Altitude Sickness – Managing High-Altitude Illness

Understanding, Preventing, and Managing High-Altitude Sickness

Travelling to high-altitude destinations offers unique experiences and presents the risk of altitude sickness. Also known as acute mountain sickness (AMS), altitude sickness can affect anyone who ascends to high elevations too quickly, regardless of their physical condition. In the following, we discuss an overview of altitude sickness, including its causes, symptoms, prevention strategies, and treatment options.

Causes of Altitude Illness

Altitude sickness occurs when the body fails to adapt to the lower oxygen levels and decreased air pressure at high altitudes. As altitude increases, oxygen concentration decreases, meaning less oxygen is available for the body. This can lead to various symptoms as the body struggles to acclimate to the reduced oxygen supply.

Symptoms

The symptoms of altitude sickness typically develop within hours of ascending to a higher altitude and can range from mild to severe. Common symptoms include:

• Headache: Often the first symptom to appear and can be pretty severe.
• Nausea and Vomiting: Occurs frequently in this condition.
• Dizziness: Feeling lightheaded or unsteady.
• Fatigue: Unusual tiredness and weakness.
• Shortness of Breath: Difficulty breathing, especially during physical activity.
• Sleep Disturbances: Difficulty sleeping or frequent waking.

In more severe cases, altitude sickness can progress to high-altitude pulmonary edema (HAPE) or high-altitude cerebral edema (HACE), both of which are life-threatening conditions requiring immediate medical attention.

Prevention

Preventing altitude sickness involves gradually allowing the body time to acclimate to high altitudes. Key prevention strategies include:

1. Gradual Ascent:
   • Ascend Slowly: Increase altitude gradually, allowing the body to adjust. Once above 2,500 meters (8,200 feet), a general guideline is to increase sleeping altitude by no more than 300 to 500 meters (1,000 to 1,500 feet) per day.
   • Rest Days: Incorporate rest days into your itinerary to give your body time to acclimate.
2. Hydration:
   • Drink Plenty of Fluids: Staying well-hydrated helps the body adapt to high altitudes. Avoid alcohol and caffeine, as they can contribute to dehydration.
3. Medications:
   • Acetazolamide (Diamox): This medication can help prevent and reduce the severity of altitude sickness by accelerating acclimatization. Consult a healthcare provider for appropriate dosing and usage.
4. Avoid Overexertion:
   • Take it Easy: Limit physical activity during the first few days at high altitude to reduce strain on your body.
5. Diet:
   • Eat Light Meals: Consume a diet high in carbohydrates and low in fat to provide easily accessible energy for the body.

Treatment

If symptoms of altitude sickness occur, it is crucial to prevent the condition from worsening. Effective treatment strategies include:

• • Move to a Lower Altitude—The most reliable treatment for altitude sickness is to descend to a lower altitude. Even a few hundred meters of descent can significantly improve symptoms.
  • Rest and Acclimatization – Stop further ascent and allow time for acclimatization. Rest and avoid strenuous activity until symptoms resolve.
  • Medications—Over-the-counter pain medications like ibuprofen or acetaminophen can alleviate headaches and other mild symptoms. Medications such as promethazine can help manage nausea and vomiting.
  • Oxygen Therapy – Supplemental oxygen can provide immediate relief from symptoms.
  • Hydration and Nutrition – Continue to drink plenty of water.
  • Carbohydrate-Rich Diet – Maintain a diet high in carbohydrates to support energy levels.

Severe Cases

For severe altitude sickness, such as HAPE or HACE, immediate medical intervention is critical. Symptoms of HAPE include severe shortness of breath, a cough producing frothy or bloody sputum, and extreme fatigue. HACE symptoms include severe headache, confusion, loss of coordination, and hallucinations. In these cases, immediate descent to a lower altitude and emergency medical treatment are necessary.

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Final Thoughts

Altitude sickness is a severe condition that can affect anyone travelling to high elevations, but with proper preparation and knowledge, it can be prevented and managed effectively. Gradual ascent, adequate hydration, appropriate medication use, and early symptom recognition are key strategies to ensure a safe and enjoyable high-altitude experience. Always consult a healthcare provider before travelling to high altitudes, especially if you have pre-existing health conditions or concerns.

 

From Resources shared by Dr. Loy Puckett, MD