You may wish to tell your IBD team during a routine appointment if you’re planning to travel, especially if you are going overseas. They can give you advice about managing your Crohn’s or Colitis while you are away, and make sure you have enough medicines. For information about vaccinations and insurance, talk to your GP or a private travel clinic.

Even if you’re not planning a trip just yet, you could tell your IBD team if you want to travel to high-risk areas in the future. There are some vaccinations they might recommend having before you start certain medicines for Crohn’s or Colitis.

Choosing where to go and where to stay

You might already know exactly where you’re going. But if you haven’t decided yet, here are some things you might want to think about.

• Do you want to travel in the UK or overseas? If you want to go overseas, what healthcare system do they have? How do you access it? You can find this out for different countries at IBD Passport.
• Are any infections especially common where you plan to visit? Will you need any vaccinations? These might be important questions if you’re on treatment that lowers your immune system. You can find out about infections and vaccination recommendations for different countries from TravelHealthPro.
• What facilities do you need? Are you OK with shared toilet facilities, or do you need an en-suite bathroom? Do you need a fridge to store any medicines or liquid foods? Do you need laundry facilities? Ask your travel company or your accommodation provider what’s available.
• What sort of food can you get where you plan to travel? Does this fit with your usual diet? If you have particular dietary needs, let your travel company or accommodation provider know.
• Is the water supply drinkable, or will you need to use bottled, boiled or sterilised water?

Choosing when to go

You are more likely to stay well on your trip if your Crohn’s or Colitis has been under control for at least 3 months. We know Crohn’s and Colitis are unpredictable. You do not know when you might have a flare-up. But you might prefer to wait until your Crohn’s or Colitis is in remission before planning to travel.

If you can, try to plan your trip so you will not need any routine blood tests while you’re away. If this is not possible, you might be able to bring your tests forward so you’re up-to-date before you go.

Some people find their Crohn’s or Colitis get worse at certain times of year or during particular types of weather. If this is the case for you, check what the weather is like where you’re travelling at the time of year you’re planning to go.

Try to plan your trip to allow plenty of time to have any vaccinations you need.

Getting travel vaccinations

If you are travelling to another country, you might need to have vaccinations before you go. The vaccinations you’ll need depend on where you are going. To find out, you can ask your GP or private travel clinic, or check the TravelHealthPro website or the FitforTravel website.

For some vaccinations, you need more than one dose. Some take a while to work fully. It’s good idea to check what you need at least 6 to 8 weeks before you travel to make sure you have time to have them.

When you book your vaccinations, tell the clinic staff you have Crohn’s or Colitis, and what medicines you are taking. This might affect what vaccinations you can have. Non-live vaccines are suitable for people with Crohn’s or Colitis. But if you are taking medicine that weakens your immune system, they might not work as well as they do in other people. Live vaccines might not be suitable for you if you’re on medicines that weaken your immune system. Live vaccines are made from weakened versions of bacteria or viruses. If your immune system is lowered, live vaccines could cause serious infections.

Live vaccinations that you might need to have before travelling include:

• The tablet version of the typhoid vaccine. But the injected typhoid vaccine is not live and is suitable for people with Crohn’s and Colitis.
• The yellow fever vaccine. To visit some countries, you must have proof of yellow fever vaccination.

  • If you’ve already been vaccinated against yellow fever, check your vaccine certificate. The details must match the details on your passport. If you have changed your name or gender, you will need to get a new certificate.

  • If you have not already been vaccinated against yellow fever and you cannot have the live vaccine, your doctor might advise you to avoid travelling to places where yellow fever is common. If you do choose to go, ask your doctor for a medical exemption letter. Some countries might accept this instead of proof of vaccination. But some countries might not, and they could refuse to let you in. If you are not vaccinated and you travel to a place where yellow fever is common, you are at risk of catching it.

• The BCG vaccine that protects against TB. If you get TB, you might not have any symptoms. This is called latent TB. If you travel for a month or more to a place where TB is common, your doctor might suggest testing you for latent TB a few weeks after you get back. This is because some medicines for Crohn’s and Colitis can reactivate latent TB. If you have latent TB, it must be treated before you have treatment with biologic medicines.

You should wait 3 to 4 weeks after a live vaccine before starting treatment that lowers your immune system.

Malaria tablets

Malaria is a serious infection spread by mosquitoes. Having Crohn’s or Colitis does not seem to increase your risk of getting it. But if you are travelling to an area where malaria is common, your doctor or travel clinic will recommend that you take anti-malarial tablets.

There are lots of different anti-malarial tablets. Some of them might interact with some medicines for Crohn’s and Colitis. Your doctor or travel clinic can recommend anti-malarial tablets that are suitable for you. You have to start most anti-malarial tablets a few days or weeks before you travel. You carry on taking them for up to 4 weeks after you get back.

If you are travelling outside the UK, it is important to get travel insurance that covers you for Crohn’s or Colitis. To do this, you need to declare that you have Crohn’s or Colitis when you get your quote. Even if you are staying in the UK, it’s a good idea to consider insurance in case you have to cancel your holiday.

If you are travelling in Europe, you can get a free health insurance card. This lets you access state healthcare in Switzerland or European Union countries free or at a discount.

• If you have a European Health Insurance Card (EHIC), it is valid until its expiry date even though the UK is no longer part of the European Union. Some UK citizens living in the EU and some EU citizens living in the UK can apply for a new EHIC.
• Most people in the UK cannot get a new EHIC. If you do not have an EHIC or your EHIC has expired, you can apply for a Global Health Insurance Card (GHIC) instead.

EHIC and GHIC cards let you access certain healthcare in the country you are visiting. They do not cover other costs such as emergency travel if you need to be transported back to the UK. They are not a substitute for travel insurance. It’s a good idea to have both to be fully covered.

Declaring your Crohn’s or Colitis

Travel insurance might cost more if you have Crohn’s or Colitis. But it’s important to declare that you have it, even if it’s been under control for a long time. Otherwise, your policy might not cover emergency medical costs.

When you declare you have a medical condition, you need to answer questions about it. This helps the insurance company work out how likely you are to make a claim, which affects how much they charge for your policy. The cost is based on your medical conditions, but also your age, where you’re going, and how long you’re travelling for.

It can be worthwhile to shop around to find out what cover is available. Prices can vary a lot between insurance companies. If you already have an annual multi-trip travel insurance policy, you could check if it covers your Crohn’s or Colitis. If not, you might be able to pay extra to extend the cover.

• MoneyHelper is a government service that includes a directory of companies that specialise in travel insurance for people with medical conditions.
• The British Insurance Brokers’ Association also has a directory of companies that provide travel insurance for people with medical conditions.

Some insurance companies might ask you for a letter from your doctor confirming that you’re fit to travel. Your doctor might charge you for this letter.

If you need to claim on your travel insurance, you’ll need to have receipts for everything. This includes things like taxi fares to the hospital.

Try to take enough medicines for your whole trip, plus extra in case of delays. This includes any over-the-counter medicines you usually take. Some places have restrictions on what medicines you’re allowed to bring into the country. Check with the embassy of the country you’re visiting before you travel.

If you are travelling across different time zones, it can be difficult to work out when to take your medicines. You could carry on taking them based on the time it is in the UK. Or you could gradually adjust the time you take them to suit the time zone you are in. You might find it helpful to set an alarm to remind you when to take your dose. If you’re not sure when to take them, ask your IBD team or pharmacist for advice.

Travelling with biologic medicines

Biologic medicines need to be stored in the fridge. It is OK to keep them at room temperature for short periods, but the exact length of time depends on which biologic you are taking. You can find out how long your medicine will last out of the fridge in the patient information leaflet or on the electronic medicines compendium. Do not put them back in the fridge if they’ve reached room temperature. If your medicine needs to be kept cold while you’re travelling, you could use a cool bag or a cooling wallet. You can buy these online or from pharmacies.

If you are flying, you are allowed to take needles, syringes or injectable pens in your hand luggage. You will need a copy of your prescription or a letter from your doctor. It’s a good idea to tell your airline in advance in case they have any additional restrictions. They might take your medicines and equipment to store them safely in the cabin during the flight. Checked-in luggage goes in the aeroplane hold, which can reach very low temperatures. Some medicines could freeze.

You might need to buy a travel-sized sharps bin.

You may wish to talk to your dietitian if you are planning to travel when you are on a liquid diet. They can advise you on what you need to do and help make sure you have the supplies you need. Try to take enough for your whole trip if you can. Powdered products are easier to carry and take up less space in your luggage. Make sure the water you use to mix them is safe to drink.

If you are flying with ready-mixed liquid foods, you are allowed to take these in your hand luggage. You will need a copy of your prescription or a letter from your doctor. It’s a good idea to tell your airline in advance, especially if the amount you need will take you over the usual hand luggage allowance. You might have to go through extra security checks.

Having a stoma should not stop you travelling, but it takes a bit more planning. You might want to talk to your stoma nurse about it. They can advise you on the most suitable products based on what you plan to do while you’re away. You might need a change in your prescription.

Make sure you order plenty of stoma supplies before you go. You are likely to need more than usual, especially if you’re going somewhere hot or eating different foods. If you’re planning to be away for a long time, you could check if your supply company deliver where you’re going.

If you’re flying, it’s sensible to pack your stoma supplies in your hand luggage if you can, in case your checked-in bags go missing. If you tell your airline in advance, they might be able to increase your luggage allowance. You will not be able to take scissors in your hand luggage. If you need to cut your bags or flanges to fit, do this before you travel.

It’s helpful to have a certificate or a letter from your doctor explaining that you have a stoma, and the supplies you need to carry with you. You can show this at airport security. Colostomy UK have a template you can use (PDF). This needs to be signed and stamped by your GP surgery. You might have to pay for this.

The change in air pressure when you fly can make any gas in your body expand. This can lead to tummy pain, or cause more wind in your bag than usual. It might help to avoid fizzy drinks before you fly.

While you’re away, you can empty your bags into the toilet, put them in a disposal bag and throw them away in an ordinary bin.

For more information:

• Colostomy UK have travel advice for people with a stoma.
• IA (the Ileostomy and Internal Pouch Association) produce a booklet of travel tips for people with a stoma (PDF).

Long-term travelling with Crohn’s and Colitis can be challenging, but it is possible with careful planning.

If you’re travelling outside the UK, your doctor should be able to prescribe enough medicines to last up to 3 months, if they think this is safe. If you are travelling for longer, you will need to arrange to get more supplies. Ask your IBD team for advice. You may be able to get a prescription from a local doctor. Or you may be able to get a private prescription from your usual doctor and get your extra supplies from a UK pharmacy before you travel. This will not be covered on the NHS.

• IBD Passport has details of IBD clinics in other countries. This only includes IBD clinics that have registered with the website. It does not list all IBD clinics.
• The Foreign Office has a list of English-speaking medical facilities in other countries. It does not include all doctors or health centres.

If you’re going to need blood tests or an infusion while you are away, talk to your IBD team. They might be able to refer you to a hospital or health centre at your destination. Contact the centre in advance to find out what you need to do. You might have to pay for tests or treatment outside the UK.

IBD Passport has more information on accessing healthcare abroad.

As well as medicines and stoma supplies, there are extra things you might need to pack if you’re travelling with Crohn’s or Colitis.

Documents

If you have them, it’s a good idea to take:

• A copy of your prescription for all your medicines or stoma supplies. Prescriptions are often electronic. You might need to ask for a paper copy.
• A letter from your GP or IBD team confirming your diagnosis and the medicines you are on.
• Your flare-up plan. You could ask your IBD team for one if you do not already have one.
• A steroid card or MedicAlert bracelet, if you are on steroids.
• Your travel insurance policy, GHIC card or EHIC card.
• Contact details for your IBD team.
• Your vaccination record.
• Contact details of a doctor or IBD clinic where you are travelling. You could also give these details to the people you’re travelling with, in case they need to help you get medical care.
• A Crohn’s & Colitis UK Can’t Wait Card. This is available in 29 different languages. Members can get translated cards by emailing membership@crohnsandcolitis.org.uk.

It might also be helpful to take a summary explaining your medical needs. You could take a list of key words or phrases about Crohn’s or Colitis in the local language. Our All About Crohn’s and Colitis information is available to download in six different languages.

Emergency travel kit

Some people pack an emergency kit containing things they might need if they have an accident. This could include:

• Wipes, tissues or toilet roll
• Disposable gloves
• Hand sanitiser
• A change of clothes
• A bag for dirty clothes
• Sanitary disposal bags
• Barrier cream for sore skin
• Air freshener

However you decide to travel, there are extra things to think about when you’re living with Crohn’s or Colitis.

Avoiding blood clots

People living with Crohn’s or Colitis have a higher risk of getting blood clots than other people. Blood clots are more likely to develop when you sit still for a long time – like on long-haul flights or long rail or road journeys. Your risk is higher if you have had surgery recently.

To help prevent blood clots when you’re travelling, you could:

• Wear loose, comfortable clothes.
• Walk around every few hours – either up and down the aisle of a train or aeroplane, or during stops if you’re travelling by road.
• Choose an aisle seat if you can, to give yourself more room. Make sure your luggage does not restrict your leg movement.
• Stretch your feet and ankles and flex your calf muscles often, even if you’re sitting still.
• Drink plenty of fluids (but not too much alcohol).
• Think about wearing travel compression stockings. You can buy these from pharmacies or airports. Ask the pharmacist for advice on the right size for you.

Travelling by road

If you’ve had surgery recently, your surgical team can advise you on how long you should wait before it is safe to drive. This depends on several things, like:

• How well you’ve recovered from the surgery and the anaesthetic
• Whether you have any pain or other symptoms that could affect your driving
• Whether you need to take any painkillers that might affect your driving

You should also check with your car insurance company to make sure you are covered to drive after surgery. If you are travelling as a passenger after surgery, it’s sensible to make sure you can move around easily and sit comfortably before going on a trip.

Some people with Crohn’s or Colitis might be able to get a Blue Badge if they get certain benefits or find it hard to walk from their car to where they’re going. Blue Badges let you park closer to where you’re going, often free or at a reduced cost. You can apply for a Blue Badge online or through your local council. You might find it helpful to use Crohn’s & Colitis UK’s letter of support for applications.

If you have a Blue Badge, you can check online to find out where you can park in the UK. You can also use it in many European countries. The government has a list of European countries where you can use your Blue Badge. Some countries outside Europe also recognise the Blue Badge scheme. The FIA Foundation and BlueBadgeParking.com have information on parking in different countries.

If you’re travelling by road, you might want to check what toilet facilities there are on your route. The Great British Toilet map is a searchable website of public toilets in the UK. There are also lots of mobile apps that help you find accessible toilets. Some of these are worldwide and others cover particular countries. Search “toilet finder” in your app store to find an app that suits you.

Some accessible public toilets are kept locked. You need a Radar key to open these. Crohn’s & Colitis UK members can request a Radar key as part of their membership package. You can also buy keys from The Radar Key Company. These keys work in the UK. Some other countries have a similar scheme. You can buy keys for these from the Radar Key Company too.

Some people take a travel potty on long car journeys, just in case.

If you’re travelling by bus or coach, you could contact the company to check if there is a toilet on board. You may want to find out if you can book an aisle seat close to it.

Travelling by train

If you need it, you can get extra support when you’re travelling by rail, such as help carrying your luggage or getting on and off the train. You can ask for this when you arrive at the station, but it is a good idea to request it in advance. You can do this using National Rail’s Passenger Assist service. For train journeys within the UK, you should request support at least 2 hours before you travel. For international train journeys, you should request support at least 48 hours before you travel.

You can check if your train has toilets on board using National Rail’s facility checker. If you can, pre-book an aisle seat near the toilets. You can also check what facilities are available at the station.

If you receive disability benefits, such as Personal Independence Payments (PIP), you might be eligible for a Disabled Persons Railcard. This gives you money off rail travel in the UK.

Travelling by plane

If you’re flying, you could contact your airline, tour operator or travel agent to find out what support they can offer. You might be able to pre-book a seat near a toilet, or increase your luggage allowance if you need to take lots of bulky medicines or equipment. Let them know what support you need before you travel. They might need a letter from your GP or IBD team, so allow enough time for this. Tell your airline if you have any specific dietary needs.

Many airports offer sunflower lanyards to show that you have an invisible disability. You can usually get these from your airport’s assistance point. These may allow you to access priority lanes if you are not able to queue.

The UK Civil Aviation Authority recommends that you do not fly for 10 days after having abdominal surgery. This is to reduce your risk of complications. You are likely to need a ‘fit-to-fly’ certificate or medical information form from your doctor if you plan to fly sooner. You usually pay for this.

The change in air pressure when you fly can make any gas in your body expand. This can lead to tummy pain. It might help to stick to foods that do not usually upset you and avoid fizzy drinks before you fly.

Travelling can be exciting and rewarding, but it can also be tiring. Try to give yourself time to relax and rest if you need to. It’s just as important to look after yourself when you’re away as it is at home. Make sure you remember to take your medicines.

If you know certain foods make your symptoms worse, try to stick to things you usually eat at home. Some people worry about having an accident while they’re away. You could take a towel or disposable bed pad to put under you while you sleep, just in case.

You might find our information on Fatigue, Food and Living with Crohn’s or Colitis helpful.

Managing flares

Flare-ups are unpredictable. In some people, travelling to a different country, eating different food, being in a different climate or being at high altitude can trigger flare-ups. So it is best to be prepared. Before you go, consider asking your IBD team for a flare-up plan. Make sure you know what to do if you have a flare while you’re away. Your IBD team should be able to provide any medicines you might need.

If you need medical help, you could:

• Contact your insurance company if you have travel insurance. They can help you arrange medical treatment.
• Check the IBD Passport network for information on how to access healthcare in other countries. You have to register to do this, but it is free and quick to do.
• Check the Foreign Office advice for the country you’re in. For many countries, it has information on how to get medical help.
• Or contact the nearest British Consul. They can help you find a local doctor.

Traveller’s diarrhoea

Anyone travelling overseas is at risk of getting traveller’s diarrhoea, especially in developing countries. Having Crohn’s or Colitis does not seem to make you more likely to get traveller’s diarrhoea. But if you do get it, it might be more severe or last longer than in other people.

There are a few things you can do to reduce your risk of getting traveller’s diarrhoea:

• Wash your hands well or use hand sanitiser before eating and after going to the toilet.
• Use bottled, boiled or sterilised water to drink, brush your teeth or prepare food.
• Avoid ice in drinks.
• Avoid salads and raw fruit or vegetables (unless you wash or peel them yourself).
• Avoid unpasteurised fruit juices or dairy products, including ice cream. Pasteurised products are OK.
• Make sure meat or fish are thoroughly cooked. Avoid shellfish.
• Avoid food that has been left uncovered or kept warm.
• Avoid street food, unless it is freshly cooked in front of you and is piping hot.
• Try not to swallow any water if you go to a swimming pool, hot tub or spa or waterpark.

TravelHealthPro has more information on traveller’s diarrhoea and food and water hygiene for travellers.

Most cases of traveller’s diarrhoea get better within a few days. If you get traveller’s diarrhoea, here are some things that might help:

• Drink plenty of fluids. But avoid caffeine and alcohol.
• Take oral rehydration salts if you are losing a lot of fluid. You can buy these from pharmacies or supermarkets. Make sure the water you mix them with is safe to drink.
• Carry on eating normally if you can. You might find easy-to-digest foods like bananas or rice gentler on your tummy.
• Consider taking anti-diarrhoeal medicines. You should not take anti-diarrhoeal medicines if you are in a flare, if you have a high temperature, or if you have blood in your poo. You may not be able to take anti-diarrhoeal medicines if you have a narrowing in your bowel called a stricture.

Depending on where you are travelling, your GP or IBD team might prescribe a course of antibiotics that you can start taking if you get traveller’s diarrhoea.

For more suggestions on how to cope with diarrhoea, see our information on Diarrhoea and constipation.

Dehydration

If you’re in a hot country, you have diarrhoea or you’re exercising a lot, you’ll need to drink more than usual to avoid getting dehydrated. Symptoms of dehydration include thirst, a dry mouth, headaches, tiredness and dark-coloured wee. It’s important to drink plenty of non-alcoholic drinks. Try to avoid being very active in the hottest part of the day.

We have separate information on Dehydration.

Avoiding insect bites

Insects can spread infections, including malaria. Try to avoid being bitten if you can, especially if you are taking medicines that lower your immune system.

To help protect yourself from insect bites, you could:

• Wear loose, long-sleeved tops and long trousers
• Wear socks and shoes
• Use insect repellent
• Sleep under a mosquito net

If you need to use both sunscreen and insect repellent, put sunscreen on first.

TravelHealthPro has more information on avoiding insect bites.

Staying safe in the sun

Some medicines used to treat Crohn’s or Colitis can make your skin more sensitive to sun damage or might increase your risk of skin cancer. Everyone needs to protect themselves from the effects of the sun. But it is especially important if you are taking Crohn’s or Colitis medicines that lower your immune system.

You can protect your skin from the sun by:

• Covering up with long-sleeved tops, trousers or a long skirt. Wearing sunglasses and a wide-brimmed hat also help.
• Using sunscreen that is factor 30 or more, with a 4- or 5-star UVA rating. For it to work well, you should reapply it at least every 2 hours, and after swimming, exercising or drying yourself with a towel.
• Staying in the shade when you can.
• Trying to stay out of the sun between 11am and 3pm.

TravelHealthPro has more information on sun protection.

We follow strict processes to make sure our information is based on up-to-date evidence and easy to understand.

Please email us at evidence@crohnsandcolitis.org.uk if:

• You have any comments or suggestions for improvements
• You would like more information about the sources of evidence we use
• You would like details of any conflicts of interest

You can also write to us at Crohn’s & Colitis UK, 1 Bishop Square, Hatfield, AL10 9NE, or contact us through our Helpline: 0300 222 5700