Altitude Sickness in Nepal: Prevention, Symptoms & What To Do

Acute Mountain Sickness (AMS) affects roughly 50% of trekkers who ascend above 4,000m. It can strike anyone regardless of fitness level, age, or previous altitude experience.

What Causes It

At high altitude, air pressure drops and each breath delivers less oxygen to your body. Your body needs time to adjust by producing more red blood cells. If you ascend faster than your body can acclimatize, you get sick.

The Three Stages

Mild AMS (Very Common) - Headache - Loss of appetite, nausea - Fatigue - Difficulty sleeping - Dizziness

**What to do**: Stop ascending. Rest. Hydrate. Take ibuprofen for headache. If symptoms improve in 24 hours, you can continue.

Moderate AMS (Serious) - Severe headache not relieved by medication - Vomiting - Extreme fatigue - Loss of coordination (ataxia) - Shortness of breath at rest

**What to do**: DESCEND immediately (at least 500-1000m). This is not optional.

HACE / HAPE (Life-Threatening) - Confusion, disorientation - Inability to walk straight - Gurgling breath sounds - Blue lips/fingernails - Coughing up pink frothy sputum

**What to do**: Emergency evacuation. Administer Dexamethasone and Nifedipine if available. Descend immediately.

Prevention Rules

1. **Climb high, sleep low**: Take acclimatization days every 1,000m above 3,000m 2. **Stay hydrated**: Drink 3-4 liters per day 3. **Ascend gradually**: No more than 500m of sleeping altitude gain per day above 3,000m 4. **Avoid alcohol and sleeping pills**: They suppress breathing 5. **Eat carbohydrates**: Your body needs fuel for acclimatization 6. **Consider Diamox**: 125mg twice daily as a preventative (consult your doctor)

The Golden Rule

**Never ascend with symptoms.** If you feel unwell, stay put or go down. The mountain will always be there tomorrow.