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Travel sickness
Central nervous system
Travel sickness or motion sickness is the sensation of feeling sick, or actually being sick, as the result of movement. People can be affected by travel sickness while travelling by sea, road or air or even when on fairground or playground rides.

Under normal travel conditions, it is estimated that about a third of the population can be affected by travel sickness. If conditions become extreme, for example a very rough sea crossing, almost everyone can be affected, even experienced sailors. Men and women are affected equally, but it is particularly common in children especially when travelling on long journeys.
The inner part of each ear is the area of the body that detects movement and which is responsible for balance. Within the inner ears are three special fluid filled structures called semi-circular canals. The three semi-circular canals are at an angle to each other and are able to detect movement in all directions - backwards and forwards, side to side, up and down. They are also able to detect changes in speed - slowing down or speeding up. The semi-circular canals are able to do this because of the fluid they contain. As the body moves or changes speed, the fluid in the semi-circular canals also moves. Movement of the fluid is picked up by special sensors which convey messages to the brain, allowing us to keep our balance. For example, when a person trips he or she reacts quickly and avoids falling, thanks to the semi-circular canals conveying the message to the brain that balance has been lost.

Travel sickness is caused by the brain receiving conflicting signals from the semi-circular canals, the gut and the eyes. For example, feeling giddy or dizzy after being spun around is due to the fluid in the semi-circular canals continuing to move even though we can see that we have stopped spinning. Children particularly get travel sick on long car journeys because they usually sit in the back seats looking out of the side windows while experiencing a forward motion. These conflicting messages confuse the brain and cause a feeling of wanting to be sick.
Symptoms of travel sickness include dizziness, feeling clammy, hot, sweaty, yawning uncontrollably, turning pale, producing a lot of saliva, nausea and eventually being sick or vomiting. The onset of symptoms may vary. With some, travel sickness will only develop when movement becomes particularly violent. With others, simply the thought of travel makes them feel apprehensive and nauseous because they have suffered from travel sickness before. For most sufferers, symptoms resolve shortly after the journey is over.
There are a number of medicines that can help ease or prevent travel sickness. In all cases, the medicines work best if taken or used before setting off on a journey and before the feeling of travel sickness begins.

There are two main types of medicine used to control travel sickness, antihistamines and anticholinergics. Antihistamines include cinnarizine, cyclizine, meclozine and promethazine. Anticholinergics include hyoscine. Although these are two different types of medicine, they work in a similar way by reducing the messages from the ear and the gut to the brain. Some of the products work longer than others. Some products are suitable for young children others are not. Consequently, choice of medicine is dependent on the length of the journey and the age of the person affected. For adults and children over the age of 10 who are unable to swallow tablets, or who cannot keep anything down, hyoscine is available as a patch that can be applied to the skin and which will give protection for up to 72 hours.

Antihistamines also have the ability to cause drowsiness which may be an advantage for a passenger, but NOT for a driver.
When to see your pharmacist
There are many preparations for the relief of travel sickness available from your local pharmacy without the need for a prescription.

Some products act for short periods, for example hyoscine tablets last for 1 to 3 hours, and are best for short journeys. Other products, for example promethazine, last much longer and are suitable for long journeys. If you tell your pharmacist your expected journey time and whether you are travelling by road, sea or air, he or she will recommend an appropriate product and how and when it should be taken.

The different types of travel sickness remedies are not suitable for everyone. If there are several members of the same family who are affected, particularly if they are children of different ages, you may need different types of medicine. Your pharmacist will be able to advise which products are most suitable for the people affected.

Side effects of both the antihistamine and anticholinegic type of medicine may increase the side effects of other medicines, or they may increase symptoms in people who have prostate or urinary problems or who suffer with glaucoma.

For all of these reasons, when buying medicines to prevent travel sickness, it is important that you let your pharmacist know who the medicine is for, the age of the person, whether the person is pregnant, breast feeding, has any other illness or is taking any other medicines.
When to see your doctor
If you or a member of your family is badly affected by travel sickness and you have found that over the counter remedies do not work, visit your doctor. There are stronger medicines that are not available over the counter that your doctor may prescribe to control symptoms.
Living with travel sickness
Some simple precautions will help reduce travel sickness. If a child suffers from travel sickness and is travelling in the back seat of the car, try changing the child's seating position so he or she can focus on the road ahead. Try to distract the child by playing games. For everyone, avoid reading, as looking down can increase the feeling of nausea. If travelling by sea, go up on deck, face the direction of travel and focus on the horizon. Avoid eating large meals before and during travel. Close your eyes or get some sleep if you are able to do so.

Some people find that acupressure wristbands, eating ginger biscuits or sucking peppermints help reduce travel sickness.

All travel sickness remedies work best if taken or used before setting off on a journey and before the feeling of travel sickness begins. If you or a member of your family usually suffers from travel sickness, it is worth keeping a supply of the medicine at home so that it is readily available to take before a journey. If you have an early start, some tablets can even be taken the night before setting off on a journey the next day.
Useful Tips
  • Avoid alcohol and large meals, before, or while travelling
  • Try and sit in the area of the aeroplane or boat where there is the least motion (usually in the middle of the craft) and if possible look at the horizon
  • Don't let the inside of your car get to hot
  • Avoid reading in the car
  • Avoid sitting in areas where there are strong odours or people smoking