The truth is, if you’re taking your pancreatic enzyme replacement therapy (PERT) and your condition is well controlled, you’ll probably have a smooth flight, says Santhi Vege, MD, chair of the American Gastroenterological Association section for pancreatic disorders and a gastroenterologist and professor of medicine at the Mayo Clinic in Rochester, Minnesota. If you are newly diagnosed with EPI, however, you might want to hold off on air travel until your treatment has been tweaked enough and you know it’s effective. It can take some time to find the appropriate dosing of PERT for your particular symptoms. An article published in July 2019 in Journal of the Pancreas notes that finding the ideal dosing of PERT for a particular individual can be challenging because the response to treatment can vary widely from person to person.
Traveling With PERT
Because PERT therapy replaces the digestive enzymes your pancreas isn’t producing adequately, it’s crucial that you take your medication with the first bite of your in-flight meal — same as you would when you’re eating on the ground. By packing your prescription medications in your carry-on, you’ll not only be able to take the capsules whenever you need them, you’ll also be able to stick to your at-home schedule should your checked luggage get lost or delayed. (Another reason to store in your carry-on: Your meds should be kept in a dry location and at room temperature.) “You don’t want to change your [routine] because you’re traveling,” says Timothy Gardner, MD, director of pancreatic disorders and an associate professor of medicine at the Geisel School of Medicine at Dartmouth in New Hampshire. Base your dosage on what you’re eating, the same as you would at any meal, he adds. Enzymes work best in a low-acid environment, so if you regularly take antacids for this reason, be sure you remember to bring them as well. Tell security officers at checkpoints about your medications and keep them in their original, labeled bottles to make going through security easier, the Transportation Security Administration (TSA) advises.
6 EPI Tips From a Seasoned Traveler
Joseph Ritson, 52, of Newton, Massachusetts, has had EPI from chronic pancreatitis since 2010. As a consultant, he also travels frequently, logging about 120,000 miles a year in non-pandemic times. Here are his tricks to make traveling with EPI easier:
Get prescreened. As a frequent flyer, Ritson has TSA PreCheck, an expedited screening program that can help reduce stress when you’re flying, he says. You may be eligible to sign up for the TSA’s PreCheck service for a fee.Bring healthy snacks to fuel yourself. If you have EPI, small meals are better for your digestion, so pack some nutritious snacks that contain healthy fats, such as nuts or avocado toast. And steer clear of fried and processed foods, which airport terminals can have in abundance. Ritson has learned this lesson the hard way — and paid for it. Now, before flying, “I only eat what I know my body can process,” he says. “If I know I’m getting on an airplane, I won’t dare eat something I shouldn’t.“Order a vegetarian in-flight meal. When Ritson books his flight in business or first class, he always pre-orders a vegetarian meal because it usually has less protein and fat — two nutrients that can cause him trouble. That said, it isn’t a foolproof solution: One time, he was served lasagna with lots of cheese — a fat and protein combo that can be difficult for people with EPI to digest. Now Ritson also tells the airlines he’s allergic to cheese.Don’t drink alcohol. Whether you’re in the air or on the ground, no amount of alcohol is safe when you have EPI, The National Pancreas Foundation (NPF) says. That’s because alcohol can contribute to dehydration, which may cause pancreatic disease to flare, according to the NPF. Alcohol also makes it even harder for your body to absorb fat, according to Loma Linda University Health, in California. “Even a little glass of wine can send me to the emergency room,” Ritson says.Stay hydrated. As noted, becoming dehydrated can invite a flare in people with pancreatitis, as well as worsen EPI symptoms, the NPF warns. The air on a plane is usually very dry, which contributes to the problem. Make sure you bring water or other liquids to drink during your flight. You can stock up once you’ve cleared security, or bring an empty water bottle with you. Many airports have stations in the terminal where you can fill water bottles for free.Expect the unexpected. Not only does Ritson make sure he has his PERT with him at all times, he also carries a list of his medications and a letter from his doctor about his condition in case of an emergency — either on board, or once he reaches his destination. When you have a chronic condition like EPI, Ritson says, “you always have to hope for the best, but prepare for the worst.”
