High-Altitude Medical

HANDBOOK

At high altitude, you may experience a reduced appetite. In addition, nausea may occur as part of Acute Mountain Sickness (AMS).

Changes in diet and the consumption of local foods during travel may also worsen appetite or lead to diarrhea.

RISK OF GASTROINTESTINAL BLEEDING

At high altitude, due to hypoxia and low temperatures, the risk of gastrointestinal bleeding increases. It most commonly occurs within the first three weeks of staying at altitude.

The main symptoms of gastrointestinal bleeding include:

➤ bloody vomiting,

➤ black, tarry stools,

➤ rectal bleeding.

Studies of individuals who developed gastrointestinal bleeding at altitude have shown gastroscopic findings such as:

➤ hemorrhagic gastritis,

➤ gastric mucosal erosions,

➤ gastric and duodenal ulcers.

FACTORS INCREASING THE RISK OF BLEEDING

Factors that may increase the risk of gastrointestinal bleeding at high altitude include:

➤ previously diagnosed peptic ulcer disease,

➤ increased red blood cell count,

➤ alcohol consumption,

➤ use of nonsteroidal anti-inflammatory drugs (NSAIDs),

➤ use of dexamethasone.

RECOMMENDATIONS FOR PEOPLE WITH PEPTIC ULCER DISEASE

Individuals with active peptic ulcer disease should not plan high-altitude expeditions.

Those with a history of peptic ulcer disease should avoid the following while at altitude:

➤ alcohol,

➤ smoking,

➤ coffee,

➤ nonsteroidal anti-inflammatory drugs (NSAIDs).

Products such as milk-based drinks, fermented milk, or yogurt may help relieve stomach discomfort.

Dexamethasone should be used only in cases of symptoms of High-Altitude Cerebral Edema (HACE).

When taking pain medications or dexamethasone, it is recommended to use protective medications for the gastric mucosa, such as proton pump inhibitors (PPIs).

If gastrointestinal bleeding occurs at altitude, evacuation should be organized as quickly as possible, and a double dose of proton pump inhibitors should be administered.

CHRONIC INFLAMMATORY BOWEL DISEASES

Patients with chronic inflammatory bowel diseases during a flare, such as:

➤ ulcerative colitis,

➤ Crohn’s disease,

should not travel to high mountains.

During remission, it is recommended to avoid very long trips to remote areas far from medical care and civilization.

HEMORRHOIDS AND HIGH ALTITUDE

If you suffer from hemorrhoids, it is advisable to consult your doctor before traveling to the mountains. Worsening symptoms during an expedition can significantly reduce travel comfort.

PRE-EXPEDITION MEDICAL CONSULTATION

People with gastrointestinal diseases should consult a physician before planning a high-altitude trip in order to assess the risk of complications and establish appropriate prevention and preparation for travel.

REFERENCES

• Travel at High Altitude –www.medex.org.uk

• K. Mieske et al., Journeys to High Altitude—Risks and Recommendations for Travelers with Preexisting Medical Conditions, Journal of Travel Medicine, 2010; Volume 17 (Issue 1): 48–62.

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WANT TO LEARN MORE?

If you want to better prepare your health for trekking or a high-altitude expeditions, check out the expanded guide in the ebook "High-Altitude Medicine for Trekkers and Climbers" >>

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Gain practical skills for handling emergencies in the mountains through our online training "High-Altitude First Aid" >> - prepared for those planning trips to high altitudes.

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 For a detailed list of what to include in your expedition medical kit and step-by-step instructions for assembling your personal first aid set, see the ebook "High-Altitude Expedition Medical Kit Guide" >>

PLANNING A TREK OR A HIGH-ALTITUDE EXPEDITION?

If you would like to check whether your health condition allows you to safely participate in a trek or high-altitude expedition, consider booking a medical consultation >> or using a telemedical expedition package >>

This allows you to assess potential health risks in advance, prepare properly fot altitude, and increase your safety during the expedition.

The company was established in 2004. The goal of MedEverest is education in the field of mountain medicine and the dangers of high altitudes. I deal with all medical aspects of staying at high altitude. I organize medical support for trekking and high-altitude expeditions.

Specialist Medical Practice Medeverest Robert Szymczak based in Gdańsk (80-360), at ul. Bolesława Krzywoustego 19F, NIP: 5841943576, REGON: 220148318.

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