International travel with Inflammatory Bowel Disease (IBD) can be tough. I have traveled to 4 continents since being diagnosed with Crohn’s Disease and with every trip I have learned a little more along the way. While I have not had to keep medication cold for the duration of a flight or had to worry about getting infusions abroad, travelling still knocks me out. The lack of sleep, jet lag and new foods tend to shock my body. The effects are often exacerbated by the fact that I have IBD. Over the years, I strived to figure out how to make the most of my travel and stay healthy while still enjoying local cuisine!
In 2014, I spent 6 weeks in India. My body was so thrown off by the time difference that I wasn’t eating normally for my first 10 days in the country. My first breakfast at my host family’s home was a paratha, a whole wheat bread. Whole wheat generally makes me sick. Looking at the bread sitting on my plate, I remember thinking to myself, “How am I going to eat this? I am going to be so sick!” I asked my host mother if the bread was whole wheat and explained to her that I can’t eat whole wheat. She assured me that the whole wheat in India is more processed. I ate half of the bread and said a prayer that I wouldn’t get sick. I ended up being okay. The next morning, I sat down for breakfast and another paratha was put on my plate. All I wanted was some cereal or even a banana. I took a bite and realized that this wasn’t just a plain paratha, it was stuffed with cabbage. I didn’t think it could get worse but I felt like I was doomed. Now I was being fed cabbage AND whole wheat. My intestines’ worst nightmare! I ate a quarter of the paratha and then told my host mother that I prefer the plain paratha and that cabbage bothers my stomach. It was going to be a long 6 weeks.
At lunch on my second day in India, I was served a meal with raw jalapenos. I kept insisting that I couldn’t eat anything raw or eat food that had been washed with the local water but the host insisted that the jalapenos were washed with purified water. I trusted her and ate a little bit of jalapeno (if I hadn’t been jet lagged, I probably would have made a better decision!). I was really sick that night. Without going into detail, let’s just say I knew it was the jalapenos that made me sick. Not only was I sick, but I was alone. Luckily I had my own bathroom. I mixed powdered Gatorade (I came prepared!) with a few water bottles to re-hydrate myself and tried to sleep.
The next morning, I came out of my room to see bananas on the counter. My heart almost jumped out of my chest. I asked if I could have bananas for breakfast. I took two and got some peanut butter from my room. My guts were so happy to have familiar food. I ate a protein bar for lunch. I could feel my body returning to normal. I slowly adjusted to the food but remained incredibly careful about what I ate for the duration of the trip.
When you travel, you never know what will make you sick. This is especially true with IBD. When I was in South Africa last year, I got sick at a 5 star hotel from food I ordered through room service. I don’t know what I ate, but I was really sick. I say this not to deter you from travelling, but to be an educated traveler and to be prepared.
There are a number of things I buy to prepare for international (and domestic) travel. Here’s my packing list:
- Powdered Gatorade/Powerade – If I am going for a short trip (less than 2 weeks), I bring a box of little packets that I can mix in water bottles. If I will be travelling for more than 2 weeks, I bring a larger container of powdered Gatorade. If you don’t use it, don’t sweat it. It’s worth the money to be prepared. If you end up sick and need to rehydrate, you will be so grateful you have it!
- Non-perishable safe foods (you should determine your safe foods)
- Peanut butter (I bring individual cups)
- Protein bars (For me, it’s low fiber Luna bars, one for at least half of the days I will be gone)
- Banana chips (I love bananas)
- Pretzels (one of my favorite foods and they are pretty easy on my gut)
- Travel toilet paper (you can buy travel sized Charmin rolls at an outdoor store like R.E.I) – you never know when you will need toilet paper. My host family didn’t use toilet paper (I can’t even imagine!) and I ended up having to buy toilet paper for myself
- Probiotics – When I travel I take Culturelle (1 per day). Culterelle is known to help prevent traveler’s diarrhea. My gastroenterologist recommended it when I traveled to India. It has become a staple in my packing list when I travel internationally. Culturelle and Florastor are most the most commonly used probiotics in IBD care.
Air Travel – What you need to know
The travel to get to your final destination can also be rough. Sitting on a plane for 8 or 16 hours, long layovers and connections, adds stress and just wreaks havoc on your body. Make sure to push fluids and walk around during the flight (Aisle seats are the best!). Take any chance you get to drink and drink WATER. Don’t order soda (soda dehydrates you). Drink water at any chance you get and walk around. If you are stuck in an airport, window shop to pass the time. Keep yourself moving and drinking. I try to prep for international flights by pushing fluids the day of. I just feel better when I am hydrated.
Germs on airplanes
This is a tough topic, especially for those who are on medications that make them immunosuppressed. If you are really nervous, bring a face mask. I don’t want to be that person with a face mask, but you do what you need to do to feel comfortable. Make an effort to wash your hands every couple of hours (especially before you eat). If you are seated next someone who is clearly sick, talk to a flight attendant and let them know that you are immuno-suppressed and ask if there are any open seats you can move to (away from the sick passenger). I am known to develop colds after traveling. Sometimes it’s just unavoidable.
What to do before you travel:
- If you will be carrying medicine with you, obtain a doctor’s note that mentions that you have IBD, are under his/her care and therefore must carry _______ with you.
- If possible, get extra copies of each of your prescriptions to bring with you.
- Identify the nearest hospital to where you are staying and ask your doctor if he/she can recommend any gastroenterologists in the area (hopefully you won’t need a doctor, but you still need to be prepared).
- If possible, carry extra medicine with you. If I’m travelling for a week, I bring a 2 or 3 week supply. You want to be prepared if you get stuck somewhere.
- The internet is your friend – look up restaurants and menus before you go. Identify a few places where you know you can eat.
Do you have any travel tips? Let me know!
Thanks for reading and HAPPY TRAVELS!