The following are the requirements for the medical certification of aircrew, including guidance material issued by the UK CAA Medical Department in relation to the digestive system.
MED.B.020 Digestive System
(b) Applicants with any sequelae of disease or surgical intervention in any part of the digestive tract or its adnexa likely to cause incapacitation in flight, in particular any obstruction due to stricture or compression shall be assessed as unfit.
(c) Applicants shall be free from herniae that might give rise to incapacitating symptoms.
Assessment by a consultant gastroenterologist is required to exclude other medical conditions such as inflammatory bowel disease. Underlying stress should be addressed. If symptoms persist, increased physical activity and dietary modification may be helpful. Symptom targeted medication may include antispasmodics, laxatives, antimotility medication and analgesics.
Certification for Class 1 or 2 is possible if symptoms are well controlled with acceptable medication. In intermittently symptomatic cases, an OML may be appropriate for Class 1 certificate holders.
Peppermint oil is acceptable for aeromedical certification when symptoms are controlled. If broad spectrum antibiotics are prescribed the licence holder should be considered unfit until the course is completed and symptoms have settled. If there is evidence of bleeding or during episodes of diverticulitis the licence holder is unfit. If colectomy is required for severe complications or failure to respond to medical treatment, the licence holder will be unfit until at least three months post operatively.
In intermittently symptomatic cases, an Operational Multipilot Limitation (OML) may be appropriate for Class 1 certificate holders.
Acceptable Means of Compliance
Class 1 (e) Peptic ulceration Applicants with peptic ulceration should be assessed as unfit pending full recovery and demonstrated healing.
Class 2 (e) Peptic ulceration Applicants with peptic ulceration should be assessed as unfit pending full recovery.
Aeromedical certificate holders will be assessed unfit while undergoing H. pylori eradication therapy. Following successful eradication of H. pylori proton pump inhibitors and H2 receptor antagonists are acceptable for maintenance therapy.
An aeromedical certificate holder with inflammatory bowel disease is assessed unfit unless the condition is in remission.
For Class 1 the pilot must have been in remission on minimal medication for six months for aeromedical certification. Initially this will be with an Operational Multipilot Limitation (OML). This limitation can be reviewed after a further 6 months of remission. The applicant should be warned of the risk of significant interruptions in their ability to exercise licence privileges if their condition relapses.
Medication used in Gastrointestinal Conditions
Medical Reports -
Medical Reports -
Med.B.020 (d) (5) Abdominal Surgery
UK CAA guidance on certification following surgical procedures (digestive tract).
Medical Reports -
CAA statement on Class 1 Medical Certification: https://t.co/Nu44NrS3QU
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