How safe is it for IBD patients to travel?  A retrospective study from adult patients with IBD (n=222) compared with controls (n=224) indicates that the risk of travel for IBD patients is only a little more than the general population (Clin Gastroenterol Hepatol 2012; 10: 160-65).

IBD patients with an average age of 37 years had infections during 15% of trips compared with 11% for controls.  92% of infections were due to enteric disease. However, this increased risk was identified in travel to industrialized countries not to developing countries.  This likely indicates that much of the increase is due to IBD flares rather than increased susceptibility to infections.  Nearly half of patients in this study were receiving immunosuppression: immunomodulators 29%, biologics 5%, dual therapy 6%, or corticosteroids 4%.  Not surprisingly, patients with increased IBD flares (OR 1.9) and IBD-related hospitalizations (OR 3.5) represent a group with higher risk for illness.  Most illnesses were mild & self-resolving in a few days.  Only five IBD patients required hospitalization for the following: dehydration, perianal abscess, malaria, flare, & small bowel obstruction).

Additional references:

• -Clin Gastro & Hep 2010; 8: 490. Review of traveler’s diarrhea. Recs pepto if emesis, rifaximin or cipro or azithromycin if watery diarrhea, azithromycin if bloody diarrhea
• -Clin Gastro & Hep 2007; 5: 451. Use of rifaximin (200mg tid)-loperamide provided rapid improvement.
• -NEJM 2006; 354; 119. Traveler’s diarrhea.
• -NEJM 2002; 347: 505.  Illness after travel.
• -www.cdc.gov/travel/index.htm