How Can I Deal With a Really Bad Hangover?

Hangover, which belongs to mild acute alcoholism, refers to a state of central nervous system dysfunction that occurs after a short period of ingestion of large amounts of alcohol or alcoholic beverages, and often exhibits behavioral and conscious abnormalities. Hangover due to excessive drinking, after the rest of the night, the body's alcohol, namely ethanol, has been completely drained, but still have symptoms such as headache, dizziness, fatigue, nausea, upset stomach, drowsiness, sweating, excessive thirst and blurred cognition. This is because after a large amount of alcohol is consumed, liver cells are unable to remove all harmful substances such as acetaldehyde and so on, causing acute poisoning symptoms. When hangover, the liver will accumulate fat, the gastrointestinal tract is prone to alcoholic acute gastritis, the autonomic nervous system imbalance causes the heartbeat to accelerate, the blood and electrolyte balance imbalance, etc., can also cause brain edema and functional neuritis.

Basic Information

nickname

Hangover disease

English name

hangover

Visiting department

Emergency Department

Common causes

Excessive drinking

Common symptoms

Headache, dizziness, fatigue, nausea, upset stomach, drowsiness, sweating, extreme thirst, blurred cognition, etc.

Contagious

no

Causes of Hangover

Post-drunk state due to the direct effects of excessive drinking. The cause may also be related to the non-ethanol component of alcohol.

Clinical manifestations of hangover

Physical symptoms can include fatigue, headaches, thirst, dizziness, stomach problems, nausea, vomiting, insomnia, dizziness, and muscle spasms, hand tremors, and increased or decreased blood pressure. Mental symptoms include acute anxiety, irritability, oversensitivity, depression, or guilt. Some symptoms of hangover are similar to alcohol withdrawal syndrome. The amount of alcohol required to cause a hangover varies depending on the individual's physical and mental state. There are individual differences in alcohol absorption and clearance and depend on many factors, such as: age, gender, body mass, physique, nutritional status, smoking, diet, existing food in the stomach, gastric motility, ascites, cirrhosis, and Whether drinking alcohol for a long time, etc. Generally speaking, the higher the blood alcohol concentration during drunkenness, the more severe the subsequent symptoms. Hangover generally refers only to the aftereffects of a single drink, usually lasting no more than 36 hours.

Hangover check

The physical examination only has the emotional and neurological manifestations of language excitement, such as incoherent speech but no aggressive behavior, can walk, but has mild movement incoordination, drowsiness can be awakened, simple answers are basically correct, and neuroreflexes are normal.

Hangover diagnosis

75% of drunk people will feel uncomfortable hangover. Hangovers are considered an early stage of alcohol withdrawal. When the liver breaks down alcohol, toxic metabolites such as acetaldehyde will spread throughout the body, irritating nerves and causing headaches. The diagnostic criteria for hangover or mild acute alcoholism:

1. Clear history of excessive alcohol or alcoholic beverage intake

2. Exhaled breath or vomit has an alcohol smell and one of the following:

(1) Irritable and provocative, multilingual or silent, incoherent speech, emotional instability, rude or aggressive behavior, nausea, vomiting;

(2) I feel sluggish. I have uncoordinated muscle movements, agitation, unstable gait, obvious ataxia, nystagmus, and diplopia.

Differential diagnosis of hangover

Disulfiram-like reactions: Patients who drink alcohol during or after using certain drugs experience similar reactions to taking a disulfiram, also known as disulfiram, abstaining from sulfur, after drinking, Onset usually occurs within 0.5 hours after drinking, mainly manifested as facial flushing, headache, chest tightness, shortness of breath, increased heart rate, limb weakness, excessive sweating, insomnia, nausea, vomiting, blurred vision, severe blood pressure drop, and difficulty breathing. The occurrence of loss of consciousness and convulsions, and extremely rare deaths, may be inhibited by aldehyde dehydrogenase, and the acetaldehyde concentration in the body will increase, leading to vasodilatation. The clinical manifestations of the disulfide wake reactions are quite different. Symptoms usually last 2 to 6 hours. The disulfide-like reaction is similar to many diseases, and it is easy to cause misdiagnosis. It should be identified.

Hangover Treatment

1. Treatment of mild (conscious) patients

(1) If you feel uncomfortable after drinking a large amount of alcohol, you should immediately induce vomiting repeatedly. This is the most effective measure to prevent alcoholism, which can greatly reduce the pain and injury of patients, and achieve twice the result with half the effort. If you drink alcohol for more than 1 hour, the effect of gastric lavage will be greatly reduced. Strictly speaking, emetic lavage and activated carbon are not suitable for patients with simple alcoholism, because most of the alcohol consumed is absorbed within 1 hour.

(2) Patients with pure acute mild alcoholism do not need treatment. At home observation, you can eat some sugary foods such as apples, bananas, oranges, honey, etc., as well as foods rich in vitamin C and vitamin B. At the same time, encourage Patients drink plenty of water to promote urination. Those who are restless can be restrained appropriately to protect their head and face to avoid injury. If you have basic diseases such as obesity and poor ventilation, you should ask them to keep warm. Lateral position to prevent complications such as vomiting and aspiration. Those with severe disulfide-like reactions should be treated early.

2. Treatment for coma patients

(1) Patients who are drowsy and unconscious, and those with cardiovascular disease should be sent to the hospital for examination and treatment. Before arriving at the hospital, the patient should be placed in a side-lying position, and care should be taken to keep the patient's airway open.

(2) Not all patients with alcoholism must go to the hospital. If the patients are generally better, sometimes they do not need to go to the hospital. For patients who do not go to the hospital, the most important thing is that they must be attended to by the patient until the patient is awake. Do not let him sleep alone, otherwise the patient may suffocate due to vomiting while sleeping, and similar tragedies are endless.

(3) Stomach lavage should be evaluated for severe patients, weighing the pros and cons, and it is recommended to limit to one of the following conditions: No vomiting within 2 hours after drinking, evaluate patients with coma that may worsen their condition; coexist or highly suspect other drugs or poison The gastric tube has been indwelled, especially in patients with coma and shock. The gastric tube can be used for artificial gastric lavage. The treatment in the hospital is to observe the vital signs closely. It is best to implement ECG monitoring while maintaining water and electrolyte balance to prevent complications. happened. Proper fluid replenishment and vitamin B ₁ B ₆ C are beneficial to alcohol oxidation and metabolism. Metadoxine, which promotes the metabolism of alcohol, may be used as appropriate to accelerate the excretion of ethanol and its metabolites. For patients with deep coma, naloxone, nalmefene hydrochloride and other wake-up treatments can be applied. For manic patients, diazepam, haloperidol, and olanzapine can be treated equally. Avoid chlorpromazine, morphine, and phenobarbital. Proper sedatives. Some traditional Chinese medicine adjuvant therapies can also be used, as reported in the medical literature. Drinkers of the Chinese medicine pueraria soda are helpful to patients with alcoholism, so they can be tried out.