National Doctors' Day 2022: Causes, symptoms, preventive tips for Economy Class Syndrome or travellers thrombosis

Deep Vein Thrombosis or Economy Class Syndrome occurs to many people when they regularly travel in airplanes and face difficulties related to health. Ahead of National Doctors' Day 2022, doctors reveal all you need to know about causes, symptoms and preventive tips for travellers thrombosis

Economy Class Syndrome is the medical term for a blood clot(s) in the major veins carrying blood from the lower (usually) limbs to the heart when one may have to sit in the same position for a long time for example, sitting on an airplane for long hours can lead to something called travellers thrombosis, which happens when someone sits in the same position for a long time without much movement and it affects approximately two to three people per 1000 individuals per year. As travelling has opened up, people are continuously flying long hours and travelling several miles to various destinations hence, Deep Vein thrombosis or Economy Class Syndrome occurs to many people when they regularly travel in airplanes and face difficulties related to health and ahead of National Doctors' Day 2022, we are going to throw light on its causes, symptoms and preventive tips.

National Doctors' Day 2022: All you need to know about the causes, symptoms, preventive tips for Economy Class Syndrome or travellers thrombosis (Twitter/cuticahealth)

Causes:

In an interview with HT Lifestyle, Dr Ambanna Gowda, Consultant Physician and Diabetologist at SPARSH Hospital, shared, “There are multiple reasons for this. It happens because the aircraft creates a micro environment condition where immobilization, reduced oxygen tension, tight uncomfortable seats, circadian dysrhythmia i.e changes in disruption of the normal sleep cycle pattern of wakefulness and sleep, due to differences in their timezone (jetlag) leading to Economy Class Syndrome. These are the conditions that disturb the passengers health.”

Bringing his expertise to the same, Dr Suheil Dhanse, Interventional Cardiologist at Thane's Horizon Prime Hospitals, revealed, “it has also been known to occur after long-haul flights, earning it the moniker “Economy-class syndrome”. Remaining seated, especially sleeping, in a cramped seat with little room for leg movement results in pooling of blood in the lower limbs, and thus, a tendency to form blood clots in the veins. This is further exacerbated by dehydration during air travel and the consumption of alcohol. Women who are pregnant, the elderly, patients with cancer or other pro-coagulant states (conditions causing a predisposition to clotting) and those on oral contraceptive therapy are at added risk.”

Symptoms:

According to Dr Ambanna Gowda, it causes symptoms like fatigue, anxiety, nausea, swelling, redness, muscle pain, tenderness around the calf muscle part of the leg. He said, “A passenger’s high BMI, hypobaric hypoxia, low humidity, pregnancy, hypercoagulable state, people who smoke, women who are on oral contraceptives, on hormonal therapies, cancer patients are more predisposed. When they sit for long hours without movement and if the above mentioned factors exist, they are considered high risk for developing blood clots in the leg due to travelling, also known as venous thromboembolism or travellers thrombosis. It can happen in middle aged or older people commonly.”

Adding to the list, Dr Suheil Dhanse said, “The symptoms are usually pain, swelling and redness of the affected limb. DVT is known to occur during pregnancy, or after a period of prolonged bed rest or immobilisation (such as after a major surgery/hospitalisation). A potentially fatal complication of the condition is Pulmonary embolism – a condition where a portion of, or the entire clot breaks free and travels to the heart. The clot lodges in the blood vessels carrying blood from the heart to the lung and causes serious symptoms like shortness of breath or even cardiorespiratory collapse and cardiac arrest.”

Preventive tips:

Highlighting that preventive measures are very few and very specific for each individual, Dr Ambanna Gowda suggested:

1. Pick a suitable outfit: Pick something that you are comfortable wearing.

2. Take frequent walks: Don’t sit idle for more than six to eight hours at one place in the flight

3. Do light exercises: Walk around and do some light stretching exercises of legs.

4. Hydrate frequently: Drink water regularly

He added, “If you are predisposed to the condition, your doctor may recommend elastic compression stockings that can help you. People who develop blood clots in the legs or venous thromboembolism may experience few symptoms a few weeks after the journey. Post air travel, one can develop this for the next two to eight weeks. So make sure you mention your travel history to your doctor if you notice any symptoms. The clots in the legs can sometimes get dislodged from legs and move to the lungs and cause a condition known as pulmonary embolism causing heart conditions, like stroke to the heart or the brain. This can be a serious complication.”

Dr Suheil Dhanse advised following simple steps can help prevent DVT and its complications. These steps include:

1. Drink adequate amounts of water

2. Avoid excessive consumption of alcoholic beverages

3. Stand up and walk for a few minutes at least once in 1-2 hours

4. While seated upright or in the reclined position, exercise both your legs by flexing your foot up and down (as if pushing down on the accelerator and releasing it) as frequently as possible. This exercise acts like a pump for the blood vessels of your leg, improving the return of blood to your heart.

5. Wear “graduated compression stockings” that are tighter around the ankles and feet, than the thighs, to reduce pooling of blood in the legs and feet.

Whenever people with such predisposing factors or past history of medical illness are travelling for long distances, they should consult and inform the family doctor or the treating doctor because most of the time, they think that this is not important. Ideally, it’s good to inform and discuss with your doctor if you are taking long distance flights so that necessary precautions can be taken and incidences of Economy Class Syndrome can be avoided. The longer the flight travel, the higher the risk.