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P574. A recent flare of disease does not prohibit travel: early results of a single centre study in inflammatory bowel disease and travel

K. Greveson, T. Shepherd, M. Hamilton, C. Murray, Royal Free Hospital, Gastroenterology, London, United Kingdom

Background

Travellers with Inflammatory bowel disease (IBD) are at greater risk of travel-related morbidity [1]. Relapse and acquired infection are the main risks to IBD patients while abroad, and ECCO recommend expert consultation prior to travel, particularly for those on immunosuppression [2]. IBD limits a majority of patients choice of travel destination [1]. Despite this, there is limited data regarding IBD patients pre-travel preparation and travel experiences.

Methods

All IBD patients attending the Royal Free Hospital specialist IBD clinic during November 2013 were given the opportunity to complete an anonymous questionnaire. We asked for demographical and disease specific information, in addition to detailed travel questions; including perceptions, pre-travel planning and recent travel experiences. Data was entered and analysed on an anonymised database. We hypothesised that patients who had flared within the last 6 months would be more concerned about travel and would be less likely to travel in that same period.

Results

A representative 75 IBD patients (38 [51%] Crohn's disease, 34 [45%] male, age 18–82 years [median age 40 years]) completed the questionnaire. 36 [48%] were immunosuppressed and 32 [43%] had IBD related surgery. 30 [40%] experienced an IBD flare in the last 6 months. Although 55% [n = 41] report IBD affects travel, 49 [65%] travelled in the last 6 months. A majority of the patients that had experienced a flare in the last 6 months (18 [60%]) travelled in the same period, despite most of them (14 [78%]) reporting IBD affects travel. Only 5 [10%] (2 in recent flare group) of travellers sought pre-travel medical advice of any kind and only 16 [33%] (8 in recent flare group) had travel insurance (the majority [11] paid a premium). 12 [24%] (5 in recent flare group) travellers reported a change in bowel habit while abroad, but only 3 sought medical advice. We also report that 50% [n = 18] of immunosuppressed patients are unaware of the need to avoid live vaccines.

Conclusion

This small study confirms that IBD patients feel their disease affects travel, although 65% still went abroad recently. A recent IBD flare did not prohibit travel during the same period. Numbers suggest patients are not receiving the recommended travel medical advice, including the need to avoid live vaccinations if immunosuppressed, and are possibly not or under insured. The continued collection of data will allow statistical meta-analysis to support the need for dedicated IBD travel patient education.

1. D Soonawala, (2012), Pretravel Preparation and Travel-related Morbidity in Patients with Inflammatory Bowel Disease, Inflammatory Bowel Disease, 2079–2085.

2. J F Rahier, (2009), European evidence-based Consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease, Journal of Crohn's and Colitis.