P204 Elevated Fecal Calprotectin Levels Predict Flare-up in Patients with Inflammatory Bowel Disease During International Air Travel

Park, J.(1);Hyuk, Y.(2);

(1)Department of Internal Medicine- Institute of Gastroenterology- Yonsei University College of Medicine- Seoul 03722- Korea, Department of Internal Medicine, Seoul, Korea- Republic Of;(2)Department of Internal Medicine- Seoul National University Bundang Hospital- Seongnam- Korea, Department of Internal Medicine, Seoul, Korea- Republic Of


Inflammatory bowel disease (IBD) patients often experience disease flare-ups during international air travel. We aimed to evaluate the proportion of patients that experiences IBD flares during international air travel and identify risk factors associated with enhanced disease activity.


Patients with scheduled international air travel were enrolled in the study from the Seoul National University Bundang Hospital IBD clinic. Flight information and clinical data were collected via questionnaires and personal interviews, and risk factors associated with IBD flares were determined.


Between May 2018 and February 2020, 94 patients were enrolled in the study (mean age, 33.0 years; males, 53.2%; mean disease duration, 56.7 months), including 56 (59.6%) with ulcerative colitis and 38 (40.4%) with Crohn’s disease. Of the 94 patients enrolled, 15 (16.0%) experienced an IBD flare-up and 79 (84.0%) remained in remission throughout travel. Logistic regression analysis revealed that high fecal calprotectin levels before travel (odds ratio [OR]: 1.001, 95% confidence interval [CI]: 1.000–1.001, p = 0.016), the presence of a comorbidity (OR: 6.334, 95% CI: 1.129–35.526, p = 0.036), and a prior emergency room visit (OR: 5.283, 95% CI: 1.085–25.724, p = 0.039) were positively associated with disease flare-up. The previous and current use of immunomodulators and biologics, time of flight, altitude, number countries visited, travel duration, objective of visit, and previous medical consultations were not associated with disease flare-up.




Factors including fecal calprotectin levels, prior visit(s) to the ER, and the presence of a comorbidity predicted IBD flare-up during international travel.