Traveling With Cirrhosis: What You Need To Know

Since my diagnosis with Cirrhosis, I have had to learn and change a lot of things that I was used to doing. Learning to take extra considerations into things that I took for granted before. In this case, traveling with my disease. The truth is, I wasn’t much of a traveler before I was diagnosed, now it feels more like I need to experience things before it may be too late. 

What I didn’t expect was all the issues I need to think about before I plan any kind of traveling. Since information for these things have been limited, I felt that maybe I should put together the research I have been doing in one place so that it can help others who have been diagnosed. Hopefully, they will see that they can still live a normal life and do all that they want to do. 

The information I provide is through my research. I am not a doctor nor am I trained in any health related field. Always talk to your doctor and take their advice before you plan any kind of travel. Should you choose to still travel, then make sure you are taking all the precautions needed to keep you and your health safe.

Can Cirrhosis Patients Travel?

The answer can vary, due to where your personal diagnosis is. 

Patients with liver conditions may be at an increased risk of some travel-related illnesses. To be safe, check with your medical provider at least 6 – 8 weeks before traveling. Remember, having cirrhosis or any liver disease can put stress on your ability to fight off illnesses. The liver is designed to detect, capture, and clear bacteria, viruses, and macromolecules. Your liver is the frontline defense of your immune system and should be considered before any travel.

With your liver under stress from your condition, your ability to fight off colds and viruses will be lessened. As your condition worsens, so will your resistance. Even if your liver is currently functioning normally, you still need to consider what issues you may run into. Speak to your healthcare provider about getting pills for travelers diarrhea, this can be critical in making sure you are not seriously hurt and will help in speeding up recovery. 

Only your and your doctors can adequately determine if you are physically able to travel safely. Listen to their advice. 

What’s my health status

Before you even begin planning vacations or any kind of travel, you need to keep in mind what the status of your health is. Are you healthy enough to make the trip? Are there underlying conditions that could prevent you from flying or traveling long distances? These are very real factors that you need to consider. 

If you are planning to fly outside of the country, check with your doctor to see if there are any conditions that may make travel more difficult. With Covid still circulating, you need to make sure you take every precaution so you are not exposing yourself, needlessly.

Make sure your Covid vaccinations are up-to-date. Seek out any other vaccinations that are travel related and make sure that you have also caught up on your Hepatitis A, B and C vaccines. 

Research your destination for possible vaccine needs or what conditions can be more harmful to you. Include your healthcare provider in those talks. This way you know your current condition and how it can relate to where you are going. Any medications you may need, for your trip, should be carefully examined to make sure there are no adverse side effects to your condition. Make sure there are adequate medical facilities, in case the need arises. An absolute muse is traveler’s insurance. More on that later. Carry a first aid kit that can be tailored to the area you are visiting. 

Ultimately, the choice is yours but make sure you are heeding the advice of your medical professional.

How can travel be dangerous?

Travel, by its very nature, is stressful. You may have to get up early to catch a flight, you are rushing around to make sure you are on time, planes aren’t really conducive for rest, and you can end up in places where disease and illness may be as easy to contract as drinking a glass of water.  As a cirrhosis patient, these things become much more of a health issue for you.

Don’t forget to check into your vaccination status. The state department has a list of vaccinations you need for specific countries, so it is best to check it out ahead of time. Talk with your doctor about where you are traveling to and see if there is anything else they recommend. Where you can, try to get your vaccines early enough to see if you have any kind of reaction to them. Nothing would be worse than getting them and getting to your destination only to become really ill. 

Altitude issues can affect any traveler, patients with liver conditions may be affected more. A review article in 2014 stated that certain groups of cirrhosis patients may be at an increased risk of health problems while in high altitudes. Hepatopulmonary syndrome (a rare lung complication of liver disease) may cause hypoxemia (reduced oxygen levels in the blood) following ascent to altitude. Those with portopulmonary hypertension may be at risk for high altitude pulmonary edema (fluid accumulation in the lungs) and acute right ventricular dysfunction. Make sure you talk to your healthcare provider and have them check for these conditions.

Traveler’s Insurance and etc

Okay, you are probably going to say that you already have insurance, so why do we need to discuss this here? The truth is that your insurance will cover a lot of things, but if you are outside of the country there is a chance you will have to pay the hospital bills upfront and have your insurance company reimburse you, after the fact. That is where travelers’ insurance comes in. It can cover the cost of a medical evacuation, upfront costs, and other health related things that leave you insurance to cover the bigger costs. 

Some countries require you to have extra health insurance before you visit them, so make sure you’re checking the country’s website or the state department. 

It is also important to check where hospitals will be, in relation to where you are staying. This way you will know about how long it may take to get there and what kind of treatment they can offer. We stayed in a fairly remote village in Costa Rica, but the hospital was only about ten minutes down the road. That definitely was a reassurance, in case I needed it. 

Travelers Insurance

Comprehensive traveler insurance is a must for all travelers. Remember to declare all health conditions when you are purchasing your insurance. There are plenty of insurance providers that will cover cirrhosis, hepatitis, haemochromatosis, and any others.

Travel First-aid Kit

As much as knowing where hospitals are and having insurance coverage is mandatory, so should carrying a small travel first-aid kit. Contents may vary but it is good common practice to include the following: insect repellents, medicines and oral rehydration solutions, alcohol gel to clean hands, condoms, and basic wound dressing. 

Environmental concerns

If you are traveling outside of the country, then you also need to worry about diseases that may be prone to that area. Certain parts of the world may be prone to malaria, diphtheria, or other illnesses. All of these can wreak havoc on your body, even when you are healthy. Remember that cirrhosis affects the liver which ultimately affects your immune system. Basically, you are immunocompromised. 

Oftentimes, patients are advised to consume a more restricted diet, after liver condition diagnosis. This kind of diet can be harder to follow while traveling. If you are restricting salt and sugar while keeping protein levels up, it may be best to ensure you are carrying proper snacks to help offset those concerns. 

Food and Water-borne issues

All travelers run the risk of contracting a condition called Traveler’s Diarrhea and this can be harder on liver disease patients. Contact your doctor before your travel to make sure you have a supply of needed medication and proper documentation on how to take it. Liver disease can impact how medications are metabolized through the liver, so care needs to be taken. Make sure you are staying away from medications with Tetracycline, as they can become toxic. Your doctor may recommend ciprofloxacin, as it has not shown to cause drug-induced acute liver injury.

Remember that local herbal remedies can be potentially dangerous for you and should be avoided at all costs. 

Contaminated food and water can be especially problematic, they are prone for spreading Hepatitis A and E as well as typhoid and paratyphoid. These illnesses can impact liver function and cause unplanned stays in hospitals. Swimming, fishing, and boating carries the possibility of spreading Leptospira, a bacteria that causes liver inflammation and is a greater risk for travelers with pre-existing liver disease.

Vector-borne risks

Insect bites are another concern for travelers with liver disease. Many of these bites can cause illness that causes liver inflammation. This inflammation causes undue stress on the liver and can lead to failure, if not treated. Mosquito transmissible illnesses to be aware of are yellow fever, dengue, chikungunya, and West Nile. Make sure you are using strict avoidance measures.

Malaria is also a big concern. Most anti malarial drugs are excreted or metabolized by the liver, therefore a risk of drug accumulation in severe liver impairment is increased. Be aware of the importance of compliance with malaria prevention and seek medical help early, should you become exposed.

In Summary

Receiving a diagnosis of liver disease can seem like the end of your life, but with proper medical care, important considerations, and staying on top of your health, it won’t restrict you from your daily life. In many cases, you are still able to travel, as you always have been. Now, it will take a little more effort before you actually disembark to your destinations. Don’t let your disease be the deciding factor in how you live your life, instead use it as a guide on how to live it better. 

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