Before your ostomy surgery, your life may have included traveling.
You may be hesitant to travel with a stoma. You may be concerned about not finding a clean place to change your pouch, or that you will not have the needed supplies on hand.
This article can help you take the steps to enjoy a worry free trip.
The key is planning. If you plan and organize ahead of time, you can be sure you are prepared for the new situations you will encounter.
As you read and take note of the information and tips included here, you can anticipate the pleasure of taking a plane to a country you’ve always dreamed of, or just traveling to see a close friend in a nearby town.
Travel and Holidays
There is no reason why having a stoma should stop you from traveling anywhere in the world. Here you will find information that will help you be ready and prepared before you ever leave home.
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.
The following are general guidelines for things to consider before starting to travel. Of course, your requirements are specific to your situation and will depend on your unique preferences.
If you are unsure of some of the terms used in this booklet, there is a glossary included at the bottom of the page to briefly explain the most common terms.
Preparation for Travel
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.
Before starting off on any journey – whether it is a weekend break to a local seaside town or a month’s holiday in the Far East – it is best to plan ahead.
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.
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.
Ostomy Associations can give you contacts of suppliers abroad.
When traveling abroad, you will naturally make sure that you have important papers such as a passport, tickets, visas, etc. However, other documents may come in handy. A travel certificate available from the Ostomy Association will help explain what your pouches, skin barriers, and medications are for, thereby avoiding embarrassing questions at Customs.
The certificates are available in a variety of languages, which may be helpful should more supplies be required or medical advice needed while traveling abroad.
You also may be purchasing travel insurance to cover loss of luggage or money as well as cancellations. Carefully check for any exclusion, such as age limits or pre-existing medical conditions. If you are in doubt about whether you are fully covered, check with your insurance agent, broker or travel agent.
Finally, before you leave, find out how to obtain medical aid abroad and have emergency contacts available.
Last Minute Arrangements
You may be tempted to reduce the flow from your stoma while traveling by changing your regular eating or drinking routine. However, it is generally not advisable to vary your normal routine or usual eating habits.
On the other hand, some people find that a whole new pouching system before departure gives confidence and maximum security 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.”
Air and Auto Tips
Here are a few ways to make sure you are comfortable and prepared when you fly or take a trip by car, coach or train.
Weight limits. If you are traveling by air with a lot of supplies, check with the airline for the luggage weight allowance. Some airlines may offer special allowances for medical supplies.
Forbidden items. 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.
Your travel agent, pharmacist or ostomy product supplier can usually advise you of items that are on the prohibited list.
You can also check with the airline.
Pre-boarding security checks. Your hand luggage will be inspected at the security baggage check before boarding the aircraft. If you have any drugs with you, have your doctor prepare a card explaining that they are medical supplies. Some countries do not allow certain drugs, such as codeine, to cross their borders.
You may be searched before boarding the aircraft, so be prepared to explain about your stoma. Travel cards for this are available from some companies and ostomy associations. Travel-for-All provides these for all clients traveling with an ostomy
Using airplane toilets. During a long flight, there are times when many people want to use the toilet, perhaps after a meal. During mealtime, food trolleys can block the way to toilets. So keep your eyes open for a chance to use the toilet when most people are in their seats.
Your may want to request a seat that has easy access to the toilet and is easy to get out of, like an aisle seat.
Car travel. Traveling by car is much simpler than flying, and there are ways you can plan ahead to ensure your comfort and convenience.
Your car seat belt should sit across your hip bone and pelvis, not your abdomen and stoma.
If you want to give your stoma extra protection from the strap, car accessory shops carry products that make seat belts more comfortable. An extension bracket can be fitted to lower the angle at which the belt crosses the body. For other types of seat belts, a “klunk klip” device eases the pressure on your shoulder, chest and abdomen without interfering with the belt operation.
Special Tips & Advice for Your Type of Stoma
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.
Irrigation, a technique of administering an enema through the stoma, can be used to empty the bowel at a time which is convenient to you. It should prevent stoma activity between irrigations. This can be very helpful when your schedule means limited access to a bathroom.
Irrigation can only be carried out if your stoma is in the lower part of the colon. This procedure should not be attempted at the last minute! Successful irrigation relies on an established regimen, e.g. daily or every other day. Be sure to get professional directions and advice from your Stoma Care Nurse before you leave home.
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 skin care 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.
Traveling with pouches and supplies
Once you have prepared a travel checklist, packing equipment and pouches should be easy.
When you are at home, you probably keep most of your pouches and supplies together. For travel, you might want to consider the “divide and conquer” approach – divide the items you will need, and keep some in your carry-on bag. Put the rest in the luggage that you check with the airline or in the baggage of a traveling companion. That way, if one of the bags is lost, you still have supplies available in the other.
Your short-term needs go in hand luggage so they remain with you at all times and are within easy reach. A separate, small travel kit containing items needed for a change of pouch should be kept in your hand luggage to make visits to the toilet simple and discreet.
With recent changes in airport security, many airlines may not allow scissors on board aircraft, even for ostomy products. So if you use a cut-to-fit product, be sure you have enough pre-cut skin barriers to use before reaching your destination.
You can pack your scissors in your checked luggage. Some airlines do allow ostomy scissors, but it is always better to be prepared either by checking first or having your products cut already.
Storage of Ostomy Products
Storage of ostomy products is also important. They should not get too warm while in transit. When traveling by car, especially in warm and humid climates, do not keep supplies in the boot (trunk) or glove compartment, which are often the hottest spots in the vehicle. A cooler may be a useful container to transport your pouches in.
“I have found, especially when on a camping holiday, that in order to keep my 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 products. This is especially useful when staying in hot climate locations. Bathrooms are often coolest and, as long as they are not too steamy, are probably the best places to keep your products.
Disposal of used stoma pouches should not be difficult if you make proper preparations. Before changing your pouch, check that the sink is not in a separate room from the toilet and that a means to dispose of the pouch is at hand.
Make sure your travel kit contains toilet paper to wrap up the used pouch, as well as plastic carrier bags to dispose of them at a convenient place and time. Carry cleansing wipes to clean up any accidental mess. Don’t hesitate to go into hotels or restaurants; their facilities are more likely to be clean and have sinks and sanitary bins available.
Some manufacturers supply disposal bags in which used pouches can be wrapped for easy disposal. You also could use nappy/diaper disposal bags that come pleasantly scented. Freezer bags, available in convenient sizes with ties to close them, also make disposal of used pouches simple and discreet.
Overnight stays at hotels and homes
Staying overnight – whether at a friend or family member’s home, a hotel or motel in your own country, or abroad – can be a cause for concern or worry.
At home, everything needed is at hand and you can expect privacy. But with good planning, you will have everything you need neatly packed in your travel kit.
If you are staying in the home of friends or family who may not be aware of your special needs, you may be surprised at how understanding they can be. Explain briefly about your stoma, and try to use the bathroom not during rush periods, whenever possible.
Before staying in a hotel at home or abroad, try to make sure you have a bathroom en-suite or attached to your room. That way, pouch changes can be made easily in private and at your leisure, at a time convenient to you.
Safe Storage of Ostomy Products.
If you are staying at a hotel, inn or in a location that makes you think your ostomy supplies may not be safe, ask management to lock the bulk of them in a safe place.
Food and drink
While abroad, general advice on food and drink is the same for anyone. Common sense precautions, such as avoiding local drinking water, apply to everyone. If in doubt about the quality of the water supply, buy bottled water for drinking and cleaning teeth. You should also use bottled water if you irrigate your colostomy.
Likewise, eating foods that have been well-cooked or washed in clean water, or come from a reliable source is important for everyone. Be aware of the possibility of becoming dehydrated in hot climates.
Any change of water, climate or food can upset a person’s bowels, so be prepared. You may want to pack some antidiarrheal medications or rehydration salts just as a precaution. Antidiarrheal medications are available without a prescription from your local pharmacist or chemist, and, if taken at the first signs of diarrhea, will usually nip the problem in the bud.
Diarrhea, 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. Don’t take salt on its own, always add it to your food. If it persists for 24 hours, seek medical help.
In hot climates, as chances of dehydrating increase, people with stomas should drink more fluids – preferably water.
A sign of being dehydrated is the production of less urine than usual.
Special rehydrating solutions, such as sports drinks, can be useful for severe cases of dehydration and are readily available. However, commercial sports drinks contain varying amounts of salt and sugar.
If you have antidiarrheal medication with you and watch what you eat and drink, you can enjoy the local delights; but be sensible and avoid excess. Also remember: too much alcohol will accelerate dehydration, so don’t overdo it.
Looking good in your clothes
When you are on a holiday or vacation, you want to relax and enjoy yourself. Part of this is to be able to wear what you like.
With a stoma, there are very few restrictions on clothing. Just be careful to avoid especially tight clothing that may restrict the flow of body waste into your pouch.
There is no reason why people with a stoma cannot enjoy the beach or a pool. But swimwear might be the exception to the ‘wear what you like’ rule. Depending on the position of your stoma, you may not be able to wear a brief bikini or swim trunks.
Some people select a bold-patterned swimsuit that helps distract from any bulges that may be caused by the pouch. Women also find beach wraps and throws useful over their swimsuit.
If you can’t find a swimsuit that you like, there are special suppliers that make bathing suits for special needs. Ostomy Associations and your Stoma Care Nurse can also help.