Traveling to Italy with a colostomy, a PEG tube, and a need for Ensure can be a bit daunting, especially when it comes to navigating airport security. Here are some helpful tips and insights to make your journey smoother:

- Obtain a detailed letter from your doctor. This should explain your medical needs, including your ostomy and PEG tube, and list all necessary supplies like ostomy gear and feeding-tube items. It should also request permission to carry the required quantities of Ensure or other nutritional shakes. Many travelers have found that this letter satisfies both TSA screeners and airline staff.

- Check with your airline about extra baggage allowances for essential medical supplies. Some travelers have received an additional 15 kg or an extra checked bag labeled "Essential Medical Supplies" without any fees or issues.

- Request a separate or private screening at the airport. U.S. airports often have a medical-liquids line, and you can ask for a private room inspection to avoid exposing your stoma or PEG tube in public.

- For in-flight liquids, the amount of Ensure you need for the flight is usually allowed once declared as medical nutrition. You can pack the remaining cases in checked luggage or use the extra medical-supplies allowance.

- If you're worried about finding nutritional drinks in Italy, Ensure is manufactured by Abbott Laboratories, and their website lists worldwide distributors. Fortisip, a similar high-calorie liquid, is widely available in Europe and can be a good substitute if Ensure is unavailable. You can arrange for delivery to your hotel through an Italian pharmacy or an international medical-supply company, or ship supplies ahead as "medical freight."

- Many travelers with colostomies have passed through various European airports without issues. Problems only arose when beverages were undeclared, but no one has been detained or labeled suspicious because of their ostomy appliances.

- It's a good idea to contact the airline and the departure and arrival airports early to document your needs. Mark any checked cartons as "Medical Nutrition – Not Restricted." Keeping a positive attitude can also help, as staff generally prefer to avoid any public relations issues over medical concerns.