Feeling unwell after a night out in Paceville? When rest is enough, and when to see a doctor

These may be ordinary hangover symptoms, but more serious conditions can initially appear similar. Persistent vomiting, an injury, heat illness, alcohol poisoning, a medication interaction or an unknown substance in a drink should not be dismissed as just a hangover.

This article is for general guidance only. Seek an individual medical assessment when symptoms are severe, unusual, persistent or concerning.

Common hangover symptoms

A hangover is a group of physical and mental symptoms that can follow excessive alcohol consumption. Common symptoms include:

• Headache
• Thirst
• Fatigue and weakness
• Nausea
• Stomach discomfort
• Dizziness
• Muscle aches
• Sensitivity to light or sound
• Sweating
• Irritability or anxiety
• Poor concentration

The US National Institute on Alcohol Abuse and Alcoholism describes typical hangover symptoms as including fatigue, weakness, thirst, headache, muscle aches, nausea, stomach pain, vertigo, sensitivity to light and sound, anxiety, irritability and sweating.

Symptoms vary considerably. How someone feels can be influenced by the amount consumed, drinking speed, food intake, sleep, medications, health conditions and the surrounding temperature.

What can you do for a mild hangover?

For mild symptoms in an alert person who can drink normally and is not repeatedly vomiting, rest in a cool, safe place and avoid driving, swimming, strenuous exercise and prolonged sun exposure until you feel fully recovered.

Take small, regular sips of water. Drinking too quickly can worsen nausea. An oral rehydration drink may be useful when there has been substantial sweating, vomiting or diarrhoea, but people with kidney, heart or other medical conditions should obtain individual advice before consuming large quantities of fluid or electrolytes.

Simple food may help once nausea settles. Do not force food if you are actively vomiting, and avoid more alcohol: hair of the dog does not treat the underlying problem and can delay recognition of a more serious condition.

Be cautious with painkillers. Some medicines can irritate the stomach, affect the liver, cause drowsiness or interact with alcohol. Speak to a doctor or pharmacist when you are uncertain, especially if you have liver, kidney or stomach problems or take regular medication.

Malta's heat can make the situation worse

A night out may be followed by a hot morning, time at the beach or walking around St Julian's. Alcohol can contribute to dehydration, and drinking around periods of heat exposure may increase the risk of heat-related illness. Watch for:

• Increasing dizziness or faintness
• Weakness
• Heavy sweating
• Muscle cramps
• Headache and nausea
• Confusion
• Reduced urination
• Difficulty tolerating fluids

Move to a cool environment and seek medical help if symptoms are significant or fail to improve.

When should you contact a doctor?

Arrange a medical assessment when you have:

• Repeated vomiting or difficulty keeping fluids down
• Severe or worsening headache
• Significant dizziness or fainting
• Persistent abdominal pain
• Palpitations
• Fever or unusual weakness
• Confusion that has improved but not fully resolved
• Symptoms continuing longer than expected
• An injury sustained during the night
• A possible medication interaction
• Concern that your drink was tampered with
• A chronic condition that may be affected by alcohol or dehydration

A doctor may need to check your hydration, circulation, neurological condition, abdomen, blood pressure or possible injuries. Further testing or hospital referral may be recommended depending on the findings.

When is it not just a hangover?

Some dangerous conditions can resemble a severe hangover. Alcohol poisoning can affect breathing, consciousness, heart rate and temperature regulation. Warning signs include:

• Confusion or stupor
• Inability to stay awake, or inability to wake the person
• Repeated vomiting
• Seizure
• Slow or irregular breathing
• Pale, blue-tinged or clammy skin
• Very low body temperature
• Reduced gag response

These are recognised signs of alcohol overdose and require emergency action. Call 112 immediately in Malta if alcohol poisoning is suspected. Do not assume that an unconscious person simply needs to sleep it off.

Head injury

A fall or collision may cause concussion or a more serious head injury, even when the person does not remember the incident clearly. Seek urgent assessment for:

• Loss of consciousness
• Increasing drowsiness
• Repeated vomiting
• Severe or worsening headache
• Confusion
• Unequal pupils
• Weakness or numbness
• Seizure
• Blood or clear fluid from the nose or ears
• Significant memory loss

Alcohol can make it harder to recognise changes in neurological condition.

Possible drink spiking

Seek prompt help when there is:

• Sudden extreme intoxication inconsistent with the amount consumed
• Unexpected memory loss or a missing period of time
• Severe confusion
• Difficulty walking
• Loss of consciousness
• Unusual agitation
• Concern about assault

Move to a safe place, stay with someone trusted and seek medical or police assistance as appropriate. Do not remain alone when you feel unexpectedly impaired.

Alcohol withdrawal

Someone who drinks heavily or regularly may experience withdrawal rather than a simple hangover when their alcohol level falls. Symptoms can include shaking, sweating, anxiety, nausea, rapid heartbeat, hallucinations, confusion or seizures. Severe withdrawal can be dangerous and requires urgent medical care.

What should you do while waiting for emergency help?

When someone is unconscious but breathing:

• Call 112
• Stay with them
• Place them in the recovery position when appropriate
• Monitor their breathing
• Keep them warm
• Follow the emergency operator's instructions

The recovery position helps keep the airway open and reduces the risk of choking on vomit. Do not leave the person alone, give them more alcohol, offer coffee as a sobering treatment, put them in a cold shower, force them to walk, try to make them vomit, or give food or drink to an unconscious person.

Official alcohol-poisoning guidance warns against coffee, cold showers and inducing vomiting, and advises staying with the person because of the risks of choking or stopped breathing.

Can IV therapy cure a hangover?

IV fluids should not be marketed or regarded as a guaranteed hangover cure. A medical professional must first assess the severity of dehydration, ongoing vomiting, vital signs, medical history, current medication, heart and kidney health, possible injury and whether another condition is causing the symptoms.

Some patients may not require IV treatment. Others may need testing, medication, monitoring or hospital care instead. At Doctor St Julian's, IV therapy should only be provided when medically appropriate following an individual clinical assessment.

IV therapy in St Julian's

Can a doctor visit your hotel after a night out?

A hotel or home visit may be available when you are stable but do not feel able to travel to the clinic. The doctor will need:

• Your full name and age
• Hotel or accommodation name
• Room number where appropriate
• Contact telephone number
• A brief description of the symptoms
• Information about any injuries
• Current medication and medical conditions

A call-out service is not suitable for a life-threatening emergency. Call 112 when the person is unconscious, having difficulty breathing, experiencing a seizure, bleeding heavily or deteriorating rapidly.

When should you visit the clinic?

An in-clinic consultation may be preferable when:

• A physical examination is required
• Blood pressure or oxygen level must be checked
• You may need treatment or a prescription
• You have a minor injury
• Symptoms are persistent
• The doctor may need access to clinic equipment
• Physiotherapy assessment may be required after an injury

Book a consultation

Contact the clinic first so the team can advise on availability.