How to Own Your Crohn’s & Ostomy While Traveling to India

By Tina Aswani-Omprakash

As IBD warriors, it’s always nerve-wracking to travel with our conditions and/or an ostomy. For me, it’s been 7 years of me traveling all over the U.S. and Europe for patient advocacy work. And even though I’ve spoken many times virtually for events in India and Pakistan, I hadn’t traveled to the region to speak given the pandemic.

Now that we are out of the pandemic and back at in-person conferences, it was fantastic to be invited to speak about my experiences as an IBD patient & ostomate at Global Association of Physicians of Indian Origin’s (GAPIO’s) conference in Mysuru, Karnataka, India. Plus, traveling to Karnataka meant I could visit many, many relatives and reconnect 😊

But visiting India also meant mustering up the courage to sit through a very long flight. India, with a layover, can be a 24-hour flight easily, which really throws off my gut motility among a whole host of other health issues (migraines, sinuses, etc.). Visiting India also meant being very careful with drinking water, food, and GI bugs given the IBD & ostomy as well as managing my asthma given the pollution. So, there was a lot to think about and plan for before my trip.

Tips for Travel

- Clear travel with physicians. I spoke to my gastroenterologist and my pulmonologist several months in advance to make sure it was reasonable for me to travel.
  - - My GI ordered blood work, a colonoscopy, and an abdominal/pelvic MRE to make sure I was doing okay Crohn’s-wise and to have a baseline on me. He also prescribed antibiotics, steroids, anti-nausea medications for me to have on hand just in case I had issues during travel. I was also asked to take extra motility medications in case things did slow down a lot during the flights.
  - - My pulmonologist ordered a breathing test to ensure my breathing looked okay. She prescribed steroid inhalers just in case and asked me to take allergy medications while in India, so the dust or pollution doesn’t set anything off.

- Get the appropriate vaccinations. I spoke to my PCP, and she asked me to see Travel Medicine, who prescribed a typhoid vaccination. I had already gotten a Hepatitis A vaccination years ago to visit India. The Travel Medicine doctor also made sure I had the COVID and influenza vaccines before I left for my trip.

- Carry & use insect repellent. Normally, Travel Medicine also recommends malaria pills just in case, but for the region of India I was visiting, I didn’t seem to need them. However, I was asked to use insect repellent spray with Deet 25% and up.

- Carry plenty of medications & ostomy supplies. I packed more than enough medications & ostomy supplies, enough to get me through 3 weeks since I was going for 2 weeks.

- Eat only piping hot food & drink bottled water.
  - - Food: I did not touch any chutneys, chaats, cold sweets, or anything that was sitting out for too long. Whether it was dosas, rotis, daals, curries, gulab jamun, manchurian, it had to be super hot before I ate them. I did manage to eat out at times at the hotel I was staying at and at reputable restaurants, but I always stuck to hot foods. If I was eating out, I did often ask for my dishes to be cooked to a mild spice level as spicy food is often the norm in our culture.
  - - Drink: I drank bottled water for the most part (e.g., Bisleri, Aquafina, Kinley to name a few good brands). Many homes have a good filtration system called Aquagard installed, which worked fine for me. And in hotels, they have reverse osmosis (RO) water and often provide you with jugs or bottles of RO water, which is safe for consumption. If you feel more comfortable, you can heat up the water before drinking; many hotels have kettles to boil the water.

- Carry hydration packets & plenty of food items. I carried plenty of hydration packets just in case of dehydration. I also carried powdered milk in case the milk there didn’t suit my gut. And I carried protein bars and instant oatmeal in case I was hungry and didn’t have many options given all my sensitivities.

- Get plenty of rest. With jetlag, it can be hard to get the rest you need as an autoimmune warrior. My doctor recommended magnesium + Melatonin for me to fall asleep when it was nightfall, and I drank some Indian chai or coffee with breakfast to wake me up in the mornings. Please talk to your doctor about what’s right for you.

- Wear a mask & wash hands often. On the flights, I wore a mask to avoid respiratory illness, and in large public gatherings, I wore a mask even if those gatherings were outdoors. I washed my hands or used hand sanitizer every chance I got. There are many GI & respiratory bugs in different parts of the world that can affect our immunocompromised bodies, so I took whatever precautions I could.

- Note down a local GI and/or hospital. In case of an emergency situation, I always note down a local GI doctor and/or hospital to ensure I can get care abroad when necessary.

Indian Style Toilets

***Something to note: Indian style toilets are very different from Western toilet seats. Most homes and hotels have Western style toilets, but when I was out sightseeing, I had to sometimes use an Indian style toilet. Since the Indian style toilet is kind of like a hole in the ground, it might be a good idea to practice doing squats before your trip (I’m not joking!). If you have a colon or a j-pouch, it might be worth carrying some baby wipes too. Indian style toilets have water taps, and you can clean your bottom with those or if you feel more comfortable with baby wipes, feel free to use those instead.

If you have an ostomy, to be honest, it’s much easier to use the Indian style toilet. I just squatted over the toilet hole and emptied my ostomy and then wiped down the end of my ostomy bag (the Velcro or clipped part) with some water. In general, I found it relatively easy to get around India with an ostomy. If you’re out and need to pull over and stop off the road, it’s easy to just empty your ostomy and get a move on. And even when hiking in the woods or elsewhere, I’ve honestly had no issues with taking a bit of detour and emptying off to the side where there is no public. Of course, carry wipes and hand sanitizer no matter what, and it should be relatively hygienic.

Traveling with Disabilities

It was also fantastic to see Bengaluru’s international airport, which was one of the most world-class airports I’ve ever seen in my life. And with its disability line for passengers with disabilities, it felt good to be acknowledged, recognized, and respected going through Security, which I realize may not be the case in other airports in India or in Asia. Nevertheless, it was a breath of fresh air unlike many other American and European airports where I’m often racially profiled and pat down; if that’s not bad enough, Security often demands to see my ostomy in Europe, which is humiliating beyond belief. If you have an ostomy, it may be worth carrying a note from your physician or surgeon asking Security to be more sensitive.

Owning My Crohn’s & Ostomy

All in all, I had a fab experience visiting India. I’m grateful to have had a positive experience traveling to India both for a medical conference and to visit many relatives. And I hope many of you will consider traveling to Asia and other parts of the world in spite of our IBD and our ostomies, j-pouches, what have you. I am living proof that we *can* travel successfully with some precautions, of course.

So, own your Crohn’s, own your ostomy, and take the precautions needed to travel the world while living life to its fullest. 😊