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Travel and Holiday
This pamphlet aims to reassure and advise all ostomists that travelling short or long distances can be relaxing and enjoyable.
There is no reason why having an ostomy should stop you from travelling anywhere in the world. Many ostomists, particularly soon after the operation, associate problems which lead to stress with even the shortest journey. Fear of not having clean facilities available when required, running out of or misplacing appliances or even not sleeping in your bedroom where everything is familiar, can be a worry. The best way to overcome these concerns is to plan ahead. If all possible disasters have been catered for, there should be nothing to worry about. No matter where, when or how you make a journey — be prepared.
The following gives general guidelines to advise on things that should be considered before a journey is started. Of course everyone's requirements are specific to their needs and will depend on their particular preferences. However, general advice will help make preparation for holidays and journeys a lot easier.
GENERAL TIPS & ADVICE
  • If you are going away for a long period of time and are travelling by air with a lot of supplies, your luggage weight allowance (20 kilos per person in most cases) may be a problem. Some airlines may offer special overweight allowances for medical supplies. Check with the airline when making your booking.
  • Remember that IATA (International Air Transport Association) regulations forbid passengers to take dangerous items on board an aircraft, such as ether meths which could cause flash fire. It is the passenger's responsibility, if in doubt, to check with the airline. Your travel agent, pharmacist or ostomy equipment supplier can usually advise you of items that are on the prohibited list.
  • During a long haul flight remember that a queue for the toilets will develop after a meal and that food trolleys can block the gangway to toilets for a period of time, so beat the rush and go before food starts being served.
  • Your hand luggage will be inspected at the security baggage check before boarding an aircraft, so if you have any drugs with you, have your doctor prepare a card explaining that they are medical supplies. Remember also that some countries do not allow certain drugs, such as codeine, to cross their borders, so check before taking drugs abroad. You may be frisked when leaving the terminal to board the aircraft, so be prepared to explain about your ostomy.
  • Travelling by car should present no problems. Obviously your car seat belt should be comfortable. It should sit across your hip bone and pelvis, not your abdomen and stoma. If you feel you need to give your stoma extra protection from the belt strap there are inexpensive, commercially available devices for making seat belts more comfortable. An extension bracket can be fitted which lowers the angle at which the belt crosses the body or for inertia reel belts a "klunk klip" device eases the pressure on your shoulder, chest and abdomen without interfering with the belt operation. Both of these are available from car accessory shops.
  • While staying in foreign accommodation, if you feel that your appliances are not safe, speak to the management and ask to have the bulk of your supplies locked away in a secure place.
Tips & advice for Ileostomists.
  • Due to the nature of the ileostomy appliance, leakages may occur during the night. It is a good idea to take along a plastic mattress cover or sheet so that in the event of a leak during the night the mattress does not get damaged.
  • Non-ileostomists are often more prone to "Travellers Trots" or "Montezuma's Revenge" because these bugs act mainly on the colon. However, ileostomists should take extra care as acute diarrhoea can lead to dehydration through loss of fluid.
Tips & advice for Colostomists.
  • A change in air pressure in an aeroplane cabin can create wind for anybody, but it can be a particular problem for colostomists. So avoid obvious things like gassy drinks, eating too quickly or anything which causes you to swallow air. There are appliances that are especially fitted with flatus filters. A small hole in the top of the pouch allows air to escape through the filter which absorbs any odours while releasing the trapped wind.
  • If you are making a journey of a day or more's duration, it is a good idea to either eat something which you know will constipate you for a day or two or obtain tablets from your doctor. This will reduce worries of having to change your appliance while en-route.
  • Irrigation, a technique of administering an enema through the stoma, empties the bowel at a scheduled time convenient to you. It should then prevent stoma activity between irrigations. This can be very helpful when travelling or on holiday. Irrigation is a complicated process however, which can only be carried out by colostomists who have their stoma in the lower part of their colon. You will need to get detailed instruction from your Stoma Care Nurse well in advance of your holiday on how to irrigate and it is important that you do nothing without professional guidance and advice.
Tips & advice for Urostomists.
  • For urostomists who are worried about having embarrassing accidents while away from home and for peace of mind, take a plastic mattress cover so that in the even of a leak during the night the mattress will not get damaged.
  • In hot climates dehydration can be a problem which may lead to the development of a urinary infection. It is important that you drink plenty of fluids to keep up your usual urine production in order to 'flush' out your system. See a doctor if you begin to feel ill, as a urinary infection may be developing. Carefully keep up your usual skin care around the stoma, especially in hot climates.
  • Take an overnight drainage bag or leg bag with you when travelling. This will be useful when travelling on an overnight journey to extend periods between pouch emptying. Be sure that if you should fall asleep, however, you have made arrangements to ensure no accidents can occur.
APPLIANCES
Supplies and hand luggage
With a prepared travel check list, packing equipment and appliances should be easy. In general it is advisable to keep most of your supplies together as hand luggage so that it remains with you at all times and is in easy reach. Particularly when travelling by air, when luggage has been known to go missing, it is wise to keep hold of the essentials. It is much easier to replace clothes than ostomy equipment. However, in case your hand luggage is misplaced, extra supplies should also be kept in your suitcase or travelling companions luggage as a precaution. A separate small travel kit containing items needed for a change of appliance should be kept closed at hand to make visits to the toilet simple and discreet.
Storage of appliances
Storage of appliances is also important. They should not be allowed to get too warm while in transit. When travelling by car, especially in warm and humid climates, do not keep supplies in the boot or glove compartment which are often the hottest places in warm weather.
"I have found, especially when on a camping holiday, that in order to keep m y appliances at a constant temperature, I keep them in a picnic cool box or bag. The adhesive seals remain in perfect condition and all my supplies are kept in one place within easy reach whenever I need them." Angela Cooke, National Secretary of the Urostomy Association.
Most manufacturers provide guidelines for storage of ostomy equipment which are especially useful when staying in hot climate locations. Generally, when abroad, bathrooms are often the coolest place and as long as they are not too steamy are probably the best place to keep your appliances.
Disposal
Disposal of used ostomy pouches while abroad will not be difficult if you make proper preparations. Before changing your pouch, check that the washbasin is not in a separate room from the toilet and that a means to dispose of the pouch is at hand. In your travel kit make sure you have toilet paper to wrap up the used pouch, plastic carrier bags to dispose of them at a convenient place and time and carry cleansing wipes to clean up any accidental mess. Don't be embarrassed to go into hotels or restaurants to use their facilities as they are more likely to be clean and have washbasins and sanitary bins available.
Some manufacturers supply self-seal polythene disposal envelopes in which used pouches can be wrapped for easy disposal. Alternatively, nappy disposal bags are very handy and come pleasantly scented or freezer bags, available in convenient sizes with ties to close them, make disposal of used appliances simple and discreet.
PRE-TRAVEL ADVICE
It is only natural that you feel a little apprehensive about travelling for the first time after your operation. It makes sense therefore, to start with short trips away from home to build up your confidence. Once reassured that you equipment stays secure during normal day-to-day activities you can start to venture further afield.
Preparation for Your Holiday or Journey
Before starting off on any journey - whether it be a weekend break to your local seaside town or a month's holiday in the Far East - plan ahead. A few days or even weeks before departure, prepare a checklist of things to take with you at your leisure. Go through your daily routine of pouch changes to help remind yourself exactly what you use and need such as pouches, flanges, skin protective wipes, filters, disposal bags and so on. Don't forget to take along different sized pouches to cater for sporting activities when a smaller one may be necessary or for long journeys when a bigger pouch may be needed as pouch changes may have to be delayed.
Calculate the number of pouch changes you normally need to make and then double it to make sure you have plenty of appliances at hand. You never know what may happen, your return journey may be delayed, some appliances may go missing or the changes in climate and environment may mean more pouch changes are needed than usual. Having extra supplies can only add to your peace of mind.
Travel Documents
When travelling abroad it is wise to check you have all the necessary travel documents well in advance. The usual paperwork such as passport, tickets, visas etc. will be a matter of course. However other documents may come in handy. A travel certificate available from the Ostomy Associations will help explain what your appliances and medications are for, thereby avoiding embarrassing questions at custom checks. The certificates are available in a number of different languages which may be helpful should more supplies be required or medical advice needed while abroad.
Travel Insurance is essential as it covers loss of luggage and money as well as cancellation of holidays. Carefully check any exclusions such as age limits or pre-existing medical conditions. If you are in any doubt about whether you are fully covered or not by your policy contact either your Insurance Broker or Travel Agent for advice.
If you are travelling within the EC (and some other countries) there are reciprocal agreements which entitle you to free emergency treatment if required. To claim you must carry an E211 form which can be obtained from your local Post Office. An accompanying leaflet (SA36) entitled "How to get treatment in other European Community Countries" gives precise details of what treatment is free and what you may have to pay for.
Finally, familiarise yourself with the procedure for obtaining medical aid abroad and have emergency contacts available as a precaution. Chances are you won't need them, but it is best to be prepared for anything. The various Ostomy Association can give you contacts of suppliers abroad.
Last Minute Arrangements
Many ostomists may be tempted to reduce the flow from their stomas while travelling by changing their regular eating or drinking routine. In general it is advisable not to vary your normal routine or usual eating habits. However, some people find a complete change of their equipment before departure will give maximum security and confidence from the possibility of leaks.
"As a Urostomist, I have found it advisable to change my appliance three or four hours before departure to give time for it to settle down and ensure it is working satisfactory." Fiona Solman, Urostomist.
ACCOMODATION ABROAD
An area that often causes a lot of concern is that of foreign accommodation. At home everything needed is at hand and total privacy ensures nothing embarrassing can happen. Fear that all this will change when away frequently keeps people from staying with friends and family or going away on holiday. So often this fear is totally unfounded. With good forward planning you should have everything you need neatly packed in your travel kit. Most hotels now have en-suite bathrooms so that pouch changes can be made easily, in private and at your leisure, at a time convenient to you. If you are still concerned then check when making a booking that you have private bathroom facilities adjoining your room. When staying with friends or family who may not be aware of your special needs, try to use the bathroom out of rush periods if at all possible or explain briefly about your operation - family and friends are sure to understand.
FOOD AND DRINK
While abroad, general advice on food and drink is the same for anyone. Common sense precautions, such as avoiding the local drinking water, eating foods that have been well cooked or come from a reliable source and being aware of the possibility of becoming dehydrated in hot climates apply to everyone regardless of whether they have an ostomy or not.
However, a change of water, climate or food can upset your bowels so be prepared. Diarrhoea medications are available without a prescription over the counter from your local chemist and if taken at the first signs of diarrhoea, will usually nip the problem in the bud.
Diarrhoea, particularly if accompanied by a fever and vomiting, may also lead to a shortage of salt in the body. The difficulty is knowing how much salt needs replacing. Normally one level teaspoon of salt a day is all you need, but if your 'output' is doubled then salt needs to be doubled. Don't take salt on its own, always add it to your food or take commercial salt solutions or tablets which are available from your chemist.
Dehydration
In hot climates, as chances of dehydrating are increased, ostomists are recommended to drink more fluids (preferably water). A sign of being dehydrated is the production of less urine than usual. Special rehydrating solutions such as Dioralyte or Rehidrat can be useful for severe cases of dehydration and are available from most chemists. Provided you have diarrhoea medication with you and you take care of what you eat and drink you can enjoy the local delights, but be sensible and avoid excesses. Remember also — too much alcohol will accelerate dehydration as well as give you a hangover in the morning so don't overdo it.
FASHION
When away on holiday, the main objective is to relax and enjoy yourself. Part of this is to be able to wear what you like. As you know there are very few restrictions on what you can wear, however, be careful with especially tight clothing that may restrict the flow of your body waste into your appliance.
Swimwear is possibly the only exception to the 'wear what you like' rule. How brief swimming trunks or bikinis can be depends on the position of your stoma, but there is no reason why ostomists should not take to the water. People tend to be very self-conscious, especially of the way we look, but how often do we notice other people around us? Ostomists make the mistake of believing everyone will immediately turn to their stoma and stare, in truth most will not even notice the colour of your costume, let alone what may lie beneath it. If you are worried, wear a bold-patterned swimming costume which will distract the eye and camouflage any bulges that may be caused by your appliance or otherwise!
If you can't find a swimsuit that you like, there are a number of special suppliers of swimwear who make swimming costumes to suit particular needs. Below lists contact names and addresses.
EXTRA SUPPORT
Having an ostomy is a major operation which should not be underestimated. The first few weeks or even months following the operation may be difficult as you adjust gradually to being an ostomist. However, once fully recovered and settled at home, returning to the lifestyle enjoyed before the operation should be no problem.
As long as you have no complications an your doctor has no objection, you can enjoy any kind of sporting activity. Even violent contact sports such as rugby, karate or kung fu are enjoyed by fellow ostomists and sports such as bowls and aerobics, which involve a lot of bending, have been taken up.
If you would like to talk to someone about a particular sport, contact your Ostomy Association. They may be able to put you in touch with an ostomist who currently enjoys your sport and who can give you some practical advice.
USEFUL ADDRESSES
Hollister Limited
Rectory Court
42 Broad Street
Wokingham
Berkshire
RG40 1AB
Telephone: 0118 9895000
Advisory Service: (FREEPHONE) 0800 521377
Website: www.hollister.co.ukLeaving Hollister.com
Hollister Limited
Belgard Road
Tallaght
Dublin 24
Ireland
Telephone: 00 353 14041680
Advisory Service: (FREEPHONE) 1800 503400
Website: www.hollister.co.ukLeaving Hollister.com
British Colostomy Association
15 Station Road
Reading
Berkshire
RG1 1LG
Telephone: (FREEPHONE) 0800 3284257
Website: www.bcass.org.ukLeaving Hollister.com
The Ileostomy Association of Great Britain and Ireland
Peverill House
1-5 Mill Road
Ballyclare
BT39 9DR
Telephone: (FREEPHONE) 0800 0184724
Website: www.ileostomypouch.demon.co.ukLeaving Hollister.com
Urostomy Association
Buckland
Beaumont Park
Danbury
Essex
CM3 4DE
Telephone: 01245 224294
Website: www.uagbi.orgLeaving Hollister.com
NASPCS - Association for Support of Parents of Children with Stomas
51 Anderson Drive
Valley View Park
Darvel
Ayrshire
KA17 0DE
Telephone: 01560 322024
National Association for Colitis and Crohn's Disease
4 Beaumont House
Sutton Road
St Albans
Hertshire
AL1 5HH
Telephone: 0845 1302233
Website: www.nacc.org.ukLeaving Hollister.com
SWIMWEAR & LEISUREWEAR SUPPLIERS
Chums Limited
Caddick Road
Knowsley Industrial Park South
Prescot
Merseyside
L34 4AB
Telephone: 0151 548 8088
Respond Plus Limited
7 Gauntley Court
Ward Street
Nottingham
NG7 5HD
Telephone: (FREEPHONE) 0800 220300
Website: www.respondplus.co.ukLeaving Hollister.com
Ostomart Ltd
10 Leofric Square
Peterborough
Cambridgeshire
PE1 5TU
Telephone: 0845 757 3023
Travel and Holiday
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