Traveling with an ostomy is a concern for many ostomates. Having issues when going through security, privacy and hygiene during the journey and in the place of destination are some recurring and disturbing thoughts, causing people to avoid traveling. The long-term effect of this self-imposed travel ban is self-isolation and its associated problems. The correct planning can prevent these disturbances and improve the traveling experience.
“Many people with a stoma, particularly soon after the operation, can experience stress at the prospect of even the shortest journey. For example, they worry about not having a clean place to change a pouch, running out of or misplacing pouches or even sleeping in a strange bedroom. The best way to overcome these concerns is to plan ahead. If all possible challenges have been anticipated, you will feel more relaxed and, therefore, not worry as much.
It is only natural to feel apprehensive about traveling for the first time after your operation. You might want to start with short trips away from home to build up your confidence. Once reassured that your pouching system stays secure during normal day-to-day activities, you can start to venture further.”1
General Recommendations Before Driving and Flying
“After surgery, your doctor may recommend you wait until you are walking around easily and able to sit comfortably before traveling. How long this takes depends on the type of surgery you have had and how quickly you recover, but it may be three to four weeks.
Your general practitioner (GP) will tell you when you can start to drive again. You will need to be in full control of the vehicle and not affected by any medicines that may make you feel sleepy, like some painkillers. You should feel comfortable when you are driving and be able to do an emergency stop with confidence. You will need to tell your car insurance company about your operation and they can tell you how long you need to wait before you are insured to drive.
You may need to wait until you have been back to the clinic for your review (4-6 weeks after surgery) before you can fly. If you need to fly sooner than this, your consultant may suggest waiting for at least 10 days after surgery, depending on the type of surgery you have had. This is because the air pressure within the cabin causes the gas in your intestines to expand, which could cause pain and stretch your wound. You will have a higher risk of blood clots (deep vein thrombosis) on long journeys if you have recently had surgery. To reduce your risk, you may want to wear compression stockings (properly fitted by a health professional) and move your legs as much as possible during the journey.”2
For security considerations, certain guidelines now exist on how to do this successfully. In the U.S, Transportation Security Administration (TSA) has clear information for traveling ostomates. It includes:
- Informing the TSA staff that you have an ostomy pouch.
- Letting them know of areas that are painful if touched
- Arriving early at the airport so that all liquid medicines you are carrying get screened and tested in time.
Considerations when Flying with An Ostomy
“Empty your pouch prior to entering the security area and boarding the plane. This will help take away anxiety about pouch filling or pressure. It’s a good idea to pre-cut all of your barriers at home, since some airports may not allow scissors in your carry-on. Even though the U.S. Transportation Security Administration (TSA) allows an exception for “ostomy scissors,” this applies only to flights departing the United States. Airport rules can vary from country to country, and airport to airport. So, if you do take scissors, keep them in your checked luggage. For the latest information, check the TSA website (www.tsa.gov) for updates. All airport screening must be conducted in a way that treats the passenger with courtesy, dignity, and respect. If the security staff need to do a hands-on pat-down check, you can ask that it be done in a private area. You might find it helpful to carry one or two documents with you. One is a letter from your doctor stating that you have an ostomy. The letter should also include the contact information for your primary care doctor and your ostomy doctor. The second document is the United Ostomy Associations of America (UOAA) Travel Communication Card. You can print the card from the UOAA website (www.ostomy.org). The card offers information about the surgery and the supplies you’re carrying.
There is always a risk that checked luggage will reach your destination late, or not at all. It is important to pack all of your supplies, if possible, in your carry-on luggage. Consider carrying travel ‘packs’ on the plane as well. Put all of the supplies you’ll need for a pouch system change in a zip-top plastic bag. That will make it easier to go to the restroom with the supplies you need, and allows you to throw away the pouch in the plastic bag. If you have a colostomy, you may want to try using a closed-end pouch when traveling on a plane. It can be easier to throw away a used pouch instead of emptying it. Drink fluids to counteract the effects of dehydration and jet lag. A glass of water or fruit juice every hour will reduce the risk of dehydration. Avoid gas-producing foods and liquids on the plane. You may also want to use a pouch with a filter to decrease gas build-up.”3
Planning is Vital when Traveling with an Ostomy
A few days, or even weeks before departure, prepare a checklist of things to take with you. Keep track of your daily routine of pouch changes to remind yourself exactly what you need and use: Pouches, skin barrier, skin protective wipes, disposal bags and so on.
Don’t forget to take along different sized pouches – perhaps a smaller one for sports activities or a bigger pouch for longer time periods when pouch changes may be delayed.
Count the number of pouch changes you normally need to make, then double that number to make sure you have plenty of supplies and pouches on hand. That way, you are ready for the unexpected – a delay in returning home, lost pouches, or changes in climate and environment that call for more pouch changes than usual.
Depending on the type of surgery you have had, there may be additional ways to make sure you are comfortable and prepared.
If You Have an Ileostomy
Because of the consistency of the ileostomy fluid, it is possible that chance leakage may occur during the night. You might want to take along a plastic mattress cover or sheet to prevent mattress damage. In hot climates, dehydration can be a potential problem. It is important to drink plenty of fluids to remain well hydrated.
If You Have a Colostomy
A change in cabin pressure on a plane or diet can create gas or wind for everyone. But it can be a particular problem for people with a colostomy. Avoid obvious things like gassy, carbonated drinks, eating too quickly, types of food you know that cause gas, or anything that causes you to swallow air. You can also use a pouch with a filter. There is a small vent in the top of the pouch with a filter that absorbs odors but allows trapped gas to escape.
If You Have a Urostomy
If you will be in a hot climate, make sure that dehydration does not become a problem. Be sure to drink plenty of fluids to maintain your usual urine production so you are always flushing out your system. Carefully keep up your usual skincare around the stoma, especially in warm weather. If you begin to feel ill, do not wait to see a doctor because a urinary infection may be developing. When you are traveling, take an overnight drainage bag or leg bag with you. This will be especially useful when you have extended periods between pouch emptying. Be sure that if you should fall asleep, you have made arrangements to ensure no accidents occur.4
Carry a Travel Kit
“The only difference from being in your home to traveling is that you need to plan ahead and be prepared. Whether you are traveling by car, plane, ferry or train take plenty of supplies with you and always make sure that when you go out you carry a travel kit – a small bag containing emergency supplies so that you can change your pouch should the need arise.
How Much to Take with You?
There is no real answer to this but if you double up on the quantity you use at home that should usually be enough. Remember to double up on the number of wipes, tissues, and disposal bags as well as the pouches (one piece) or flanges and pouches (two-piece).
Where to Pack Your Stoma Supplies?
If you want complete peace of mind, always pack your entire stock of supplies for the holiday in your hand baggage and keep this with you at all times. Carriers, whether they be airlines or ships do lose baggage. So if you pack half the supplies for your holiday in your hand baggage and a half in your luggage which goes in the hold and your luggage gets lost, this means that you only have half the supplies you need. Note: Cabin/Hand baggage is luggage that you carry on the plane with you, while hold baggage is luggage that you check-in. All baggage items, including hand baggage, must be screened, regardless of size. You should always check size limits with your airline and airport before you travel. Airlines may also have their own rules about the number of bags you are allowed to take on the aircraft. It’s best to contact them if you have any questions.5
Preparation At Home Includes:
- Pre-cut all the ostomy bags you will need during your travel to avoid carrying scissors, which are prohibited through security (especially for international travel).
- Have additional supplies with you to cover your needs in case of unforeseen delays in areas where supplies are not available
- Have your ostomy supplies both in your carry bag and in the bag to be checked. This gives you easy access to the supplies when you need them.
- Get a note from your ostomy nurse or physician explaining your condition and need for a private room if required.
- If traveling to a foreign country where language is a problem, have all your ostomy related information translated into the host country’s official language of communication.
- Domestic flights within the U.S allow scissors of up to four inches long. International flights prohibit this.
- “Remember that IATA (International Air Transport Association) regulations forbid dangerous items on board. For example, ether, methylated spirits, or flammable aerosol adhesives and removers are not allowed because of a fire hazard. Scissors may not be allowed either, so pre-cut your barriers before traveling.”6
- Get all information on the amount of medical/ostomy related fluids allowed both in the local and international flights.
- “In the event that you do need additional supplies while traveling, most manufacturers have products available around the world.
- Before you leave home, check to see where you can purchase new supplies in the areas where you plan to travel.” 7
- Carry the blue travel communication card that indicates that you are an ostomate. This ‘speaks’ on your behalf when you do not wish to talk about your status loudly. This card avoids unnecessary delay and embarrassment at the full-body scanner when the machine identifies your pouch.
- In several airports, both local and international, the staff should treat ostomates are with courtesy and dignity. However, sometimes overzealous security staff may treat them discourteously. If this happens, do not allow it to spoil your travel experience.
Other general guidelines for all travelers are also applicable to ostomates. These patients should take multiple precautions while traveling. Avoid drinking water of questionable sources or safety and do not consume too much alcohol and beverages especially coffee. Only eat foods from hygienic outlets to prevent digestive issues.
Take a travel insurance cover and make sure that your already existing health condition (ostomy and others) are covered in the policy.
“When traveling abroad, you will naturally make sure that you have important papers such as a passport, tickets, visas, etc. Other documents may also come in handy. A travel communication card is available from the UOAA and will help explain what your pouches, skin barriers, and medications are for, to help avoid extra questions at customs and/or security checkpoints. The certificates are available in a variety of languages, which may be helpful should more supplies be required or medical recommendations needed while traveling abroad. It’s also a good idea to have a letter from your healthcare professional explaining your medical condition.
There is no reason why having a stoma should stop you from traveling anywhere in the world.”8
Having an ostomy should not impede any traveling experience. Consider all the facts presented above, and, if you will, seek an ostomy nurse/ostomy support group for additional advice.
(1, 4, 6, 7) LifeStyle Bk Template. https://travel-for-all.com/wp-content/uploads/2017/07/Travel-with-an-Ostomy.pdf
(2) Living with a Stoma. http://s3-eu-west-1.amazonaws.com/files.crohnsandcolitis.org.uk/Publications/living-with-a-stoma.pdf
(8) Living with an Ostomy. living–with–an–ostomy_travel_923123-0417.pdf