High altitude journeys and flights are associated with an increased risk of flares in inflammatory bowel disease patients

J Crohns Colitis. 2014 Mar;8(3):191-9. doi: 10.1016/j.crohns.2013.07.011. Epub 2013 Aug 13.

Abstract

Background and aims: Hypoxia can induce inflammation in the gastrointestinal tract. However, the impact of hypoxia on the course of inflammatory bowel disease (IBD) is poorly understood. We aimed to evaluate whether flights and/or journeys to regions lying at an altitude of >2000 m above the sea level are associated with flare-ups within 4 weeks of the trip.

Methods: IBD patients with at least one flare-up during a 12-month observation period were compared to a group of patients in remission. Both groups completed a questionnaire.

Results: A total of 103 IBD patients were included (43 with Crohn's disease (CD): mean age 39.3 ± 14.6 years; 60 with ulcerative colitis (UC): mean age 40.4 ± 15.1 years). Fifty-two patients with flare-ups were matched to 51 patients in remission. IBD patients experiencing flare-ups had more frequently undertaken flights and/or journeys to regions >2000 m above sea level within four weeks of the flare-up when compared to patients in remission (21/52 [40.4%] vs. 8/51 [15.7%], p=0.005).

Conclusions: Journeys to high altitude regions and/or flights are a risk factor for IBD flare-ups occurring within 4 weeks of travel.

Keywords: Crohn's disease; Hypoxia; Hypoxic stress; Inflammatory bowel disease; Ulcerative colitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aerospace Medicine
  • Air Travel*
  • Altitude*
  • Colitis, Ulcerative / etiology*
  • Colitis, Ulcerative / physiopathology
  • Crohn Disease / etiology*
  • Crohn Disease / physiopathology
  • Disease Progression
  • Humans
  • Hypoxia / complications*
  • Middle Aged
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Young Adult