regular sized fridge to store your feed or a only a mini-bar? You should be able to call ahead and request a fridge in the room or arrange for storage of feeds in the hotel facilities.
Additional extras to consider
- Take extra batteries for your pump
- Ensure you have a travel adapter at the correct voltage for your pump
- Take contact details of your specialist at home and the nearest hospital to your destination
- Take extra supplies in case of breakage, spills, unexpected delays to your trip.
Sources of information
- Patients on intravenous and naso-gastric nutrition therapy (PINN)- artificial nutrition support website http://pinnt.com/Members-Area/New-Members-Information/Holiday-Guideline-2013.aspx
- The Oley foundation www.oley.org
- The dietary card www.dietarycard.com
- Crohn’s and Colitis UK Travel and IBD information sheet www.crohnsandcolitis.org.uk
- Crohn's and Colitis UK (Edition 6-2012) Food and IBD booklet
- Spira A. Preparing the traveller. 2003; Travel Medicine; 361: 1368-1381
- Sara Ringer inflamed and untamed IBD Blog http://www.inflamed-and-untamed.com/