Could Advil Ease Hikers’ Altitude Ills?

March 20, 2012 § Leave a comment

By Dr. JESSICA ROSE, ABC News Medical Unit:

Larry Stack, 51, knew something was wrong as he ascended a mountain on a recent climbing trip to Quito, Ecuador.

“I had had shortness of breath on trips before, but this was different,” said Stack, who is a physician. “I developed a headache, and felt like I was going to pass out.”

Stack’s experience during his rapid ascent may be a familiar hazard to many of the millions of Americans who trek up the side of a mountain each year. He was experiencing acute mountain sickness. Commonly referred to as altitude sickness, it is a serious condition — and in its worst form, it is potentially deadly.

Now, new research published in the Annals of Emergency Medicine suggests that those who climb may do well to add a bottle of ibuprofen, a common anti-inflammatory painkiller, to their hiking packs.

Ibuprofen is  available over the counter and is perhaps most widely known by the brand names Advil and Motrin — although it is available in numerous other formulations as well.

Study author Dr. Grant Lipman, an emergency medicine physician at Stanford University, first noted a decrease in the symptoms of acute mountain sickness — dizziness, fatigue, difficulty breathing, nausea and vomiting — while researching a previous group of study participants at high altitude.

“We saw that ibuprofen helped headache and, as a secondary finding, decreased the symptoms of acute mountain sickness,” Lipman said.

He then tested this hypothesis using 86 volunteers. Each was given either ibuprofen or a placebo pill just before a summer climb in the White Mountains of California. Lipman’s group found that those hikers taking ibuprofen were three times less likely to develop altitude sickness than those who took the dummy pill.

Currently, there are two commonly used treatments for altitude sickness, and both require a trip to the doctor’s office for a prescription.  Dexamethasone, a steroid, and acetazolamide, a diuretic or “water pill,” both have significant side effects.

During his experience with altitude sickness, Stack took acetazolamide, but he did not like the side effects, which included excessive urination and a “weird taste.” His altitude sickness sent him to a local emergency room where he had an extensive workup — a CT scan, X-rays and an evaluation by a heart doctor.  After several days, his symptoms resolved, but the current study suggests that taking ibuprofen could have helped him avoid these problems in the first place.

However, more studies may be needed to convince some physicians that this inexpensive, easy-to-administer pill should change the way they advise mountain climbers.

“Based on just one study, I’d be hesitant to recommend the use of ibuprofen for those at risk of acute mountain sickness, but I admit if I were traveling to the mountains, I’d be sure to have a supply of ibuprofen in my carry-on bag,” said Dr. Richard O’Brien, an emergency physician at Moses Taylor Hospital in Scranton, Pa.

If one thing is certain, it is that those who experience these symptoms should seek help — and quickly. Emergency physicians said acute mountain sickness, if not treated, could lead to breathing problems, brain swelling, and death.  Descending to a lower altitude at the first sign of distress is crucial.

“Unfortunately, every year there are climbers who die of high altitude cerebral edema [brain swelling] who took medications and pushed ahead on their ascent, instead of recognizing and acknowledging their symptoms and descending while they still had the opportunity,” said Dr. Gabe Wilson, associate medical director at St. Luke’s-Roosevelt Hospital’s emergency department.

***

We highly recommend discussing any treatments or ailments you may have with your physician prior to traveling

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