Dear Doctor: What can you recommend for motion sickness? We’ve been taking the family driving a lot lately to get us out of the house, but unless I’m the one behind the wheel, the mountain roads where we live make me nauseated.

Dear Reader: There’s nothing like a bout of motion sickness to ruin an otherwise fun day. The symptoms can range from the queasy stomach that you describe to dizziness, a throbbing headache, cold sweats, anxiety and vomiting. It’s a common affliction, and we wouldn’t be surprised if the other passengers in your car aren’t suffering a bit as well.

Although the exact cause of motion sickness remains unclear, it appears to be linked to a miscommunication between what our eyes are telling us and what is being reported by the delicate structures of the inner ear. Known as the vestibular system, this is the mechanism that controls balance. When you turn your head, bend down or twist around, the resulting image you’re seeing is in sync with what your inner ear says is happening. Your physical body is in motion, but the ground is stationary. In a car on a twisty road, however, the signals get mixed. Your eyes say your body is sitting still, but to your inner ear, your body is in motion. It’s not clear how or why, but this sensory dissonance stimulates pathways in the brain that lead to the often gut-churning symptoms of motion sickness. For whatever reason, the brain has decided the body is best off purging itself, and either nausea or vomiting can be the outcomes.

For some people, medications that address the symptoms of motion sickness can be helpful. This includes over-the-counter products with dimenhydrinate, an antihistamine used to control nausea and vomiting, or meclizine hydrochloride, an antiemetic to prevent nausea, vomiting or dizziness associated with motion sickness. Take it an hour or two before you head out. If over-the-counter meds aren’t working, consider prescription medications such as the scopolamine patch and promethazine. These are also useful for symptoms of seasickness. Dimenhydrinate and meclizine hydrochloride can cause dry mouth and drowsiness. If you choose a prescription remedy, be sure to go over the potential side effects with your pharmacist.

Since you know you’re prone to motion sickness, you can take precautions before the drive. Avoid a heavy meal before you head out. Stay hydrated, but skip the caffeine, beer or cocktails. Crack a window to get a steady supply of fresh air. Opt for the front seat, where you can easily keep your eyes on a fixed point on the horizon in front of you. That helps your brain unscramble the mixed signals sent by your eyes and inner ear. Some travelers swear by ginger, available in powdered form, to ease nausea. Despite conflicting evidence about its efficacy in easing motion sickness, acupressure also has its proponents. In this method, constant pressure is applied to the insides of the wrists via specially designed elastic wristbands.

If all else fails, consider taking a turn behind the wheel. It’s not known why, but having control over the car sharply reduces the risk of motion sickness.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Why do I sneeze after a meal? It doesn’t matter what kind of food it is, and it doesn’t have to be after a particularly big meal. Beverages don’t seem to be an issue. What’s going on?

Dear Reader: You’ve described a condition known as gustatory rhinitis. When something irritates the mucous membranes of the nose and causes them to become inflamed or swollen, it’s known as rhinitis. It can result in nasal congestion that ranges from mild to severe, a runny nose, postnasal drip and sneezing. Rhinitis is divided into two categories: allergic and non-allergic. Gustatory rhinitis falls into the latter category. Although the symptoms are similar to those of an allergy such as hay fever, the condition doesn’t involve the same type of immune response.

We tend to think of sneezing as a reaction to inhaling an irritant that “tickles” the nose, such as pollen, dust, pet dander, perfumes, mold, pollutants or smoke. The purpose of the propulsive gust of air delivered by a sneeze is to clear away that irritant. However, sneezing has other triggers. Some people sneeze in response to cold air, fizzy drinks, pungent foods such as chili or peppermint, sexual activity, exercise, when plucking an eyebrow, or when emerging from dim light and then looking at the sun or other bright light. Interestingly, sneezing associated with bright light, known as photic sneeze reflex, occurs in 20% to 35% of the populace and has been linked to genetics. Individuals who have this response often sneeze the same number of times in each episode.

People who sneeze when their eyebrows are plucked are responding to stimulus to the trigeminal nerve, one of the 12 cranial nerves. It has three separate branches, which send sensations from the upper, middle and lower portions of the face to the brain. When the branch of the trigeminal nerve in the forehead is stimulated by tweezing, threading or waxing an eyebrow, the branch of the nerve in the nasal area is activated as well, which can result in a sneeze.

When it comes to the type of gustatory rhinitis you’re experiencing, which some people refer to as “sneezures,” the mechanism isn’t fully understood. In some cases, post-meal sneezing arises as the result of spicy or pungent foods. Common triggers can include horseradish, peppercorns, hot peppers, pickled foods, wasabi and dark chocolate. Temperature can also play a role. For some people, a sip of hot soup can bring on a sneeze. Sneezing at the end of a meal also has been linked to the stomach becoming full and, thus, distended. There is evidence that this, too, has a genetic component. Gustatory rhinitis also becomes more common as people age.

Although not a health risk, sneezing after a meal can be an unpleasant distraction. It’s a good idea to monitor what you’re eating just to rule out a link to the contents of the meal. A pattern you hadn’t noticed before may emerge. It’s also possible that eating smaller meals, which don’t distend the stomach as much, may also bring relief.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Our kids are having a hard time with social distancing, which seems like it will last forever. My husband and I know some people who have formed a “quarantine bubble” for socializing and getting the kids together. How does that work? Is it safe?

Dear Reader: An important thing to understand about sustained contact during the pandemic, whether it’s with the people in your own household or the quarantine bubbles that have become increasingly popular, is that everyone is only as protected as the least-careful person in the group. The novel coronavirus is highly contagious, and evidence continues to show that it can be spread before an individual develops symptoms. So when talking about groups of people quarantining together, safety is a relative term.

Protecting against the virus requires ongoing vigilance by every individual within a group. This includes frequent and thorough handwashing, sanitizing high-touch surfaces, keeping at least 6 feet apart from any new contacts and wearing a facial covering while in public. As we mentioned recently, emerging research suggests that face masks made with multiple layers of cloth may offer a measure of protection to the wearer as well as the people around them.

All of which brings us to the quarantine bubbles -- some people refer to them as pods or “quaranteams” -- that you are asking about. These are small groups of people who have agreed to engage in non-distanced activities only with each other. Outside of the group, they continue to wear a mask, stay 6 feet apart and limit the time of contact. Quarantine bubbles have been formed with groups of friends as well as with groups of families. They have arisen out of necessity. In the early days of the lockdown, it was possible for people to white-knuckle their way through strict isolation. But as the pandemic stretches on, people are responding to a need to take care of their mental and emotional health as well. Since the pandemic began, depression, anxiety and loneliness have increased dramatically. Each of these are risk factors for physical illness, including heart disease, stroke and premature death. In the language of public health, the formation of quarantine bubbles is a harm-reduction strategy.

You can mitigate risk by following some important guidelines. Be certain that the network you’re forming or joining is as serious about safety measures as you are. It’s important to keep the group small, 10 people at most. Each additional member increases risk for everyone. Each group member agrees to limit non-distanced activities only to the group, with no exceptions. For the concept to work, you need a closed circuit. Have a plan for what happens if someone breaks safety protocols. Indoor venues are risky, so when possible, keep interactions outdoors. And agree on a trial run, maybe a week or two. That lets everyone get comfortable with the mechanics involved, and to figure out if the bubble approach is right for them.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)