Barotrauma
Barotrauma is the overarching term for medical conditions caused by sudden or significant shifts in air or water pressure. Most barotrauma conditions aren’t serious, and their symptoms go away without treatment. But in some instances, barotrauma may be life-threatening and require immediate medical attention.
Barotrauma refers to the way a sudden change in barometric (air) or water pressure affects your body. Ear barotrauma is the most common type and often affects the middle ear. Other types may affect your lungs, gastrointestinal tract or sinuses. You may experience barotrauma while flying in an airplane or deep-water diving.
Healthcare providers classify barotrauma by the part of your body that it affects. Barotrauma types include:
- Ear barotrauma (airplane ear) affects your middle ears
- Gastrointestinal barotrauma may affect your stomach or intestines in your gastrointestinal tract
- Pulmonary barotrauma affects your lungs
- Sinus barotrauma (sinus squeeze or barosinusitis) puts pressure on your sinuses
Barotrauma causes different symptoms. Your symptoms will depend on the part of your body that air and water pressure changes affect.
Ear barotrauma symptoms
Ear barotrauma (airplane ear) symptoms may include:
- A feeling that your ears are full or stuffed up
- Dizziness
- Hearing issues
- Nausea and vomiting
- Severe ear pain
Gastrointestinal barotrauma symptoms
You may have this condition if you swallow air while doing deep-water diving or scuba diving. Symptoms include:
- Belching
- Belly pain
- Cramps
- Feeling of fullness in your belly
- Flatulence (farting)
Rarely, gastrointestinal barotrauma may cause a hole in your stomach or your intestines. Symptoms are severe belly pain or nausea and vomiting. It may hurt when you touch your belly. Go to an emergency room right away if you have these symptoms.
Pulmonary (lung) barotrauma symptoms
Pulmonary barotrauma can happen during free deep-water or scuba diving. Symptoms often include:
- Bloody froth at your mouth
- Bloody nose
- Chest pain
- Cough
- Shortness of breath (dyspnea)
Sinus barotrauma symptoms
You may experience sinus barotrauma symptoms while doing free diving or scuba diving. Symptoms may include:
- Bloody nose
- Facial pain
- Headache
- Nasal congestion
Barotrauma causes
Barotrauma happens when air or water pressure changes faster than your body is able to adapt. That can happen while flying in an airplane or scuba diving.
A healthcare provider will ask about your symptoms. They’ll ask if symptoms started after you did things like fly in an airplane or diving. A provider will do a physical exam. They’ll use different tests to diagnose specific barotrauma types.
Ear barotrauma diagnosis
Healthcare providers may look inside your ear with an otoscope. This is a special lighted instrument that providers use to check eardrum damage, signs of infection or other issues. They may do other tests like:
- Hearing test
- MRI scan to view your inner ear
Gastrointestinal barotrauma diagnosis
A healthcare provider may do the following tests if they think you have a GI rupture:
- Chest X-ray
- CT scan
Pulmonary barotrauma diagnosis
Healthcare providers may do the following tests to diagnose pulmonary barotrauma:
- Arterial blood gas test
- Chest X-ray
- EKG
Sinus barotrauma diagnosis
A provider will examine your nose. Tests may include:
- Endoscopy to look at the inside of your nose
- CT scan to get images of your sinuses
With SMA, the nerves that control feeling (sensory nerves) are not affected. So, a person with the disease can feel things normally.
Treatment depends on the barotrauma type. Potential treatments for barotrauma are:
- Nasal decongestants for ear and sinus barotrauma
- Hyperbaric oxygen therapy and IV fluids for pulmonary barotrauma. You may need more intensive treatment if you have severe symptoms
Typically, people don’t need treatment for gastrointestinal barotrauma. The exception is when the condition causes a perforation that requires surgery.
You should talk to a healthcare provider if ear or sinus barotrauma symptoms don’t go away or if they get worse. But gastrointestinal and pulmonary barotrauma may cause complications that can be life-threatening. You should go to an emergency room if you have:
- Gastrointestinal barotrauma and you have sudden severe belly pain
- Pulmonary barotrauma and you have chest pain or shortness of breath
Your prognosis or expected outcome depends on your situation. For example, if you have airplane ear, you may not need any treatment. But you may need surgery if barotrauma damages your eardrum. If you have a form of barotrauma, a healthcare provider is your best resource for information. They’ll tell you what you can expect.
Yes, in most cases, you can prevent barotrauma:
- If you’re flying on an airplane, invest in special earplugs. Chew gum, yawn or blow your nose to protect your ears from air pressure changes.
- If you scuba dive, follow safe diving practices. That will help you reduce the risk of gastrointestinal, pulmonary and sinus barotrauma. Organizations like the Divers Alert Network (DAN) offer safe diving practice training.
Barotrauma covers a wide range of medical conditions. Some are more serious than others. Contact your healthcare provider if you’ve experienced significant air and water pressure changes that might affect your health.
References
- Battisti AS, Haftel A, Murphy-Lavoie HM. Barotrauma (https://www.ncbi.nlm.nih.gov/books/NBK482348/). 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. Accessed 4/29/2025.
- Merck Manual. Professional Version. Pulmonary Barotrauma (https://www.merckmanuals.com/professional/injuries-poisoning/injury-during-diving-or-work-in-compressed-air/pulmonary-barotrauma). Updated 4/2023. Accessed 4/29/2025.
- Merck Manual. Consumer Version. Barotrauma (https://www.merckmanuals.com/home/injuries-and-poisoning/diving-and-compressed-air-injuries/barotrauma). Updated 4/2023. Accessed 4/29/2025.