Health Condition

Vertigo

  • Laxatives & Fiber Products

    Medically, constipation is defined as having three or fewer bowel movements per week, but the reality is far different: for someone who normally has two to three bowel movements per day, having only one a day can signal constipation. If occasionally you find yourself unable to stay regular—what feels like constipation to you—a fiber supplement or laxative may help get your body back on track. Keep the following in mind as you choose a fiber or laxative product:

    • If you haven’t changed your eating habits and you’re experiencing constipation for the first time, consult your doctor. New constipation may signal a more serious health problem, especially if it lasts for more than a few days or is ongoing, even if intermittently.
    • If you are managing a health conditions, consider your medications when selecting constipation products. Consult your doctor or pharmacist if unsure about whether any particular digestion aid is safe for you.
    • Always compare ingredients to avoid accidentally doubling up on any one particular active ingredient.
    • Read labels carefully to ensure you pick the right products to meet your particular constipation issues.
    • If you are pregnant or nursing, talk to your doctor first before using any new laxatives.
    • Fiber

      What they are: There are two types of fiber (sometimes called bulk fiber), soluble and insoluble, and many different types of fiber supplements, such as psyllium, guar gum, cellulose, polycarbophil, wheat dextrin, and inulin. These products are available over the counter.

      Why to buy: Fiber supplements are designed to address one of the common causes of constipation—a lack of fiber in the diet. Dietary fiber bulks up the stool and makes it softer and easier to pass, which alleviates constipation. Insoluble fiber is more commonly recommended for constipation, but some people do better with a combination of insoluble and soluble fibers. If you try one fiber supplement and it doesn’t agree with you, try another brand, which may work better with your system.

      Things to consider: Start at a low dose, with plenty of water, and increase the amount of fiber supplement a bit at a time. Too much fiber at once may cause gas and bloating. Insoluble fiber supplements can decrease the absorption of some minerals, especially calcium, and some medications. Leave an hour or two between when you take your fiber supplement and when you take calcium. If you take prescription medications, ask your doctor or pharmacist how a fiber supplement can affect drug absorption and how you can safely take a fiber supplement without affecting your medications.

    • Stool Softeners

      What they are: Stool softeners are medications that help the stools hold onto water, making stools softer and easier to pass.

      Why to buy: Stool softeners are available over the counter and tend to be gentler on the digestive system than stimulant laxatives, making them a good option for addressing mild constipation. Some prescription medications can dry out and harden stools, so taking a stool softener with these medications can help prevent this problem. Stool softeners come as capsules, to be taken orally, and suppositories, which are placed directly into the rectum. Though suppositories are faster acting, most people prefer oral medication.

      Things to consider: Stool softeners are considered safe for most people, but do not take them without consulting your doctor if you are pregnant or nursing, or if you have serious digestive conditions such as inflammatory bowel disease or bowel obstructions. Some people are allergic to the active ingredient in certain stool softeners.

    • Stimulant Laxative & Oral Osmotic Medications

      What they are: Stimulant laxatives cause the muscles in the lower intestinal tract to relax and loosen, allowing stools to pass through quickly, and include anthraquinones such as senna. This muscular action moves stools more quickly through the digestive tract. Oral osmotics pull a lot of extra water into the digestive tract, which loosens stools, and include products that contain magnesium, sorbitol, lactulose, and polyethylene glycol.

      Why to buy: Stimulant laxatives, available over the counter, will often alleviate the toughest cases of constipation. They tend to work more quickly than fiber supplements, with more dramatic effects. Suppository stimulant laxatives often produce a bowel movement within 30 to 60 minutes; taken orally, they work within 6 to 12 hours.

      Things to consider: Stimulant laxatives should be used occasionally. Long-term use is not safe and can lead to dependency and decreased bowel function. Further, long-term use may cause electrolyte imbalances, a potentially serious condition that can lead to abnormal heart rhythms, confusion, weakness, and seizures.

    • Lubricant Laxatives

      What they are: Lubricant laxatives, which includes mineral and castor oils, make stool slippery, so it moves through the intestine more easily.

      Why to buy: Lubricant laxatives are very effective and work more quickly than fiber supplements, typically within six to eight hours, and with more dramatic effects.

      Things to consider: Lubricant laxatives decrease the absorption of some minerals and of fat-soluble vitamins and some other nutrients. For this reason, they are generally not recommended. If used, lubricant laxatives should only be taken occasionally, for short periods of time.

  • Children's Digestion Aids

    Illness, nerves, trying new foods—all sorts of things may throw your little one’s digestive system off track and cause constipation or diarrhea. Comfort your kids with safe, gentle, and effective products to help them go, or help them stop. And help keep your kids regular with a healthy diet containing plenty of fiber and water.
    • Stool Softeners & Laxatives

      What they are: Stool softeners and osmotic laxatives are kid-friendly, stimulant-free products that ease constipation—from flavored powders you mix with juice, to chewable tablets, to rectal suppositories.

      Why to buy: Stool softeners offer gentle, gradual relief from occasional constipation. Powders with oral docusate sodium also prevent dry, hard stools and generally work in 12 to 72 hours. Most chewable tablets contain the non-stimulant laxative magnesium hydroxide, known as “milk of magnesia,” and take effect in 30minutes to six hours. For more immediate relief, liquid glycerin suppositories are available in easy-to-use disposable applicators.

      Things to consider: Ask a doctor before your child uses stool softeners or laxatives if they’re experiencing abdominal pain, nausea, or vomiting; or have a sudden change in bowel habits lasting more than two weeks. These could be symptoms of a more serious condition. Stop using laxatives and stool softeners and consult a doctor if your child has rectal bleeding or still has no bowel movement after use.

    • Anti-Diarrheal Products

      What they are: Smaller dosage amounts of most adult anti-diarrheal medicines are safe and effective for children; recommended amounts are usually indicated on the label. Loperamide hydrochloride is the most common active ingredient and is safe for use by children six and older. It’s available in caplets, soft gels, and liquids. Chewable tablets and flavored liquids containing bismuth subsalicylate are safe for children over 12.

      Why to buy: Anti-diarrheals help ease stomach discomfort and stop diarrhea symptoms.

      Things to consider: Most anti-diarrheal products should not be used in children under six unless directed by a doctor. Children and teenagers who have or are recovering from chicken pox or flu-like symptoms should not use bismuth subsalicylate due to risk of Reye’s syndrome. Remember, when children suffer from diarrhea, they need to drink plenty of fluids. There are many convenient over-the-counter remedies for dehydration including popsicles enhanced with much-needed electrolytes.

  • Anti-Nausea & Motion Sickness Products

    Whether triggered by car, boat, plane, or train, motion sickness and nausea will make you miserable. And while health experts don’t know exactly what causes motion sickness, there are plenty of options for keeping it at bay. Keep the following in mind as you shop for motion sickness products:

    • If nausea, extreme sensitivity to motion, dizziness, and unsteadiness are new to you, talk to your doctor. These things may signal a more serious health problem.
    • If you are managing a health condition, especially high blood pressure, or kidney, liver or heart disease, consider your medications when selecting an anti-nausea medicine. Consult your doctor or pharmacist about your best options.
    • Use motion sickness and anti-nausea medications according to package directions and pay attention to listed side effects. Some of these drugs cause extreme drowsiness, making everyday activities, such as driving, unsafe.
    • Do not use motion sickness medications and alcohol together. Alcohol increases the sedative effects of these drugs.
    • Some motion sickness and anti-nausea medications may cause confusion or aggravate symptoms in those with dementia and in adults older than 65 years.
    • Do not use these medications if you are pregnant or nursing.
    • Compare ingredients to avoid accidentally taking two medications together that contain the same active ingredients, and check with your doctor about which products are okay to take together and how best to avoid mixing drugs that should not be combined.
    • Over-the-Counter Oral Medications

      What they are: There are several over-the-counter oral medications to prevent and treat nausea due to motion sickness. Most brand name and generic motion sickness products contain either meclozine or dimenhydrinate.

      Why to buy: Meclozine or dimenhydrinate can be purchased without a prescription, they are relatively inexpensive, and they are effective at preventing motion sickness in most people.

      Things to consider: Do not use these products without consulting your doctor if you have high blood pressure, heart disease or irregular heart beats, thyroid problems, diabetes, glaucoma, prostate enlargement, liver disease, or kidney disease. Motion sickness medications work best when taken before motion sickness occurs. Many people experience drowsiness after taking these medications, and for adults older than 65 years, motion sickness drugs can cause confusion and agitation. Other common side effects include dry mouth and constipation.

    • Prescription Motion Sickness Medications

      What they are: Prescription motion sickness products are available as oral medications (pills and capsules), transdermal patches, and rectal suppositories. Transdermal products deliver a steady, continuous dose of medication through a patch placed on the skin. Promethazine and prochlorperazine are prescribed for oral use, while scopolamine and prochlorperazine can be used as rectal suppositories, and scopolamine is very effective when used as a patch.

      Why to buy: Prescription motion sickness products are stronger than over-the-counter versions and they offer additional options for managing severe motion sickness. The scopolamine patch is particularly effective for most people and will give continuous protection against motion sickness for up to three days, or until the patch is removed from the skin. A patch may be the best option for long-term motion sickness control, such as during a boat trip or cruise.

      Things to consider: Before using these medications, tell your doctor if you have high blood pressure, heart disease or irregular heart beats, thyroid problems, diabetes, glaucoma, prostate enlargement, liver disease, or kidney disease. As with over-the-counter motion sickness medications, prescription versions work best when taken before motion sickness occurs. These drugs can cause drowsiness, dry mouth, constipation, and for adults older than 65 years, confusion and agitation.

    • Other Options for Managing Motion Sickness

      What they are: Other over-the-counter options for motion sickness include wristbands and herbal products, particularly ginger. Wristbands work by supplying continuous pressure on an acupressure point on the wrist, which is associated with nausea relief.

      Why to buy: For people with mild motion sickness, wristbands and ginger capsules may provide relief, and they do so without the side effects associated with other motion sickness medicines. These products can be used in addition to over-the-counter and prescription motion sickness medications.

      Things to consider: Wristbands and ginger herb capsules are safe for nearly all people, but check with your doctor first if you have concerns about how these products might affect other medications you use to manage an existing health condition.

  • Anti-Gas Products

    Gas isn’t always a laughing matter. It can also be painful and embarrassing. To get bloating under control fast, look to these anti-gas products for relief. If gas becomes a persistent problem, talk with your doctor about possible underlying causes or changes to your diet.
    • Basic Anti-Gas Products

      What they are: The standard active ingredient in anti-gas products is simethicone. In a nutshell, it works by decreasing the surface tension of gas bubbles in the stomach, causing them to combine into larger bubbles that can be passed more easily. Softgels, tablets, and capsules tend to have higher doses of simethicone than chewables, liquids, and dissolving strips.

      Why to buy: These basic products are convenient, proven ways to get fast relief from bloating and pressure commonly referred to as gas. Combine your anti-gas medicine with your after-meal mint—check out dissolving strips you put on your tongue, complete with breath-freshening mint flavor.

      Things to consider: When used as directed, simethicone is safe and has little to no side effects. However, no more than 500 mg of simethicone should be taken in a twenty-four hour period. Look for special anti-gas formulas with lower dosages for babies and children.

    • Anti-Gas with Antacids

      What they are: These medications are combinations of simethicone for anti-gas and antacids like calcium carbonate, aluminum hydroxide, and magnesium hydroxide. They are available in a variety of easy-to-take formulas including softgels, tablets, capsules, chewables, and liquids.

      Why to buy: Medications that combine an anti-gas ingredient with an antacid offer quick relief from the discomfort of bloating and gas and the pain of acid indigestion, heartburn, and sour stomach.

      Things to consider: Ask a doctor or pharmacist before use if you take prescription medications, as antacids may interact with certain prescription drugs. Products containing aluminum or calcium may cause constipation; those containing magnesium may cause diarrhea. Some antacids combine these ingredients in an attempt to cancel out unpleasant side effects. If gas symptoms last for more than two weeks, stop use and talk to your doctor.

    • Food Enzyme Dietary Supplements

      What they are: Food enzyme dietary supplements are easy-to-chew-or-swallow tablets made with food enzymes from natural sources—most contain the alpha-galactosidase enzyme from safe, food-grade mold. Food enzymes break down the complex carbohydrates found in many foods, making them easier to digest so they don't cause gas. You typically take one tablet per serving of “problem” food at the beginning of the meal for best results.

      Why to buy: These supplements are a natural way to prevent the gas, bloating, and discomfort caused by eating healthful foods like beans, broccoli, cabbage, lettuce, onions, peppers, a variety of grains, cereals, nuts, and seeds.

      Things to consider: Store food enzymes at or below room temperature; avoid heat. Look for vegetarian-friendly formulas. Some chewable and “melt away” varieties contain a higher dose of food enzymes; always read labels and follow directions.

  • Antacids & Acid Reducers

    If you or a family member occasionally suffers from heartburn or acid indigestion, antacids may offer temporary relief. For more frequent issues, consider acid reducers like ranitidine or omeprazole. It’s important to see your doctor if symptoms persist, as they could be early warning signs of a more serious condition. Keep the following in mind as you consider the right antacids and acid reducers for you:

    • Reduced stomach acidity may result in an impaired ability to digest and absorb certain nutrients, such as iron, magnesium, and B vitamins.
    • Since stomach acidity normally kills ingested bacteria, antacids and acid reducers may increase your vulnerability to infection.
    • They may also change how you absorb certain medications, so use carefully and talk with your doctor if you have concerns.
    • Antacids

      What they are: Antacids are chewable tablets, effervescent drink powders, liquids, and syrups containing one or multiple active ingredients shown to temporarily neutralize stomach acid and treat the symptoms of heartburn.

      • Sodium bicarbonate, also known as baking soda. Some antacids combine it with alginic acid, a gelling agent, to create a barrier which prevents stomach acid from refluxing back up into the esophagus. Effervescent formulas with aspirin provide added pain relief.
      • Calcium carbonate, typically found in chewable tablets.
      • Aluminum hydroxide and/or magnesium hydroxide, usually found in gel or liquid form.

      Why to buy: Antacids may provide immediate, temporary relief (1 to 2 hours) from minor symptoms of heart burn and indigestion.

      Things to consider: Minor side effects include diarrhea, constipation, and flatulence. Generally, medications containing aluminum or calcium are likeliest to cause constipation; those containing magnesium are likeliest to cause diarrhea. Some products combine these ingredients in order to help prevent unpleasant side effects. Consuming excess calcium carbonate can be hazardous, so read labels carefully.

    • Acid Reducers/H2 Blockers

      What they are: H2 receptor antagonists, or “blockers,” are used to decrease stomach acid by preventing histamine from stimulating acid production. There are four FDA-approved variations—cimetidine, ranitidine, famotidine, and nizatidine—all available over the counter.

      Why to buy: H2 blockers are an effective and well-tolerated treatment for heartburn and indigestion. Many can be taken before meals to prevent heartburn, and effects last longer than antacids.

      Things to consider: Cimetidine has the most instances of adverse reactions in this drug class, including headache and dizziness. Cimetidine interacts negatively with many other medications, so read labels and talk with your doctor or pharmacist.

    • Proton-Pump Inhibitors (PPIs)

      What they are: PPIs are the most potent and effective treatments available for frequent heartburn and indigestion. Available by prescription and over the counter, omeprazole and lansoprazole are the most common active ingredients.

      Why to buy: PPIs offer effective, long-lasting treatment of acid indigestion, heartburn, and ulcers by significantly reducing stomach acid production with few side effects. Most PPIs do not provide immediate relief, but take hours or days to become effective and are taken for weeks at a time. If you need both immediate and long-lasting results, look for combination products with an antacid and acid reducer.

      Things to consider: Acid reducers are not meant for long-term use. The FDA advises that no more than three 14-day treatment courses be used in one year unless directed by a doctor. Side effects may include headache, nausea, diarrhea, abdominal pain, fatigue, and dizziness. High-dose or long-term PPI use may lead to increased risk of bone fractures, and decreased vitamin B12 absorption, potentially leading to vitamin B12 deficiency.

  • Natural Digestion Aids

    From indigestion to constipation, digestion woes can ruin anyone’s day. If you suffer with these issues from time to time, a natural digestion aid may be just what you need to get your body back on track. Our guide to digestion aids will help you find the right products to meet your health and lifestyle needs. Keep the following in mind as you choose a digestion aid.

    • If you haven’t changed your eating habits and you’re experiencing new symptoms such as constipation, diarrhea, or heartburn on a regular basis, consult your doctor. These symptoms may signal a more serious health problem.
    • When selecting a product, consider medications you use and health conditions you have. Consult your doctor or pharmacist if unsure about whether any particular digestion aid is safe for you.
    • When using multiple products, always compare ingredients to avoid accidentally doubling up on any one particular active ingredient.
    • Read labels carefully to ensure you pick the right products to meet your particular digestion issues; some products are designed to address several problems at once, others only one issue at a time.
    • If you are pregnant or nursing, consult your doctor before using digestion aids.
    • Do not use any products for which a complete ingredient list is not provided.
    • Teas

      What they are: Teas to address a particular digestion issue contain an ingredient, or combination of ingredients, such as:

      • Ginger, fennel, fenugreek, or chamomile for nausea, indigestion, and heartburn (acid reflux)
      • Peppermint for nausea (good for nausea, but may worsen heartburn)
      • Parsley or fennel for gas and bloating
      • Slippery elm or meadow sweet for intestinal discomfort and spasms
      • Aloe, senna, cascara, or burdock root for constipation

      Why to buy: Herbal teas are generally safe and easy to use, offer gentle relief for occasional digestion woes, and are relatively inexpensive.

      Things to consider: Teas for constipation can have strong laxative effects in some people; start with a quarter to half cup serving and see how your body responds. Increase the dose as needed to relieve constipation. Pregnant women, people with kidney problems, high blood pressure, or heart disease, or those who are taking diuretic medications should consult their doctor before using digestion teas.

    • Herbal Capsules

      What they are: Natural digestion aids are available in capsule or tablet form and contain many of the same herbs found in digestion aid teas.

      Why to buy: Digestion aid capsules are more convenient; they can be carried with you and taken anytime, without the need to boil water to make tea. Capsules may deliver a more concentrated dose of the active ingredient than tea.

      Things to consider: As with teas, products for constipation can have strong laxative effects, so start slow and increase the dose only as needed. Consult your doctor or pharmacist before using these products if you are pregnant, or have kidney problems, high blood pressure, or heart disease, or take diuretic medications.

  • Smoking Cessation Products

    Many things motivate people to quit tobacco: being a good role model, wanting to reduce others’ exposure to second hand smoke, saving money, and wanting to feel better and improve health. Whatever your reason, keep in mind that quitting cold turkey is the least successful method for kicking cigarettes for good. Fortunately, many over-the-counter and prescription quit aids have been developed that may significantly improve your odds of success. As you figure out which quit-smoking aids best meet your needs, keep the following in mind:

    • Some treatments to stop smoking are covered by health insurance. Check with your carrier to see.
    • Some products are available both over the counter (behind the pharmacy counter) and with a prescription. Ask your health insurance about whether you need a prescription for coverage or reimbursement.
    • Try, try, and try again. People who successfully quit smoking rarely do so on the first attempt. If you’ve tried before without success, don’t be discouraged. Consider a different quit aid—the nicotine patch instead of gum, or adding in a prescription medication—and evaluate what worked and didn’t work to keep you on track during past attempts to quit.
    • Start with your doctor, nurse, or pharmacist. They can offer invaluable advice and connect you with programs for people trying to quit, including support groups and other resources. Consider taking advantage of these supports, because most people do best when they combine quit-smoking products with behavior change programs.
    • When selecting a product, consider your current medications and health conditions. Consult your doctor or pharmacist if unsure about whether any particular smoking cessation product is safe for you.
    • Use nicotine replacement carefully and follow all package directions. Some people load up on patches, gum, and sprays yet continue to smoke at the same time. This can overload your system with nicotine, resulting in jitters, rapid heart rate, high blood pressure, and trouble sleeping. Some products can be used together, so ask your doctor or pharmacist what’s best for you.
    • Nicotine Patches

      What they are: Nicotine patches are similar to an adhesive bandage; you place one on your skin and it releases a constant amount of nicotine into the body while you wear it. They come in different sizes, with larger sizes delivering more nicotine.

      Why to buy: Nicotine replacement patches are available over the counter or with a prescription, and typically cost less per day than a pack of cigarettes. Patches are convenient and easy to use and can be removed during sleep to lessen the likelihood of insomnia. Due to the constant, slow release of nicotine, you are not likely to develop a craving for a patch; it doesn’t provide the intense delivery of a cigarette.

      Things to consider: Unlike smoking, which delivers a large dose of nicotine to your body within seconds, nicotine from a patch can take up to three hours to get into the body. For this reason, putting on a patch when a cigarette craving strikes is not effective. The nicotine patch reduces smoking withdrawal symptoms, such as lack of concentration and irritability.

    • Nicotine Gum

      What they are: Nicotine replacement gums are available over the counter or with a prescription and typically cost much less per day than a pack of cigarettes. Gum comes in different strengths to provide the amount of nicotine you need, based on your previous smoking habits.

      Why to buy: Gums are relatively convenient and easy to use, although you must remember to keep yours with you, because it must be chewed frequently to deliver enough nicotine to manage cravings. Though it cannot get nicotine into your body quite as quickly as a cigarette, gum delivers nicotine within minutes, which is far faster than a patch.

      Things to consider: Nicotine gum should not be used with cigarettes and you should not eat or drink for 15 minutes before or while using the gum. To chew enough gum to quell cravings, most people need between 15 and 30 pieces per day, chewed off and on for about 30 minutes. Nicotine gum should not be chewed continuously like regular gum and should never be swallowed. It is chewed a few times to break it down and then placed in between your gum and cheek for 10 or 15 minutes, chewed again for a bit, then put back into the cheek. Continuous chewing may cause stomachaches.

    • Lozenges & Lollipops

      What they are: Nicotine replacement lozenges and lollipops are available over the counter or with a prescription. They may cost a bit more than patches or gum, but typically less than a pack of cigarettes. Lozenges and lollipops come in different strengths to provide the amount of nicotine you need, based on your previous smoking habits.

      Why to buy: Some people don’t like to chew gum and prefer sucking on a candy to replace nicotine when quitting smoking. These products are relatively convenient, but you must remember to keep them on hand to use throughout the day. Lozenges and lollipops deliver nicotine within a few minutes, similar to gum.

      Things to consider: Nicotine lozenges and lollipops should not be used with cigarettes and you should not eat or drink for 15 minutes before or while they are in your mouth. Nicotine lozenges and lollipops should not be chewed or swallowed as this can lead to heartburn and stomachaches. Some people find these products irritate the mouth and throat.

    • Nicotine Nasal Sprays & Inhalers

      What they are: These products deliver nicotine through a spray into the nose or are inhaled through the mouth. They are available by prescription only.

      Why to buy: Nicotine nasal sprays and inhalers deliver nicotine as quickly as a cigarette, making them particularly helpful for people who are highly dependent on tobacco. For the person who smokes more than a pack of cigarettes per day, these products may be very effective.

      Things to consider: You need a prescription to obtain a nicotine spray or inhaler. Sprays cost about the same as gums and patches, but inhalers can be more expensive. They may be covered by insurance, which can help reduce the cost.

    • Non-Nicotine Prescription Medications

      What they are: Two different non-nicotine prescription medications may help people quit smoking by reducing the desire to smoke.. These are bupropion (brand name Zyban) and varenicline (brand name Chantix).

      Why to buy: These medications may significantly increase the quit smoking success rate beyond using nicotine replacement alone. They can be used in conjunction with nicotine replacement, further increasing success rates of quitting.

      Things to consider: Like all prescription medications, these drugs can have side effects. Many people tolerate them well, but some people experience very serious side effects, particularly from varenicline, which in some people causes hostility, agitation, anger, aggression, depressed mood, anxiety, paranoia, confusion, mania, or suicidal thoughts or actions. These can develop when a person begins taking the medication, after several weeks of treatment, or after stopping the varenicline. Insurance may not cover the cost of these medications.

References

1. Sauron B, Dobler S. Benign paroxysmal positional vertigo. Diagnosis, course, physiopathology and treatment. Rev Prat 1994;44:313-8 [in French].

2. Baloh RW. Vertigo. Lancet 1998;352:1841-6 [seminar].

3. Daroff RB, Martin JB. Vertigo. Harrison's Online 1999. http://www.harrisonsonline.com/hill-bin/Chapters.cgi (Feb 10, 2000).

4. Sloane PD, Dallara J, Roach C, et al. Management of dizziness in primary care. J Am Board Fam Pract 1994;7:1-8.

5. Rybak LP. Metabolic disorders of the vestibular system. Otolaryngol Head Neck Surg 1995;112:128-32 [review].

6. Lehrer JF, Poole DC, Seaman M, et al. Identification and treatment of metabolic abnormalities in patients with vertigo. Arch Intern Med 1986;146:1497-500.

7. Baloh RW. Vertigo. Lancet 1998;352:1841-6 [seminar].

8. Daroff RB, Martin JB. Vertigo. Harrison's Online 1999. http://www.harrisonsonline.com/hill-bin/Chapters.cgi (Feb 10, 2000).

9. Grontved A, Hentzer E. Vertigo-reducing effect of ginger root. A controlled clinical study. ORL J Otorhinolaryngol Relat Spec 1986;48:282-6.

10. Grontved A, Brask T, Kambskard J, Hentzer E. Ginger root against sea sickness. A controlled trial in the open sea. Acta Otolarygol 1988;105:45-9.

11. Vorberg G. Ginkgo biloba extract (GBE): A long-term study of cerebral insufficiency in geriatric patients. Clin Trials J 1985;22:149-57.

12. Claussen CF. Diagnostic and practical values of craniocorpography in vertiginous syndromes. Presse Med 1986;15:1565-8 [in French].

13. Haguenauer JP, Cantenot F, Koskas H, Pierart H. Treatment of disturbances of equilibrium with Ginkgo biloba extract: A multicenter, double-blind, drug versus placebo study. Presse Med 1986;15:1569-72 [in French].

14. Taiji H, Kanzaki J. Clinical study of vinpocetine in the treatment of vertigo. Jpn Pharmacol and Ther (Japan) 1986;14:577-89.

15. Ribari O, Zelen B, Kollar B. Ethyl apovincaminate in the treatment of sensorineural impairment of hearing. Arzneimittelforschung 1976;26:1977-80.

16. Claussen CF, Claussen E. Antivertiginous action of vitamin B 6 on experimental minocycline-induced vertigo in man. Arzneimittelforschung 1988;38:396-9 [in German].

17. Herdman SJ, Clendaniel RA, Mattox DE, et al. Vestibular adaptation exercises and recovery: acute stage after acoustic neuroma resection. Otolaryngol Head Neck Surg 1995;113:77-87.

18. Asai M, Watanabe Y, Shimizu K. Effects of vestibular rehabilitation on postural control. Acta Otolarygol 1997;528:116-20.

19. Herdman SJ. Advances in the treatment of vestibular disorders. Phys Ther 1997;77:602-18 [review].

20. Whitney SL, Rossi MM. Efficacy of vestibular rehabilitation. Otolaryngol Clin North Am 2000;33:659-72 [review].

21. Gizzi M. The efficacy of vestibular rehabilitation for patients with head trauma. J Head Trauma Rehabil 1995;10:60-77.

22. Johnson GD. Medical management of migraine-related dizziness and vertigo. Laryngoscope 1998;108(1 Pt 2):1-28.

23. Yardley L, Beech S, Zander L, et al. A randomized controlled trial of exercise therapy for dizziness and vertigo in primary care. Br J Gen Pract 1998;48:1136-40.

24. Steenerson RL, Cronin GW. Comparison of the canalith repositioning procedure and vestibular habituation training in forty patients with benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1996;114:61-4.

25. Furman JM, Cass SP. Benign paroxysmal positional vertigo. Primary Care 1999; 341:1590-6 [review].

26. Epley JM. Positional vertigo related to semicircular canalithiasis. Otolaryngol Head Neck Surg 1995;112:154-61.

27. Epley JM. Particle repositioning for benign paroxysmal positional vertigo. Otolaryngol Clin North Am 1996;29:323-31.

28. Lempert T, Gresty M, Bronstein A. Epley's procedure should be used to treat benign positional vertigo. BMJ 1996;312:1300 [letter].

29. Brooks JG, Abidin MR. Repositioning maneuver for benign paroxysmal positional vertigo (BPPV). J Am Osteopath Assoc 1997;97:277-9.

30. Epley JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1992;107:399-404.

31. Brandt T, Daroff RB. Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol 1980;106:484-5.

32. Welling DB, Barnes DE. Particle repositioning maneuver for benign paroxysmal positional vertigo. Laryngoscope 1994;104:946-9.

33. Coppo GF, Singarelli S, Fracchia P. Benign paroxysmal positional vertigo: follow-up of 165 cases treated by Semont's liberating maneuver. Acta Otorhinolaryngol Ital 1996;16:508-12 [in Italian].

34. Appiani GC, Gagliardi M, Urbani L, Lucertini M. The Epley maneuver for the treatment of benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 1996;253:31-4.

35. Herdman SJ, Tusa RJ, Zee DS, et al. Single treatment approaches to benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg 1993;119:450-4.

36. Itaya T, Yamamoto E, Kitano H, et al. Comparison of effectiveness of maneuvers and medication in the treatment of benign paroxysmal positional vertigo. ORL J Otorhinolaryngol Relat Spec 1997;59:155-8.

37. Beynon GJ. A review of management of benign paroxysmal positional vertigo by exercise therapy and by repositioning manoeuvres. Br J Audiol 1997;31:11-26 [review].

38. Beynon GJ, Baguley D, da Cruz MJ. Recurrence of symptoms following treatment of posterior semicircular canal benign positional paroxysmal vertigo with a particle repositioning manoeuvre. J Otolaryngol 2000;29:2-6.

39. Strek P, Reron E, Maga P, et al. A possible correlation between vertebral artery insufficiency and degenerative changes in the cervical spine. Eur Arch Otorhinolaryngol 1998;255:437-40.

40. Franz B, Altidis P, Altidis B, Collis-Brown G. The cervicogenic otoocular syndrome: A suspected forerunner of Meniere's disease. Int Tinnitus J 1999;5:125-130.

41. Galm R, Rittmeister M, Schmitt E. Vertigo in patients with cervical spine dysfunction. Eur Spine J 1998;7:55-8.

42. Karlberg M, Johansson R, Magnusson M, Fransson PA. Dizziness of suspected cervical origin distinguished by posturographic assessment of human postural dynamics. J Vestib Res 1996;6:37-47.

43. Rzewnicki I. The examination of vestibular system in patients with degenerative changes of the cervical spine. Otolaryngol Pol 1995;49:332-8 [in Polish].

44. Hulse M, Holzl M. [No title available] HNO 2000;48:295-301 [in German].

45. Benech A, De Gioanni PP, Fasciolo A, et al. Evaluation of the posture of patients before and after orthodontic surgery. Minerva Stomatol 1997;46:435-41 [in Italian].

46. Cronin PC. Cervicogenic vertigo. Eur J Chiropractic 1997;45:65-9.

47. Cagle PL. Cervicogenic vertigo and chiropractic: managing a single case—a case report. J Am Chiropractic Assoc 1995;32:83-4.

48. Bracher ES, Almeida CI, Almeida RR, et al. A combined approach for the treatment of cervical vertigo. J Manipulative Physiol Ther 2000;23:96-100.

49. Cote P, Mior SA, Fitz-Ritson D. Cervicogenic vertigo: a report of three cases. JCCA 1991;35:89-93.

50. Hong CZ. Pathophysiology of myofascial trigger point. J Formos Med Assoc 1996;95:93-104 [review].

51. Gerwin RD. Neurobiology of the myofascial trigger point. Baillieres Clin Rheumatol 1994;8:747-62 [review].

52. Wyant GM. Chronic pain syndromes and their treatment. II. Trigger points. Can Anaesth Soc J 1979;26:216-9.

53. Quintner JL, Cohen ML. Referred pain of peripheral nerve origin: an alternative to the “myofascial pain” construct. Clin J Pain 1994;10:243-51 [review].

54. Fischer AA. Documentation of myofascial trigger points. Arch Phys Med Rehabil 1988;69:286-91 [review].

55. Fricton JR, Kroening R, Haley D, Siegert R. Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surg Oral Med Oral Pathol 1985;60:615-23.

56. Travell JG, Simons DG. Myofascial pain and dysfunction; the trigger point manual. Baltimore: Waverly Press ,1983, 204-17.

57. Curtis AW. Myofascial pain-dysfunction syndrome: the role of nonmasticatory muscles in 91 patients. Otolaryngol Head Neck Surg 1980;88:361-7.

58. Fricton JR. Management of masticatory myofascial pain. Semin Orthod 1995;1:229-43 [review].

59. McClaflin RR. Myofascial pain syndrome. Primary care strategies for early intervention. Postgrad Med 1994;96:56-9, 63-6, 69-70 [review].

60. Schneider W, Dvorak J. Functional treatment of diseases and injuries of the cervical spine. Orthopade 1996;25:519-23 [in German].

61. Toto BJ. Chiropractic correction of congenital muscular torticollis. J Manipulative Physiol Ther 1993;16:556-9.

62. Murphy GJ. Physical medicine modalities and trigger point injections in the management of temporomandibular disorders and assessing treatment outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:118-22 [review].

63. Chee EK, Walton H. Treatment of trigger points with microamperage transcutaneous electrical nerve stimulation (TENS)—(the Electro-Acuscope 80). J Manipulative Physiol Ther 1986;9:131-4.

64. Graff-Radford SB, Reeves JL, Baker RL, Chiu D, Effects of transcutaneous electrical nerve stimulation on myofascial pain and trigger point sensitivity. Pain 1989;37:1-5.

65. Zhang LJ. Thirty-one cases of vertigo treated by acupuncture based on the doctrine of supplying water to nourish wood. Int J Clin Acupunct 1999;10:99-100.

66. Yan SM. Warm-needling in treatment of vertigo due to cervical vertebral hyperosteogeny: observation of 389 cases. Int J Clin Acupunct 1998;9:193-4.

67. Lehrer JF, Poole DC, Seaman M, et al. Identification and treatment of metabolic abnormalities in patients with vertigo. Arch Intern Med 1986;146:1497-500.

68. Rybak LP. Metabolic disorders of the vestibular system. Otolaryngol Head Neck Surg 1995;112:128-32 [review].

69. Johnson GD. Medical management of migraine-related dizziness and vertigo. Laryngoscope 1998;108(1 Pt 2):1-28.

70. Lehrer JF, Poole DC, Seaman M, et al. Identification and treatment of metabolic abnormalities in patients with vertigo. Arch Intern Med 1986;146:1497-500.

71. Rybak LP. Metabolic disorders of the vestibular system. Otolaryngol Head Neck Surg 1995;112:128-32 [review].

72. Johnson GD. Medical management of migraine-related dizziness and vertigo. Laryngoscope 1998;108(1 Pt 2):1-28.

73. Endo K, Ichimaru K, Shimura H, Imakiire A. Cervical vertigo after hair shampoo treatment at a hairdressing salon: A case report. Spine 2000;25:632-4.

74. Travell JG, Simons DG. Myofascial pain and dysfunction; the trigger point manual. Baltimore: Waverly Press ,1983, 204-17.

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2025.