Traveling with an Ostomy: Recommendations for Clinicians and their Patients

Traveling is a wonderful adventure; traveling with an ostomy shouldn’t make that adventure any less fun or provoke anxiety. Persons with ostomies can enjoy seeing new places, all while carrying medications and ostomy supplies and adhering to the rules of safe air travel. As clinicians, it is very important to be up to date on the Transportation Security Administration (TSA) rules and regulations regarding what can be carried onboard and how items such as medical appliances and medications must be packaged for travel.

     Anyone with an ostomy understandably might be afraid and hesitant to go through the security screening process required to fly. We’ve all read and heard horror stories about people whose pouches leaked or were inadvertently pulled off during the screening process and/or people who encountered less-than-friendly TSA screeners. Most people with an ostomy want to be just like everyone else in the security queue, so the idea that they have to openly identify their ostomy or pouch (in a congested environment) can be daunting. Imagining the worst can make the first time going through screening the hardest; an ostomate myself, I still get a bit anxious. Having been through the process enough times, I know, in the end, it will all be okay. Most importantly, travel and TSA security have come a long way!

     Clinicians often are the key to providing their patients the information and support necessary in advance of the trip. Sharing the following tips with your patients can help them conform with travel security precautions and encourage them to go places and live their best lives. 

What is the Goal of the TSA?

The TSA website describes its responsibility as maintaining security while ensuring the public is treated with respect and sensitivity. TSA staff go through extensive training related to supporting all passengers moving through the screening process, but this doesn’t always allay passengers’ fears. If patients have questions or desire support from the TSA, they can contact a Passenger Support Specialist at least 72 hours in advance of their travel date/time. These specialists can provide information specific to the ostomate’s condition/needs. For example, if someone isn’t able to stand in line for the screening process or fears being unable to leave the line to access a bathroom, they can contact the TSA, explain their condition and needs, and ask the TSA for assistance; you can assure the ostomate he/she is not the first person with an ostomy to ask for support or assistance. The Passenger Support Specialist TSA Cares Line for passengers requesting assistance with medical/disability before they travel is (855) 787-2227, or email: TSA-ContactCenter@dhs.gov. You can also visit https://www.tsa.gov/contact-center/form/cares. 

     Clinicians should speak to ostomates about the training provided TSA agents specific to persons with medical conditions. Be proactive in supporting your patients and educate yourself by contacting the TSA. Ask the the agency pertinent questions that would benefit your patients as they navigate travel with an ostomy. 

Ways Clinicians Can Address Patient Air Travel Concerns

The rules of airline travel with an ostomy are predicated upon the TSA rules regarding Disabilities and Medical Conditions that include carrying medications and supplies onboard a plane. Having a medical condition does not exempt anyone from following the TSA rules; we just need to be more aware of how we can adhere to these rules while we remain comfortable and confident to enjoy new places and new cultures. Clinicians can provide resources for their patients so they can achieve this confidence when traveling with their ostomy. One suggestion is to download the United Ostomy Association of America’s Travel Communication Card, which contains the TSA Notification Card to better communicate with TSA agents in the screening area about having an ostomy. Patients can show the agent this card along with their passport or photo ID and quietly let the agent know about the ostomy; if additional screening such as a gentle patdown or handswab is required, the agents will be aware of any ostomy precautions that should be taken. I have experienced these additional screening procedures — they are not as scary as they might seem. Encourage your patients to be open and honest with TSA agents. This is key to a considerate encounter between your patient and the TSA. 

     I have been screened in all manners possible. Each time, the TSA agent was caring and professional. When I was taken aside, I quietly informed them I have an ileostomy and pointed to where it was located on top of my clothing. The agent either 1) patted me down, while carefully checking my comfort and their hand location/pressure on the body as they went; or 2) swabbed my hands with a piece of thin tissue-like paper after I rubbed them gently on my clothing on top of my pouch area. This paper is run through a machine to ensure no evidence of any residue of dangerous/explosive materials is found. Although screening by a uniformed agent always is a bit anxiety-provoking, I felt empowered as I walked to my departure gate. 

     Share the TSA Pre-Check option with your patients. TSA precheck prequalifies and clears a person to get through the screening lines more efficiently and quickly. Applying for Pre-Check must be done weeks in advance of the patient’s plan to travel. To learn more about TSA Pre-Checks and the current fee, visit www.tsa.gov/precheck. 

     Remind your patients to consider asking for an aisle seat when booking a flight to ensure easier bathroom access. Additionally, having a traveler card helps if an ostomate needs to inform the flight attendant about his/her medical condition and that it may require access to the bathroom at times when it is recommended flyers remain in their seats.

     Inform your patients that if, on the rare chance that they do run into a problem at an airport, they should contact the UOAA (800-826-0826). The UOAA has a TSA Liaison; if there is an incident, the UOAA can work with the TSA to ensure it doesn’t occur again. Sharing these experiences with the UOAA/TSA Liaisons will help educate all TSA agents.

Packing Tips for Ostomates

Remind your patients to bring more supplies than they might need for their time away. The general rule is to pack a minimum of twice the amount of supplies (wafers/pouches/wipes) anticipated. Remember, traveling often includes sitting more than usual (flying on a long flight), walking more than usual (touring), and eating/drinking different foods than are typically consumed. Changes in routine often render it necessary to change ostomy wafers and pouches more often than normal.

     Have your patients assemble individual packages of pouch change supplies in case of a sudden leak while in the hotel room or while touring. I use a sandwich-sized bag, which doubles as a discreet way to dispose of the used pouch/wafer. 

     Always suggest that patients precut their wafers before travel so they will not need scissors. However, you can inform patients that ostomy scissors are allowed on planes per the updated TSA rules for medical supplies. A good travel hack is to carry a pair of mustache scissors. They are curved just like larger ostomy scissors but much easier to pack and carry in a travel kit. Patients also may find it helpful to carry waterproof tape or wafer extenders to tape the edges of the wafer to facilitate swimming or tub bathing. Also, heat/humidity and/or moving around often can loosen the wafer edges. so taping provides a greater sense of security. 

     Consider recommending carrying rehydration powder mix, especially for persons with an ileostomy to add to a bottle or large glass of water. Remaining hydrated is important no matter where they are. 

     Tell patients to keep supplies with them and never pack them in their checked luggage, except for “extras” in case luggage is delayed or lost. I carry my packets in my carry-on along with my medication. I can always buy new clothing at my destination, wear what I have on, or borrow from friends, but my medication and ostomy supplies are items not easily purchased or something that I can be flexible about not having or easily replaced. Keeping supplies with me allows me to enjoy my trip without worries. 

     Follow TSA rules regarding medications, which include keeping meds in their pharmacy-labeled packages. I also recommend people pack all “in case” meds, such as any antidiarrheal, antinausea, seasickness, or pain meds one might need. These can be transported in a carry-on; I also include a letter from my doctor explaining that I have an ostomy and traveling with my supplies and associated medications. I have found that a zip cosmetic bag or even a material pencil case allows me to carry all of my meds and the letter. They are easy to access, and this type of holder is streamlined and easy to include in my carry-on. 

     Helping your patients follow and understand TSA rules and guiding them on how to do so will give your patients the confidence they need to see the world. If you are lucky, they might bring you back a souvenir for all your effort!

This article was originally published in Wound Manag Prev. 2019;65(10). This article did not undergo the Wound Management & Prevention peer-review process.