Barotrauma

Particularly this time of the year, we get more cases of Barotrauma on board than usual .

Barotrauma is the pain caused by the expansion and contraction, due to outside pressure changes of air trapped in the cavities of the body, mostly within the middle ear, sinuses, intestines or teeth.

Middle Ear

Is probably the most common, and mostly occurs in the descent when air is attempting to return to the middle ear. Pressure is normally equalised across the eardrum by the Eustachian Tube leading from the middle ear to the back of the mouth/nose. There is seldom any problem in the climb when air passes from the midle ear to atmosphere. The end of the Eustachian Tube acts as a flap valve witch allows air to escape with relative ease (required in the ascent) but can restrict air entering the middle ear (required in the descent). With a reduced pressure in the middle ear the increasing pressure outside will cause a distortion  of the ear drum and sometimes extreme pain. So the severity of middle ear Barotrauma depends upon the rate of climb and descent. It occurs mainly at lower levels where pressure changes are the gratest. One or both ears can be affected , become inflamed and swell and will cause pain, temporarily deafness, pressure Vertigo, tinnitus and/or in extreme cases even rupture and bleeding. 

So, what can you do?

Hope for the landing to be as quick as possible, and meanwhile this can help: yawning. moving the lower jaw from side to side, swallowing with the nose held, the Frenzel Manoeuvre (similar to stifling a sneeze) or the  Valsalva Manouevre (similar to blowing down a held nose wíth the mouth closed, though keep in mind that a violent usage of this method may cause pressure vertigo). If you´re travelling with babys and children, simply let them cry or ask one of your flight attendants for "Mickey Mouse ears".

Sinus Barotrauma 

Sinuses are cavities within the skull situated above the eyes, in the cheeks and at the back of the nose and are connected to the Nasal Cavity by narrow ducts. If they become swollen or obstructed or if the sinuses are infected by a cold or influenza it will cause pain, wich normally starts around the eyes spreading to the temples. Fainting to  such pain, watering of the eyes making vision difficult and bleeding from the nose may occur.

So, what can you do?

Please avoid travelling with a cold or influenza. Better change in your booking a couple days rather than having to deal with the excruciating pain inflight and with the symptoms for a week or two. If ther´s nothing else to do, try applying some nose drops.

Gastro-intestinal  Barotrauma

Air can be swallowed along with food and the digestive processes produce gas. Gas collecting in the stomach can easily escape through the mouth whereas at the other end of the system ,gas in the large intestine can be vented to the outside (known as "passing flattus"!". The main problem is gas in the small intestine. It has no exit at either end and will expand causing discomfort and sometimes pain sufficiently severe to cause fainting.

So, what can you do?

Avoid foods wich are high gas producers on board or before your flight (raw apples, cabbage, cauliflower, celery, cucumber, beer, beans, any highly spiced foods such as curries, etc), eat slowly and not rush meals, eat smaller portions (less swallowed air), don´t use chewing gum (for the same reason), ask your partner for some tummy massages (caution, might end joining miles high club), drink something hot, like a camomile tea, go for a small walk in the cabin (only if the seat belt signs are off!)

 

Barotrauma of the Teeth

Healthy teeth do not contain air but gas pockets can form in old or poor fillings or abcesses. Unlike the above barotraumas, this one is most common in the ascent as the gas may press on a nerve, causing severe tooth pain.

So, what can you do?

Good dental care and hygiene can prevent any problem. Otherwise, the only thing that will help you are pain killer pills.