Motion sickness is a relatively common occurrence and its severity varies from mild to severe requiring medical attention. In most individuals the condition is diagnosed clinically by a history of feeling ill, nauseous or vomiting while travelling via road, air or on water.

Diagnosis is important when the dizziness and sickness continues beyond the travel duration. In some cases this could be due to viral infections or the inner ear called labyrinthitis or other diseases of the inner ear. This needs to be diagnosed and treated as early as possible.

Treatment of motion sickness includes two broad approaches – self-care and preventive measures and medication therapy. 1-5

Self-care and home remedies for motion sickness

• By avoidance of head and body movement as much as possible. This can be achieved by sitting in the seat or cabin in the middle of a boat or plane that experiences least movement.

• Using a headrest or a pillow and lying down or reclining also helps to keep the head still.

• Vision should not be allowed to wander over waves, moving objects like other vehicles etc. Eyes could be kept closed or could be fixed over a point in the horizon.

• Patient is advised not to read, play games or watch films while in motion. This can worsen symptoms

• Open windows and letting in fresh air helps. Those on sea may use the top deck and those in a car may choose to sit by open windows. Excessive heat or cold exposure however should be avoided.

• Relaxing and distraction techniques. Anxiety about oncoming motion sickness may trigger the symptoms. Patients are advised to relax with music, while focusing on breathing or counting backwards etc. Staying calm prevents onset of the symptoms.

• While travelling with a child with motion sickness it helps to keep the child distracted with singing, music etc. The child should be discouraged from reading or playing video games. The driver should be asked to take bends gently, to not accelerate and slow down repeatedly.

• People who are vulnerable should avoid heavy, spicy or greasy foods and alcohol before or during travel. Hydration by drinking cool clear liquids should be maintained.

• Other alternative home remedies include ginger. This may prevent symptoms of motion sickness. Ginger biscuits and ginger tea may help reduce the nausea.

• Alternative therapies include acupressure. The utility of these in motion are not proven. This can be applied using a wristband or by pressing a finger against the middle of the inner wrist about three finger widths above the crease where the wrist joins the hand. This presses on certain nerves.

Medication therapy

There are numerous medications that may be used to treat motion sickness. These are usually effective only if taken before the onset of symptoms. This is because motion sickness delays digestion and the body is unable to absorb the medication once the symptoms begin if the pill is taken too late.

Hyoscine

This is also called scopolamine. It is the most common medication used to treat motion sickness. This drug works by blocking some of the nerve signals from the vestibular apparatus to the brain.

The drug also leads to drowsiness or sleepiness as a side effect. Sleep during travel reduces the risk of onset of motion sickness symptoms.

This is available over the counter from pharmacists. The drug needs to be taken at least 30 minutes to an hour before commencement of the journey.

Hyoscine is also available as patches that can be applied over the skin on the back of the ears. For a long sea journey hyoscine patches can be applied to the site every three days.

Side effects include sleepiness, blurring of vision, dry mouth, constipation etc. Those taking the medication are advised not to drive or operate heavy machinery.

Hyoscine should be used with caution in children and in elderly (may lead to confusion), in epileptics, those with liver, heart or kidney disease, and those with digestive system problems like gastroesophageal reflux syndrome etc.

Antihistaminics

Antihistaminics are other alternative medications. They are used to treat the symptoms of allergies and also in nausea. They have fewer side effects but may be less effective than hyoscine.

They include Cyclizine, Promethazine, Cinnarizine etc. These are taken two hours before journey and need to be repeated every 8 hours for long journeys.