Abstract
Backgrounds and aimsInflammatory bowel disease (IBD) patients often experience disease flare-ups during international air travel. We aimed to identify risk factors associated with IBD flare-up during international air travel.MethodsPatients 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.ResultsBetween May 2018 and February 2020, 94 patients were prospectively 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 history of 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.ConclusionsElevated fecal calprotectin levels, history of emergency room visits, and the presence of a comorbidity predicted IBD flare-up during international air travel.
Highlights
The incidence and prevalence of inflammatory bowel disease (IBD) has increased worldwide throughout the 21st century [1]
We aimed to identify risk factors associated with IBD flare-up during international air travel
Between May 2018 and February 2020, 94 patients were prospectively enrolled in the study, including 56 (59.6%) with ulcerative colitis and 38 (40.4%) with Crohn’s disease
Summary
The incidence and prevalence of inflammatory bowel disease (IBD) has increased worldwide throughout the 21st century [1]. IBD consists of chronic idiopathic refractory inflammatory disorders of the gastrointestinal tract, and includes both ulcerative colitis (UC) and Crohn’s disease (CD). Weight loss, and hematochezia in CD patients is typically caused by transmural inflammation of the gastrointestinal tract [3, 4]. Therapeutic targets for IBD have been developed to achieve clinical, endoscopic, and histological remission in IBD patients using aminosalicylates, steroids, immunomodulators, and various other biological agents [5, 6]. Previous studies have identified factors capable of triggering IBD, such as nonsteroidal anti-inflammatory drugs (NSAIDs), tobacco, infections, and poor adherence to IBD treatment [7, 8]
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