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Journal of Crohn's and Colitis: 9 (11)


Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium


Published on behalf of

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

Stephan R. Vavricka, Gerhard Rogler, Sandra Maetzler, Benjamin Misselwitz, Ekaterina Safroneeva, Pascal Frei, Christine N. Manser, Luc Biedermann, Michael Fried, Peter Higgins, Kacper A. Wojtal, Alain M. Schoepfer
DOI: http://dx.doi.org/10.1016/j.crohns.2013.07.011 191-199 First published online: 1 March 2014


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.

  • Crohn's disease
  • Ulcerative colitis
  • Inflammatory bowel disease
  • Hypoxia
  • Hypoxic stress
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