Travel Series – Flying with Fructose Malabsorption

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I’m not a huge fan of flying. I’m not scared of it but I don’t find it enjoyable, either; long hours (15 hours between Melbourne and LAX) in cramped seating, recirculated air, mostly unsuitable foods and the bathrooms, if you can call them that, all add up to me not having a good time. I stress about connections until we make them and about whether our luggage will make it when we do.

We have had enough mishaps with changed departure gates, delayed planes and missing luggage (LAX is a disorganised hellhole) that Ev and I have become very adept at travelling light. The last time we went home to Australia, we got everything we needed for two weeks, including things for other people, in two carry on bags… and by “carry on” I mean the real carry on bags, not the giant suitcases that American based airlines let people take on and try in vain to cram into the overhead compartments, taking up space meant for everyone. Yes, that annoys me. If I’ve been responsible and packed my belongings into a small suitcase intended for overhead bins, perhaps with valuables in there, I am not impressed when I am told it HAS to be checked, because a 3/4 full plane has already run out of overhead storage. But I digress.

Some people truly do enjoy flying but for the rest of us, here’s how I manage eating with FM and dealing with potential symptoms while flying. It’s pretty appropriate timing, because Ev and I are going to spend the next week in Cabo, Mexico! We’ve been waiting for this holiday since we got back from Cabo last summer. As much as I prefer road trips and exploring different towns, not staying in the one place for too long, sometimes it’s nice to just go and veg out somewhere that is completely relaxing and not have to worry (so much) about the food. As I have said previously, for me, Mexico/Mexican food seems to be a safe bet if I eat plainly and avoid tropical fruits.

The other posts in the travel series can be found here.

I’m sure I’ll be posting photos of tropical paradise on my Instagram account, if you’d like to follow along.

Step 1: Plan ahead, Stress less

Most people don’t need to be told that stress can increase their IBS symptoms; I know I don’t. It’s not all in our heads, though. Research also demonstrates that the two coexist (see here and here), as the autonomic nervous system and certain hormones, which are triggered during times of stress, also act upon the gut.

To avoid stress related IBS and ensure as smooth a travel/flight experience as possible, plan ahead. Some things to consider are:

  • Book your flights as early as possible – cheaper flights means more money in your pocket and less concern about finances during your trip. It’s only a small matter but everything helps.
  • Have all your home-affairs in order well before you go, so you’re not panicking about getting emergency cash out for the house/dog-sitter or paying a last minute bill.
  • Pack early. This is something I can’t help but do, as it all adds to my excitement of going on holiday. It also means you won’t be up until 3 am the morning of your 8 am flight to finish packing your bags.
  • Check in online 24 hours before your flight, if you are able. This means that your seat is reserved on the flight, all you need to do is collect your boarding pass and check in your luggage.
  • Call the airline to ask what their menu will be and decide whether it will be safe for you. This is more important for long haul flights, as I’m pretty sure that standard fare on every flight under 3 hours is a bag of pretzels/mixed nuts and a soft drink/water. Actually, mixed nuts and water sounds fine, thanks. I’ll take that. Just make sure they’re unseasoned.
  • A few days before you fly, call the airline again and re-check your meal preference. I normally go for the gluten free meal and pick what I can from it, supplementing with food I’ve brought from home. The last time I flew between Melbourne and LAX I didn’t do this; my gluten free meal was a normal meal and my husband’s normal meal was vegan. No idea how that happened. What was worse – they don’t carry spares and everyone who had successfully ordered a gluten free meal had shown up for the flight. Which is why I was glad I’d also packed snacks…
  • Pack some non-perishable FODMAP friendly snacks; more on this later, just make sure you call the airline(s) and ask what you are able to take in carry on and what must be in checked baggage.

Step 2: Make some safe food flash cards

If you don’t speak the language, flash cards listing the ingredients you can and cannot consume in the language spoken by the airline/at the airport will help prevent a lot of confusion, if you decide to brave the food.

In fact, even if you do speak the local language, flash cards might still be a good idea as the idea of fructose malabsorption is still so novel that the apparently random list of ingredients that you cannot consume might overwhelm the staff and create an unwanted fuss.

Make sure the lists are clear and concise as to what you can and absolutely cannot consume.

Step 3: Eat plain before the plane

Each time I fly, I will eat plainly in the preceding week, for a few reasons:

  • I know that additional stress seems to set me off with foods I can normally tolerate, so why push boundaries?
  • I want to give my gut the week to calm down, as some foods cause delayed reactions that can last a few days. This way, if I do happen to react to something at the end of the second-to-last week before flying, I have seven days for it to pass.
  • If I am starting from a better place, in terms of my gut, then a small slip up won’t end up with such severe results as it would if my gut wasn’t terribly happy to begin with.
  • Do you want to have diarrhoea on a plane? Exactly.

Step 4: Pack your own food

This will not always be possible, due to customs regulations and such but if you are able, I highly recommend taking FODMAP friendly snack foods to tide you over during flights and layovers while you’re away.

Some ideas include:

  • A variety of foods for different meal times – who wants tuna for breakfast?
  • Non-perishable foods (or at least foods that will keep for a few days outside the fridge) are best.
  • Easily digestible foods that won’t tax your gut too much.
  • Pack the food in a freezer bag and take what you are allowed to inside your carry on luggage. Some carry on restrictions might prevent this, so put it on your list of questions to ask when you call ahead.

Examples of what I might pack:

  • FODMAP friendly veggies of your choice, such as carrot sticks, celery (if you can tolerate polyols), cucumber etc.
  • FODMAP friendly fruits, to a lesser extent, such as bananas and berries. These will need to be kept in a hard case, as they’ll bruise easily while travelling, so I generally wouldn’t bring them on a flight as they’re more likely to get squashed than on a road trip.
  • Muesli bars, like my strawberry pepita or fruit free bars. pictured below. Muffins are delicious but I find that they squash too easily.
  • Pre-packaged snacks, such as corn chips or rice cakes.

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Step 5: Be prepared for the worst

Sometimes, despite our best efforts, shit happens. Literally. While it’s not ideal, you can lessen its impact on your travel by planning for it. If you have an FM-ergency kit, your life will be a lot easier. (See what I did there? You can use it). Keep this in your carry on, you may need it on your flight as well as at your destination.

  • Analgesics to help with cramps – ibuprofen is a known gastric irritant, so I personally don’t use it but if it works for you then don’t stop. I prefer paracetamol (acetaminophen) to help ease cramps, which are not fun to have on a plane.
  • Dextrose/glucose tablets – to help offset any excess fructose that you may accidentally consume, using the co-transport method of absorption.
  • Any supplements that you take, such as a probiotic, digestive enzyme or multivitamin. It’s best not to disrupt your schedule, if possible.
  • Stay hydrated.
  • Wet wipes/baby wipes, in case of an emergency cleaning situation.
  • Any other methods that you know work, such as Buscopan (I’m not saying it does work, it’s just an example). I would advise against using something you haven’t tried before, especially on a plane. It’s best to try those things out at home, beforehand, where you can crawl into a ball and feel sorry for yourself without upsetting the rest of the flight and your holiday.

I hope these guidelines help you fly and travel successfully, as they have me. If you think of anything that I should add, please let me know.

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