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Diarrhoeal episodes in travellers suffering from IBD
  1. Pierre Ellul,
  2. Valerie Anne Fenech,
  3. Christine Azzopardi,
  4. Lara Callus,
  5. Nicholas Delicata,
  6. Jeffrey Muscat,
  7. Neville Azzopardi,
  8. Mario Vassallo
  1. Gastroenterology Division, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Pierre Ellul, c/o Ms. Alessia Debattitista, Gastroenterology Division, Mater Dei Hospital, 2nd Floor, Brown Block, msd2000 Msida, Malta; ellul.pierre{at}gmail.com

Abstract

Background and aims There is limited data on the risk of developing diarrhoea in travelling patients with inflammatory bowel disease (IBD). We analysed the rate of developing diarrhoea among travellers suffering from IBD and their healthy controls.

Methods We performed a retrospective case-controlled study among 78 patients with IBD and their healthy travelling companion controls, thus matching both groups to the same environmental conditions. Data was retrieved through a structured questionnaire, interview and clinical case notes review.

Results Sixteen (20.5%) patients with IBD developed diarrhoea while abroad (p −0.0001) Statistical analysis using a χ² test for independence (with Yates Continuity Correction). Prior to travelling, they were in clinical remission. Only one healthy control (1.3%) developed diarrhoea while abroad. In 11 patients (14.1%), the duration of diarrhoea was 3 days or less, and resolved on its own without antibiotics, any increase in their IBD medications and without a medical consultation. The other five patients had a flare-up of their disease and needed medications to put them back into remission. There was no statistically significant difference between patients having immunomodulator medications versus those having aminosalicylates only in developing diarrhoea when abroad.

Conclusions Patients with IBD have a higher rate of developing diarrhoea compared with controls when travelling. Thus, such patients must always seek a pretravel medical consultation.

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