Langtang is a narrow valley that lies just south of the Tibetan border. It is sandwiched between the main Himalayan range to the north and slightly lower range of snowy peaks to the south. Langtang Lirung (7246m.) dominates the valley to the north, Gang Chhenpo (6388m.) and Naya Kangri (5846m.) lie to the south and Dorje Lakpa (6966m.) protects the east end of the valley. The area was designated Nepal’s first Himalayan national park in 1971. This high and isolated region is inhabited by Tamang’s whose religious practices, languages and dress are much more similar to Tibetan. A visit to the Langtang valley offers an opportunity to explore villages, to climb small peaks and to visit glaciers to comfortably low elevation. According to legend, a lama following a runway yak discovered the valley. Hence the name – Lang is Tibetan for “yak” and tang means “to follow”.
This Langtang Trek towards the base of Langtang Himal, north of Kathmandu valley offers the shortest approach to snowy mountains from Kathmandu. The Langtang Trek starts from Syabru Besi, following a trail upstream Langtang Khola through ethnic Tamang villages, lush green forests and the wide Kyanjin valley surrounded by snowy peaks from all four sides and get opportunity to ascend Kyanjin Ri (4773m), from where we get 360 degree mountain panoramic views. We retrace our route back down the valley to Syabru Besi and drive back to Kathmandu.
Duration: 13 days
Type of the Trek: Tea House, Camping
Activities: Trekking, Culture Tours
Best Months: September to November and March to May
Maximum elevation: 4773m (Kyanjin Ri)
*Close to Kathmandu, Trek through forests to alpine valley just south of the Tibetan border, Good panoramic mountains and alpine views.
*Tamang cultural heritage, Tibetan style villages, old monasteries.
Day 1: Arrive in Kathmandu (1350m)
Our representative will meet you outside the customs and immigration area at the airport. He or She will brief you on the immediate arrangements and escort you to your hotel. The trip leader will hold a short briefing in the hotel regarding trek arrangements and general orientation to Kathmandu.
Day 2: Sightseeing in Kathmandu Valley
Today, we visit the most historical and Spiritual attractions in Kathmandu which are also listed in world heritage sites. We visit Durbar Square, Swayambhunath (Monkey temple), Bouddhanath, which is one of the largest Stupa in the world and the sacred Hindu temple of Pashupatinath.
Day 3: Drive to Syabrubesi (132 km / 1460m / 5-6 hrs)
It is about 5-6 hours drive from Kathmandu on a rough, deteriorating paved highway that twists and climbs over ridges to the Trishuli valley. Passing Balaju and Nagarjun, the road leaves the Kathmandu valley at Kakani (2145m), where there are excellent views of Annapurna II, Manaslu and Ganesh Himal and descends into the broad Trishuli valley. We drive through the Ranipauwa, this is the large village and is the radish capital of Nepal. After a long descent through terraced fields, the road crosses the Tadi Khola then climbs onto a plateau and passes fields of mustard, corn and rice. The road then passes an army camp and rolls into Trishuli Bazaar at 548m. There are many shops and hotels. The Dhunche road starts at a petrol station in Trishuli Bazaar just before the bridge and follows the east bank of the Trishuli River. The road passes two bridges carrying massive pipes that feed the hydroelectric project and climbs slightly to Betrawati at 620m. Betrawati is the junction of the Trishuli and the Phalungu Khola. At Betrawati the road crosses the Phalangu Khola then switchbacks at the end of the ridge for 15 km, through Brahman and Chhetri villages to Kalikhastan at 1390m. There is the entrance to Langtang National Park; the police check the permit here. The road reaches its high point on the ridge at 1980m then makes a long contour with a few ups and downs through oak and rhododendron forests, passing above Ramche and Thare and then reaches Dhunche, the administrative headquarters of Rasuwa district, at 1950m. Just before Dhunche is the national park headquarters. Little further, there is army check post where we should show our national park permit. Dhunche is a picturesque village with narrow streets lined with buildings. The main part of Dhunche is below the road. In Dhunche here are many nice hotels, restaurants, shops and camping ground. This is the trekking starting point for Gosainkund trek. From Dhunche we drive 15 km further to Syabrubesi. We drive through Thulo Bharkhu and then descend down to Bhote Koshi. Syabrubesi is an interesting village on the banks of the Bhote Koshi at 1420m. Here are several good hotels with attached bathroom, restaurants and shops.
Day 4: Trek to Lama Hotel (2380m / 6-7 hrs)
Leaving Syabrubesi we check at police check post and cross Bhote Koshi River, walk through old Syabru village and cross Langtang Khola by long suspension bridge. After bridge we gently ascend to the trail junction, follow the lower trail, several small ups and downs and through beautiful forests, we arrive in beautiful waterfall. About 30 minutes later from waterfall we arrive in Domen, here is a very good suspension bridge and 2 simple hotels. From here it is steep climb for 10-15 minutes. Few min later, the trail from Thulo Syabru village join with this main trail and then descend and ascend to Pairo (Landslide), here are just 2 hotels. Along the way the sceneries are wonderful. The trail ascend continues to Bamboo, it is nice walk through the forest. There are some hotels and camping grounds. After Bamboo the path is long climb and then little descends down to the long suspension bridge, cross the Langtang Kola. There is a small simple hut in the other side of the bridge. Climb steeply to a landslide and the Langtang view, the first hotel at Rimche. The upper Rimche is about 25 minutes further from here (top / 2250m). There is a trail junction that connects to a high route back to Syarpa gaon and Syabrubesi. We descend gently to Changtang, and popularly known as Lama Hotel at 2380m. Here are several lodges including Lama Hotel itself, and a few camping spots. It is surrounded by forest. All the hotels are clean but not attached bath rooms. Today, we can see many birds and wild animals on the way (Yellow throated martin, wild boar, langur monkey, Red panda and Himalayan black bear.
Day 5: Trek to Langtang village (3500m / 5-6 hrs)
Leaving the Lama hotel, we gradually ascend through nice forest along the river side. About 1 hr 15-20 minutes later from Lama Hotel, we arrive in Gumanchok. We cross small stream before Gumanchok. There are some small climbs and mostly gentle ascend. The Langtang Lirung (7246m) appears through the trees. At Gumanchok is the Riverside lodge, on the banks of the river and some others. 15 minutes later there is another hotel. After Gumanchok the path is very easy for 25-30 minutes then steep climb through beautiful forest to the small top, there is old cairn and prayer flag. From here it is flat route for a while and then gradually ascends to Ghora Tabela at 3000m. Once a Tibetan resettlement project, this is now a Nepal army and national park post and has no permanent inhabitants. Here are 2 lodges and restaurants. The trail ascends gradually, as the valley becomes wider and wider, past yak pastures, and some Mani stones. About 45 minutes later we climb steep up and arrive in Thangshyap village, here are several hotels. It offers wonderful views of snowy peaks and Langtang valley. We walk through Chyamki village, cross a stream by long suspension bridge and gradually ascend to Gomba village, there are some hotels and shops in Gomba village, Gomba is at the top of the village. We can see wonderful views of Gangchhenpo and some other peaks and the valley. From here we descend gently to long suspension bridge. Langtang Lirung, other snowy peaks and small glaciers are on the top above the monastery. Past a Army check post, several water driven mills and prayer wheels then gradually ascend to the large settlement of Langtang village at 3500m This village is the headquarters for Langtang National park. Here are many good hotels. The houses of Langtang and the neighboring communities have Tibetan style flat roofs and are surrounded by stone walls enclosing fields of buckwheat, potatoes, wheat and barley. The villagers keep herds of yaks and cattle here and in pastures above the village. It is nice views of Langtang Lirung, surrounding snowy peaks and Gangchhenpo is on the top of the valley.
Day 6: Trek to Kyanjin Gompa (3800m / 3 hrs)
The trail winds through the village and climbs onto a ridge dominated by a large, square Chhorten and a long Mani walls. After this, the path bit descend and then ascend to the Mundu village, here are many Mani walls and some simple hotels. From here, the path ascends gradually through beautiful Yak pasture grounds to Yamphu, here are few small tea shops. Yamphu is the bottom of Kyanjin Gomba. From Yamphu we climb a moraine and finally arrive in Kyanjin Gompa, situated at the bottom of Kyanjin Ri, here are many good hotels. Some new hotels have attached bathrooms but mostly they don’t use it because of frozen. They also provide hot shower. All the hotels are normal but very clean and beautiful buildings. The Swiss Association for Technical Assistance started the Cheese factory in 1955. It is easy to reach Kyanjin Gompa before lunch. In the afternoon we can visit around. It is surrounded by many snow capped peaks.
Day 7: Hike to Kyanjin Ri (4773m / 5 hrs / up and down)
There are two good viewpoints in the area that we can climb. The peak to the north of Kyanjin Gompa is Kyanjin Ri, about 2 hrs 50-60 minutes climb. There are 2 different paths to go in Kyanjin Ri. The best idea is to go up through ridge line. Leaving the hotel, the path goes towards Gomba and then turns right side below the new Stupa. It climbs up by making zigzag. The path is very clear and views are becoming wonderful. About 1 hr later, we arrive in bottom of the black hill and then climb up to the top of the ridge line. From here, we walk along the ridge line, gently ascend and then steeply climb up to the top. It is very nice views of Langtang Lirung, many snowy peaks around and several huge glaciers and Moraine. Kyanjin Ri is the best point to see mountain views, here are many prayer flags. It offers really wonderful views of Langtang Lirung, Kimsung and many other peaks in the front, in the back side can see Langshisha Ri, Gangchhenpo, Naya kanga, some other peaks and several huge glaciers. We reach very close to the peaks and glaciers. From Kyanjin Ri, we descend down to the small valley (on the way back). We continue to descend down along this deep small valley. It is not any good views but we can see just some snowy peaks and some parts of the valley in the front. About 1 hr 40-50 minutes later from the top, we turn to the right side (from where the path Separate for Tsergo Ri) and descend down through steep hill slope to the hotel.
Day 8: Hike to Langshisha Kharka (4080m) and come back / 7-8 hrs / up-down
Today we continue further up the Langtang valley to Langshisha Kharka for views of Langshisha Ri (6560m), Gang Chhenpo (6378m), Dorje Lakpa (6966m), Urkeinmang (6143m) and Pemthang Karpo Ri (6865m). There are no facilities beyond Kyanjin Gompa, but we make just day trip and return to Kyanjin Gompa.
Day 9: Trek to Langtang
Day 10: Trek to Lama Hotel
Day 11: Trek to Syabrubesi
Day 12: Drive to Kathmandu
We have wonderful and scenic drive back to Kathmandu. After Trishuli Bazar, we take different road to Kathmandu. This is much better than old road but not Mountain View. We follow the Trishuli River all the time and drive through beautiful small market areas, villages and join with Pokhara Kathmandu highway then follow this highway to Kathmandu. We have lunch on the way in nice restaurant. In the late afternoon we visit around Thamel for shopping and have farewell dinner in typical Nepali restaurant with cultural program.
Day 13: Departure from Nepal
We will escort you to airport for your international flight.
- Airport / Hotel / Airport pick up & drop off service by a private tourist vehicle
- Standard twin-sharing accommodation in a three-star hotel in Kathmandu including breakfast (4 nights only)
- Guided city tour in Kathmandu valley by a private tourist vehicle
- All standard meals during the trek (Breakfast, lunch and dinner)
- Guesthouse accommodation during the trek in mostly twin-share and occasionally dormitory-style rooms
- Malla Treks licensed English-speaking trekking guide
- The required number of local staff and porters to carry your luggage during the trek (We assign one porter for every two guests.)
- Food, accommodation, salary, insurance, equipment and medicine for all staff
- Langtang National Park permits and TIMS permit for trekking
- Down jacket and sleeping bag (which need to be returned after the trek)
- Private jeep kathmandu to Syabrubesi and Syabrubesi to kathmandu
- Free duffel
- Sightseeing/Monument entrance fees in Kathmandu
- Farewell dinner in a traditional Nepali restaurant with cultural performances
- All our government taxes, vat, tourist service charges
- Official expenses
- Lunch and dinner in Kathmandu
- Travel insurance which covers emergency high-altitude rescue and evacuation International airfare and airport departure tax
- Nepal entry visa; you can obtain the visa easily upon your arrival at Tribhuwan International Airport in Kathmandu (Tourist Visa with Multiple Entries for 15 days can be obtained by paying USD 25 or equivalent foreign currency. Similarly, Tourist Visa with Multiple Entries for 30 days and 90 days can be obtained by paying USD 40 and 100 respectively. Please bring 2 copies of passport size photos.)
- Alcoholic, hot and cold drinks
- Personal trekking equipment
- Tips for trekking staff and driver (Tipping is expected.)
- Any others expenses that are not mentioned in the Price Includes section
The following gives you a general idea of the trekking equipment and clothing needed for this trek.
This is a porter-supported trek. Two clients share one porter. We will supply you a trek duffel bag where you keep your heavy items and this bag is carried by the porter. You will need to bring your own daypack to be carried by you. In the daypack, you can put money, important documents, water bottle/bladder, camera, toiletries, sunscreen, notebook, etc.
The weight limit for the porter is 30 kg or 66 pounds. 15 kg or 33 pounds for each client. So, we recommend you to pack as carefully as you can and not exceed the weight limit. You can leave your non-trekking stuff at the locker facility in the Kathmandu hotel.
- 4-season sleeping bag (We can provide one if you need it but has to be returned after the trek.)
- Duffel bag (We will provide one complimentary)
- Down jacket (Must have for mornings, nights and evenings, and for altitudes above 4,000 m; We can provide it if you need one but has to be returned after the trek.)
Upper Body – Head / Ears / Eyes
- Sun hat (We will provide you a complimentary Ace the Himalaya hat.)
- Wool or synthetic hat that cover the ears
- Sunglasses with UV protection
- Neck warmer
- Liner gloves
- Heavier shell gloves
- Lightweight expedition thermal tops
- Fleece jacket or pullover
- Water/windproof shell jacket (Preferably breathable fabric)
- Synthetic sports bras (For women)
Lower Body – Legs
- Lightweight expedition thermal bottoms
- Nylon hiking shorts
- Soft shell and hard shell trekking pants
- Water/windproof trousers
- Casual pants
- Liner socks
- Heavyweight socks
- Waterproof hiking/trekking boots
- Light shoes/sneakers/sandals
- Gaiters (For monsoon and winter)
Medicines and First Aid Kits
(Please note our guide will carry the first-aid kit bag during the trek. However we still recommend you to bring your personalized first-aid kit as well.)
- Extra Strength Excedrin for altitude related headaches
- Ibuprofen for general aches and pains
- Immodium or Pepto Bismol capsules for upset stomach or diarrhea
- Diamox (commonly prescribed as Acetazolamide) 125 or 250mg tablets for altitude sickness
- Anti-infection ointments
- Lip balm (At least SPF 20)
- Sunscreen (SPF 40)
Miscellaneous, but Important!
- Passport and extra passport photos (3 copies)
- Airline ticket (Please make a copy and leave one at our office in Kathmandu just in case if you need to change the date of your flight.)
- Durable wallet/pouch for travel documents, money & passport
- Water bottle/bladder
- Water purification Iodine tablets
- Toiletry kit (Be sure to include toilet paper stored in a plastic bag, hand wipes, and liquid hand sanitizer, towel, soap, etc.)
- Adjustable trekking poles
- Favorite snack foods (No more than 2 pounds)
- Paperback books, cards, mp3 player
- Cameras (Memory cards, chargers and also batteries)
- Pee bottle for men and pee funnel for woman
This list is only a guide. While you are required to bring everything on this list, there are numerous options, brands, and versions of each piece of equipment. Use your experience and the listed features to find the best gear for you. Some of the above equipment can be easily found in stores in Kathmandu for cheaper prices.
Note: Tight fitting, figure-hugging clothing such as those made with Lycra can often be offensive to locals, especially to women. If you find these items comfortable as a base layer, please pack something to wear on top of them.
Frequency asked question about Langtang camp trek
1) What type of shape do I need to be in trip for me?
Langtang Trek is suitable for average people who are moderately fit, thus no previous experience is required. Some physical fitness programs such as running, swimming, hiking is recommended before you embark on your journey. Persons suffering from a pre-existing medical condition must seek medical advice/consent before considering the trek. Whilst on the trek, it is common to experience some discomfort before being fully acclimatized.
To prepare for trek you should begin training at least two to three months before your departure. As a guideline, an hour of aerobic exercise three to four times per week would be considered a minimum requirement. The best preparation is bushwalking involving relatively steep ascents and descents. If you can manage a couple of valley floor to ridgeline ascents per comfortable and able to enjoy the trek to the fullest. They are physically strong, sharp-witted and have an incredibly positive attitude towards a life that we would consider extremely tough. There is something about a trek in the Himalaya that draws you back time and time again. For keen walkers it is a paradise and even avowed non-walkers find that one foot just seems to follow the other, drawn by the appeal of what lies beyond.
2)What sort of accommodation can we expect in Trekking?
Along the trekking routes, teahouses/lodges generally provide basic clean facilities with a mattress and a quilt or blanket. it is a good idea to always have your own sleeping equipment. The lodges in trekking routes usually provide single and double rooms, or occasionally a dormitory style. At times when possible, dining will be around a bon fire. In teahouses, food will be prepared in the kitchen, which you should not enter without permission. The toilet in teahouses provides essential and basic facilities and is always outside the room.
3) Is the guest house houses are heated?
The guesthouse does not facilitate with heater or air conditioner. However, as it gets colder above 3,500m, they do have facility of hitting the dining area by providing kerosene or metal heater.
4) what are the toilet facilities in the teas house / Guest house ?
Most of the tea houses do have western style flushing toilet however in higher elevation you could find the squat toilets made of either a ceramic basin on the ground or few planks precariously positioned over a hole in the ground which is always outside of the room.
5) Where do we go toilet along the Trail ?
At most cases, you can use the toilet provided by the tea houses/lodges on the trail but normally in case of emergency, you just do toilet along the trail wherever you find privacy.
6) Do I need to bring toilet paper for the Trek?
All the guest houses sell the toilet paper so you can buy it there itself. Hand sanitizer and a towel you must bring your own.
7) Is there a possibility of getting separate rooms for the Trip?
During the trek, we will try our best but normally the lodges have twin sharing and dormitory styled room instead of a single room.
8) What is the drinking water facility in the mountain?
Bottled water is easily available at the lodges and teahouses, which you can buy at the cost of USD 1 at lower elevations to USD 4 to higher elevation per liter.
If you are planning to drink normal water all the way during trek, purifying water with any sort of purification tablets or drop is must. You can bring your own purifier or can purchase it in Kathmandu.
9) What opportunities will I have for shower along the Trek?
At the lower altitude the guesthouses provide the facilities of hot shower.
And in rest of the places (at higher elevation), warm water in the bucket will be provided for shower.
For all above showers, it would cost you extra about USD 2-4 per shower. The higher you go the hot shower would be expensive.
11) what is the weather and temperature in Spring in Langtang trek?
One of the most unpredictable elements of the mountain is the weather. If you’re not properly prepared for the twists, turns and volatility of the conditions that can occur in this breathtaking region, you might find yourself in an uncomfortable and unpleasant situation. Here are some weather basics to help ensure that you come to the Himalayas as well equipped and prepared to face anything.
Generally speaking, the nights are much cooler than the daytime hours in the Manaslu region. Many first-time trekkers are surprised to learn about the incredible range that may occur in a given day. During the day, the thermometer could reach temps as high as 25 degrees C (77 Degrees F), only to dip down as low as -20 degrees C (-4 Degrees F) in less than 24 hours. While there’s no way to know exactly what each day in the mountains will bring, the weather and temperature ranges tend to be somewhat predictable based on the month and season.
Spring – March / April / May / June
Spring happens to be one of the best times of the year to visit the Manaslu region, although because of this, it can become somewhat crowded. The beautiful clear blue sky can be seen and the many different species of flower are visible in the lower altitude.
During spring time, the average temperature is 20 degrees C (68 Degrees F), with a maximum of 25 degrees C (77 Degrees F), during sunny days and a minimum of -15 degrees C (5 Degrees F), in the morning and at night for areas above 4000 meters.
Monsoon – July / August through Mid-September is Monsoon Season
This season is not really recommended to travel as it rains in the lower altitudes. There are positive sides of trekking during the monsoon months as the excess rainfall can provide ample chance to see spectacular views of the waterfall and it’s also the best season to avoid the crowds.
During this time, the average temperature is 22 degrees C (71.6 Degrees F), with a maximum of 30 degrees C (86 Degrees F), during sunny days and a minimum of -5 degrees C (23 Degrees F), in the morning and at night for areas above 4000 meters.
Autumn – End of September / October / November
Similar to springtime, autumn in this region is also a crowded season, but it’s one of the best times to trek. While it lacks the beauty of flowers, the clear blue sky can be seen, affording incredible views from just about every angle.
The average temperature during the fall is 17 degrees C (62.6 Degrees F), with a maximum temp of 20 degrees C (68 Degrees F), during sunny days and a minimum of -15 degrees C (5 Degrees F), in the morning and at night, for areas above 4000 meters altitude.
Winter- December/ January/ February
Winter start from mid-December till mid-February in this region. People still like to trek in this month due to fewer crowds. View is still good but foggy so having extra days is highly recommended during this period.
The average temperature during the winter is 10 degrees C (50 Degrees F), with a maximum temp of 17 degrees C (62.6 Degrees F), during sunny days and a minimum of -20 degrees C (-4 Degrees F), in the morning and at night, for areas above 4000 meters altitude.
The above temperature is based on outside of the guesthouse temperature. No need worry about the cold temperature as we provide the sleeping bag plus the extra blanket to make sure our clients are warm enough during the time of need.
12) What is the temperature rating of the sleeping bag that you lend to trekkers ?
The temperature rating of the sleeping bags you need are about -10 deg C (14 Deg Fahrenheit),
13) What if am very sick in the Mountain?
Our guides are 24 hours available for the services during the trek. They are trained to use first aid kit and have knowledge . They are very much aware that higher the altitude the oxygen level gets lesser so to get updated on the oxygen level of our client and to know whether they are fit enough or needs extra precautions to continue.
Guides carry local sim cards both Nepal Telecom and NCell in order to update whereabouts and situation of our every client. During the time of emergency our guides are alert and keeps updated to head office in Kathmandu that is available 24 /7 to arranging from horse to mules or helicopters in the must needed cases especially when client is seriously sick in the mountain and needed to be hospitalized.
14) Are yours trekking guide and porter insured?
Yes, they are insured.
15) I m a Vegeterain, is that a Problem ?
No problem at all because the lodges mostly serve the vegetarian meals. We always recommend our clients to eat vegetarian meals to avoid the food poisoning, eating heavy meals and non- vegetarian meals at the high altitude is not really safe for the stomach.
16) What safety measures are in place? What safety equipment do your guides carry with them on trek to deal with sickness/accidents?
Our guide is well trained for the high altitude problems and first aid. They always carry the first aid kit bag during the trek. However we still recommend you to bring your personal first aid kit as well. All our guides carry the local mobile phones.
17) Can I charge my digital camera or other equipments on my trip?
These facilities will be available in most of the places in your hotel reception by paying some service charges. Remember to bring TWO and THREE pin travel adapters!
18) Is there any communication while we are on trekking?
There are telephones in some villages along the trekking routes from which you can make international calls. Our guide is equipped with the local mobile phone. You may wish to pass the number of our guide to your family for the callback or you can make a call from the guide’s mobile and pay him directly for the international call too.
19) Can I use credit cards in the places I visit in trekking?
In the cities, yes – to some extent. Once you are out of the cities, all you need is cash. Please change the currency in local Nepali Rupees before you go to the mountains.
20) Do we carry all of our own gear?
Whilst on the trek, our porter will take care of your luggage. All you need to carry is your small day bag for your personal belongings like camera, water bottle, sun cream etc.
Altitude Sickness Info
Altitude sickness, often known as Acute Mountain Sickness (AMS) in general, may occur when people ascend quickly in altitudes of over 3000 m. During our trekking and climbing trips, we ensure minimal risk by keeping rest days in our itineraries. Most people will feel some effects of altitude, shortness of breathe and possibly lightheadedness, which is fairly common. Acute mountain sickness is very different and normally involves a severe headache, sickness and loss of awareness. In almost every potential case there are enough warning signs to take appropriate action.
Our expert and trained guides will advise you about any health requirements and also altitude sickness while you are trekking, so you should not worry about it. We do however recommend you to get advice from your physician before you leave. The following information gives you an idea about high altitude sickness and how to minimize the effects.
We take the safety of our clients very seriously. We ask all our clients to submit a copy of their insurance prior to the departure, so that we can proceed with evacuation when necessary. All our guides, porters and staffs are facilitated with cellphones (GSM and CDMA) during the trips. While on trips to remote pockets of the country where there is no connectivity, the guides are equipped with lacal phones for emergencies .
There are three stages of altitude sickness and symptoms.
- Normal AMS Symptoms – Should expect but not worry
Following are the normal altitude symptoms that you should expect but should not be worried about. Every trekker will experience some or all of these, no matter how slowly he or she ascends.
- Periods of sleeplessness
- Abnormal need of more sleep (often 10 hours or more)
- Occasional loss of appetite
- Vivid, wild dreams especially at around 2500-3800 meters in altitude
- Periodic breathing
- The need to rest/catch your breath frequently while trekking, especially above 3500 meters
- Runny nose
- Increasing urination while moving to/at higher altitudes (a good sign)
- Mild AMS Symptoms – NEVER GO HIGHER
Many trekkers in the high valleys of the Himalaya get mild AMS. Admit or acknowledge that you are having symptoms. The following symptons characterize mild AMS:
- Mild headache
- Dry Raspy cough
- Loss of appetite
- Runny nose
- Hard to breathe
What to do if a mild symptom doesn’t go away?
- If you find mild symptoms developing while walking, stop and relax (with your head out of sun) and drink some fluids. Drink frequently.
- If mild symptoms develop while walking, stop, have rest, drink some fluids and take 125-250 mg of Diamox. Diamox generally takes one to four hours to begin alleviating symptoms. Drink more water and take rest.
- If symptoms develop in the evening, take 125-250 mg of Diamox and drink plenty of fluids again.
- If symptoms partially go away but are still annoying, it is safe to take another 250 mg of Diamox 6-8 hours later.
- If mild symptoms continue getting worse, try descending for a few hours which may be more beneficial than staying at the same altitude. Going higher will definitely make it worse. You’re here to enjoy trekking, not to feel sick.
- Serious AMS Symptoms – IMMEDIATE DESCENT
- Persistent, severe headache
- Persistent vomiting
- Ataxia (loss of co-ordination, an inability to walk in a straight line, making the sufferer look drunk)
- Losing consciousness (inability to stay awake or understand instructions)
- Mental confusion or hallucinations
- Liquid sounds in the lungs
- Very persistent, sometimes watery, cough
- Difficulty breathing
- Rapid breathing or feeling breathless at rest
- Coughing clear fluid, pink phlegm or blood (a very bad sign)
- Severe lethargy/fatigue
- Marked blueness of face and lips
- High resting heartbeat (over 130 beats per minute)
- Mild symptoms rapidly getting worse
Dangerous Cases of AMS
High Altitude Cerebral Edema (HACE)
This is a build-up of fluid around the brain. HACE can lead to unconsciousness and to death within 12 hours from the onset of symptoms, but normally takes 1-2 days to develop. At the first sign of ataxia, begin treatment with medication, oxygen and descent. Usually 4 to 8 mg of dexamethasone is given as a first dose, then 4 mg every six hours, Diamox every 12 hours and 2-4 litres/minute oxygen..
High Altitude Pulmonary Edema (HAPE)
This is an accumulation of fluid in the lungs and is very serious. It is responsible for all the other mild and serious symptoms and it is often accompanied by a mild fever. By far the treatment is oxygen at 4 liters a minute but using PAC (portable altitude chamber) bag treatment is a good substitute. If there is no PAC bag or oxygen, then descent will be life saving. HAPE can lead to unconsciousnes and death very quickly.
Prevention of Acute Mountain Sickness (AMS)
- Allow sufficient time for acclimatization (After 3000 meters)
- Don’t make rapid Ascent. Don’t go too far too fast.
- No Alcohol, sleeping pills and smoking
- Drink more fluid 3-4 litres a day, clean water, boiled or treated, tea, coffee, soup and juice
- Climb high and sleep low
- Do not trek/travel alone; take guide/porter
- Follow the advice from your guide, hotel, local, guide book
- Descent if mild symptoms are rapidly getting worse
- Never leave a sick person or let him him/her descent alone
- Avoid getting cold
- Take an easy and comfortable trekking route even if it’s longer
This is the basic list to cover the more common ailments that affect trekkers. Climbing groups, expeditions and trekkers going to isolated areas will need a more comprehensive kit.
- Bandage for sprains
- Iodine or water filter (optional)
- Moleskin/Second skin – for blisters
- Antiseptic ointment for cuts
- Anti-bacterial throat lozenges (with antiseptic)
- Aspirin/Paracetamol – general painkiller
- Oral rehydration salts
- Broad-spectrum antibiotic (norfloxacin or ciprofloxin)
- Anti-diarrhoea medication (antibiotic)
- Diarrhoea stopper (Imodium – optional)
- Antibiotic for Guardia or similar microbe or bacteria
- Diamox 250/500mg (for altitude sickness)
- Sterile Syringe set (anti-AIDS precaution)
- Gel hand cleaner.
Please Note: we still recommend you to bring your personal first-aid kit as well.