March 17, 2023
4 min read
Ben-Horin and Greveson report no relevant financial disclosures.
Travel may no longer be daunting for patients with inflammatory bowel disease, thanks to a “one-stop travel advice” website that offers key resources, support and access to a comprehensive network of IBD specialists worldwide.
The nonprofit website IBD Passport was founded by Kay Greveson, an IBD nurse specialist in London, and is directed by Shomron Ben-Horin, MD, professor and chief of gastroenterology at the Sackler School of Medicine at Tel-Aviv University and director of IBD service at Sheba Medical Center. They developed the multilevel platform for patients with Crohn’s disease and ulcerative colitis to help them overcome disease-related limitations and enjoy travel. The site provides practical information and advice about vaccinations, traveling with medications, dietary guidance and managing travel-related illness.
Healio spoke with Ben-Horin and Greveson about the creation of IBD Passport and how its resources help ensure safe and easy travel for patients with IBD.
How did IBD Passport come about?
Greveson: More than 1 billion people travel outside their country annually. IBD patients face unique barriers to travel, including knowledge gaps about travel safety while on immunosuppressives and with underlying gut disorders; gaps regarding required preparations; logistic barriers to continuing biologic therapy abroad, which may reduce drug compliance and instigate disease flares; and perceived absence of IBD-expert care abroad, all of which may lead to travel abstinence. Thus, there was an unmet need for a support program to facilitate travel for IBD patients.
Ben-Horin: At the same time Greveson founded IBD Passport, I had a similar idea that I was promoting within European Crohn’s and Colitis Organization. Instead, we joined forces and have since been running IBD Passport together, as a nonprofit charity registered in the U.K.
What do you aim to accomplish with the platform?
Ben-Horin: Our aim is to provide a one-stop support platform for IBD travelers. The free website includes updated IBD-specific travel information, such as country-specific vaccine requirements, dietary tips, insurance advice and recommendations for carrying medication on airplanes or through customs. The website also includes more than 340 IBD specialty centers around the world that have joined our network and are available for patients who need IBD care abroad.
We were fortunate to have received initial funding to support the technical maintenance and updates of the website, as well as its translation into eight languages. We are now seeking new funding options that will hopefully maintain this unique, free service for traveling IBD patients worldwide.
Greveson: The IBD Passport website has thus far helped thousands of IBD patients from all countries of the world who travel for studies, business or leisure. The site also includes useful forms that can be downloaded for health care providers.
Our conviction is that traveling is an important component of modern life, and we have to do everything possible to remove barriers to travel and help IBD patients fulfill their dreams.
What advice do you give IBD patients when they travel?
Greveson: There is no one-size-fit-all advice. This is why we have many tips and useful advice on our website, divided into sections that may be relevant to individual patients. These include dietary precautions, recommendations for carrying “SOS” antibiotics when traveling to the tropics and how to use them judiciously if health care is not easily accessible, and tips for patients with ostomy on how to minimize discomfort and prepare for air travel with changing air pressure.
We also always advise patients that it is preferable to travel while in remission, to have a summary letter in English from their physician that they can show in case of trouble and to find an IBD-specializing medical center in the country of destination to approach for continued scheduled care, such as infusion of biologics, or in case of emergency.
Any specific tips for patients with Crohn’s disease or ulcerative colitis?
Ben-Horin: In general, tips for Crohn’s patients are not much different than UC patients. Some Crohn’s patients may be more sensitive to dietary changes, and some may suffer from perianal disease. Again, we advise patients to travel when disease is in remission when possible, to carry an emergency kit of antibiotics and to keep proper hygiene of the perianal area.
Greveson: The most important thing is to plan ahead, especially if on medications such as biologics, and do not leave everything to the last moment, as some preparations may take time. This will ensure a smoother and more enjoyable stay abroad.
A few weeks ago, we got an email from a patient in Germany, who received an offer to study a 6-month semester in Australia. Despite this being a terrific opportunity, he felt it would be impossible, due to interruption of his biologic drug treatment. We connected him with a local IBD center and have helped sort out the logistics to facilitate this trip.
What dietary considerations should IBD patients be aware of when traveling?
Ben-Horin: Any traveler to another country, especially one that is different in climate and food habits than one’s own country, may experience some alteration in bowel habits, such as looser stools or some abdominal bloating. This is also common with dietary changes brought on by indulging in food items that may not be part of a regular diet at home.
We do not think IBD travelers need to completely avoid local foods, as this is part of the experience and joy of traveling abroad. But we do advise Crohn’s patients with strictures to be extra careful about consumption of high-fiber food items, and we advise all patients not to consume excessive lactose-containing foods, which may cause bloating or diarrhea that can mimic a disease flare.
Additionally, we advise eating in generally hygienic places, as intestinal infections such as traveler’s diarrhea can be a problem in some regions. This advice is also true for travelers without IBD.