Ellul Pierre, Fenech Valerie Anne, Azzopardi Christine, Callus Lara, Delicata Nicholas, Muscat Jeffrey, Azzopardi Neville, Vassallo Mario
Gastroenterology Division, Mater Dei Hospital, Msida, Malta.
Frontline Gastroenterol. 2013 Apr;4(2):120-124. doi: 10.1136/flgastro-2012-100265. Epub 2012 Dec 14.
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.
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.
Sixteen (20.5%) patients with IBD developed diarrhoea while abroad (p -0.0001) Statistical analysis using a χ 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.
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.
关于炎症性肠病(IBD)患者旅行期间发生腹泻风险的数据有限。我们分析了IBD患者旅行者及其健康对照者发生腹泻的比率。
我们对78例IBD患者及其健康旅行同伴对照者进行了一项回顾性病例对照研究,从而使两组处于相同的环境条件下。数据通过结构化问卷、访谈和临床病例记录回顾获取。
16例(20.5%)IBD患者在国外期间出现腹泻(p -0.0001),采用独立性χ检验(采用Yates连续性校正)进行统计分析。旅行前,他们处于临床缓解期。只有1例健康对照者(1.3%)在国外期间出现腹泻。11例患者(14.1%)腹泻持续时间为3天或更短,自行缓解,未使用抗生素,IBD药物未增加,也未进行医学咨询。另外5例患者疾病复发,需要药物治疗以恢复缓解状态。在国外期间,使用免疫调节剂药物的患者与仅使用氨基水杨酸类药物的患者在发生腹泻方面无统计学显著差异。
与对照者相比,IBD患者旅行时发生腹泻的比率更高。因此,此类患者旅行前必须寻求医学咨询。