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(with recognition to GlaxoSmithKline and Healthy Home Newsletter as on )

A hangover usually refers to the after-effects of drinking too much alcohol. The familiar symptoms, thirst, headaches, sensitivity to light and noise, feeling unwell, diarrhoea, nausea and even vomiting, have been described throughout history from ancient Greece to present day literature and media. You would think by now we would have learnt to avoid these symptoms either by not drinking alcohol or at least by finding an antidote. For after all, alcohol is a poison.

What causes a hangover?
The symptoms of hangovers have many causes. Firstly, alcohol has a number of adverse effects on the body, such as:

bulletDehydration that can cause headaches, dry mouth, thirst, lethargy and dizziness. Alcohol increases the body's output of urine. Drinking about 50 g of alcohol (about 4-5 standard drinks) causes the loss of 600 to 1000 mL over several hours.
bulletGastritis, or inflammation of the stomach lining, causing nausea, abdominal pain and vomiting. Alcohol directly irritates the stomach lining.
bulletDilation of blood vessels in the brain that can cause or add to headache, probably the most common symptom of a hangover.
bulletA depressive effect on the brain due to alcohol affecting the levels of several brain chemicals, an effect that can last for up to 16 hours after the blood alcohol level has returned to normal.
bulletInterference with the secretion of a number of hormones that may reduce the quality of sleep and cause disruption in circadian rhythms possibly inducing a 'jet lag' like effect.

Another factor contributing to hangover is the levels of congeners (other alcohols and by-products from the alcoholic fermentation) in the beverage. Spirits containing high congeners levels, such as bourbon and brandy, are more likely to cause severe hangover symptoms than vodka or gin.

Other substances in the alcoholic beverage, such as tannin in red wine, or flavour compounds in dark beers are also reported to worsen hangover symptoms. Also, genetics can contribute to the severity of a hangover, since some people have a reduced capacity to eliminate one of the toxic substances (aldehydes) produced in the body from alcohol. Build up of these substances may cause flushing, a throbbing headache, nausea and other symptoms. Additionally, psychological factors can alter a person's perceptions about the severity of their symptoms.

Prevention and cure
As with most things, prevention is better than cure, but if you are imbibing:
bulletChoose low-alcohol drinks
bulletAllow enough time between drinks for your body to break down the alcohol
bulletEat food before or while drinking
bulletAlternate water or soft drinks with alcoholic drinks
bulletDrink water before going to bed, and if possible during the night
bulletLimit drinks with high congener content (usually the darker drinks)

A number of medications can provide symptomatic relief, for example antacids to reduce nausea and gastritis, and paracetamol or non-steroidal inflammatory agents (e.g. ibuprofen and naproxen) to treat headache. There are also a variety of other 'cures', such as caffeine and vitamin B6, which are anecdotally effective but have only limited scientific backing.


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