Flying with an ileostomy can feel a bit daunting, especially if it's your first major trip. If you're planning an 11-hour flight, there are a few things you might be concerned about, like what an ostomy travel certificate is and whether your pouch might over-inflate during the flight. Here are some helpful tips and insights to make your journey smoother:

1. Ostomy Travel Certificates:
- These are rarely requested but can be handy if airport security questions your pouch or supplies.
- You can get one from Australian state ostomy associations, and it needs to be signed by your GP or Stomal Therapy Nurse (STN).
- Hollister offers free travel cards, and there's also a detachable card in the book "Yes We Can: Traveling with an Ostomy."
- A simple letter from your surgeon listing your medical supplies can help ease TSA or airport checks.

2. Packing and Security Tips:
- Keep all your wafers, pouches, medications, and scissors in your carry-on luggage. Have a few items in an easy-to-reach tote for quick access.
- Order extra supplies well in advance, especially since the WA Ostomy Association closes from December 18 to January 6. You can also contact Dansac in Melbourne or Surgical House in Perth for samples.
- Before screening, empty your pouch. If questioned, show your card or simply say, "I have a medical bag." Some screeners might just swab your hands.

3. Preventing Over-Inflated Bags:
- Cabin pressure can add air to your pouch, so start the flight with a flat, empty pouch.
- Once the seat-belt sign is off, vent or empty your pouch. Osto-EZ Vents or Windless Tablets can help release or reduce gas discreetly.
- Avoid carbonated drinks, onions, beans, and other gas-forming foods before and during the flight.

4. Managing Output and Leakage:
- Regular marshmallows or Imodium (loperamide) tablets can thicken your output, but sugar-free marshmallows might have the opposite effect.
- Some travelers take 1 Imodium with breakfast and 1 with dinner, but always check with your doctor first.
- Wearing a disposable pull-up, like Depends, can add extra security for long flights.

5. In-Flight Restroom Strategy:
- Request a special-diet meal, such as gluten-free or low-residue, to be served first, giving you access to the aisle and toilets right after.
- Airplane toilets only flush the back of the bowl, so carry an empty paper or plastic cup to swish extra water to the front while draining your pouch.
- Keep a "change kit" in the lavatory with baby wipes, a fresh wafer, pouch, disposal bags, and Safe Seal or similar barrier strips for quick replacements.

6. General Products and Resources:
- Dansac Nova 2 Soft Convex (Ref 1443-18)
- Osto-EZ Vents
- Windless Tablets
- Safe Seal barrier strips
- Hollister travel cards
- Book: "Yes We Can: Traveling with an Ostomy"
- Website: australianstoma.com.au for detailed Australian guidelines on traveling overseas.

7. Confidence Builders:
- Many seasoned travelers report never needing the certificate and never experiencing a true "bag explosion," just minor ballooning that can be managed by venting.
- A mirrored airplane lavatory, calm preparation, and a small on-board kit can make any mid-flight changes quick and stress-free.

With a travel certificate, extra supplies, venting aids, and a few diet adjustments, most ostomates find they can travel long distances without any major issues.