Ear Infection

8 mins read

Ear infections are one of the most common infections among young children. While there are many forms of ear infection, otitis media is the most common. Most kids will have at least one incidence of ear infection before they turn two.

The ear has three parts: outer or the pinna; middle, located just behind the ear drum; and inner, consisting of the cochlea, dedicated to hearing and the vestibular system, which deals with balance.

Swimmer’s ear is what we call the type of infection when outer ear comes infected. Otitis media is inflammation of the middle ear.

Causes
Ear infections are caused by viruses or bacteria entering the ear. With swimmers ear, the infection is often brought on by the moist environment created after swimming that encourages growth. With middle ear infections, the infection begins because the passages that drain the middle ear, the Eustachian tubes, are clogged and fluid has built up inside.

Your Eustachian tubes normally drain from the middle ear to the back of the throat. As fluid builds inside the middle ear, the pressure becomes painful and you develop an earache.
There are several reasons why you or your child’s Eustachian tubes can become blocked, including:

  • Colds, flus and sinus infections.
  • Excess mucus and saliva produced during teething.
  • Tobacco smoke.
  • Infected or overgrown adenoids (the clusters of spongy tissue in the back of the nasal cavity).

Symptoms
The signs and symptoms of an ear infection often strike rapidly.

For children, they include:

  • Crying and expressing ear pain– toddlers often cry especially when they don’t get what they want. But if your kid cries more than usual, and points or tugs at his or her ears, that could be a telltale sign.
  • Children with ear infections have the tendency to be crankier even when they are not hungry and it’s not yet nap time. Also, kids with ear infections can have difficulty responding to calls and instructions.
  • Watch your kids play and see if you notice any difference in their sense of balance, which is regulated by the inner ear. Labyrinthitis is an inflammation inside your ear, and can cause loss of balance.
  • While keeping your children’s ears dry and clean at all times, watch for secretions, such as pus.
  • Loss of appetite
  • Headache
  • Fever of 100 F (38 C) or higher
  • Vomiting and diarrhea may be present especially with acute otitis media.

For adults, the symptoms include:

  • Secretion of fluid from the ear.
  • Hearing loss.
  • Sore throat.

Transmission
Ear infections are not contagious, but the cold and flus that trigger them are. A good diet and hygienge, and frequent hand-washing are all ways to minimize risk and exposure to these illnesses.

Diagnostic test
Ear infections are relatively easy to diagnose. Your physician will likely ask about your symptoms and when they developed, and give you a physical exam. Using a pneumatic otoscope, he or she will likely look inside your ears to see how much fluid may be behind the ear drum. If there is any doubt about the diagnosis, he or she may order additional diagnostic tests.

Treatment options
Most ear infections clear up by themselves without medication. Depending on the age of your child, the level of pain and any other symptoms, your doctor may prescribe a wait-and-see approach for the first 48 to 72 hours to see if the body heals itself.

  • If the pain is severe, you can try over-the counter pain medications, such as ibuprofen or acetaminophen. Do NOT give aspirin to children. You can also try over-the counter pain relief ear drops, or ask your doctor about prescription pain relief ear drops. A warm moist washcloth placed over the baby’s ear can also lessen the pain.
  • Children under six months with a fever or other symptoms will probably be given antibiotics. Your health care provider is also likely to prescribe antibiotics if your child is under age of two, has a fever or is not improving after 24 to 48 hours. The first line of antibiotic treatment is Amoxicillin, which is common enough that is has the colloquial name, “the pink stuff.” It is highly effective, inexpensive, and is easy on the stomach and intestines. If the infection is resistant to this treatment, other antibiotics, such as Azithromycin, Augmentin may be used.

If you or your child is given an antibiotic to treat your ear infection, it’s important to take them for the full duration of the treatment, even after the symptoms clear. While the pain and other symptoms may have subsided, there may still be residual bacteria left in the ear than can cause further infection if all the bacteria is not eliminated through the full course of treatment.

  • If your child continues to have a build-up of fluid even after the course of antibiotics, they may need an ear tube to ventilate the middle ear. This is a surgical procedure that is used only in persistent cases of ear infection.

Alternative Therapies

  • There are a number of natural medicines that can be used against the bacteria that cause infection. Homeopathic remedies include chamomilla, lycopodium, belladonna and pulsatilla. Immune boosters include garlic pills and Echinacea [1]. Be careful when using natural remedies; the dosage for adults and children will likely differ and some are appropriate for adults, but not for children. And some may affect the medications prescribed – so talk to your doctor if you plan to take any alternative medicines.
  • Studies carried out on the use of essential oils derived from clove, lavender and geranium in the treatment of acute otitis have shown promising results in treating acute ear infections [1, 4].
  • Cod liver oil [5] which is a rich source of vitamin A is also found to be beneficial in ear infections. Vitamin A deficiency hampers the clearing mechanism of the ear and thus Vitamin A supplementation can help aid this process [6].
  • Onion has long been known as a natural remedy to treat all types of ear infections. The anti-inflammatory and cleansing properties of onion help in unblocking the ear canal and provide temporary relief [1,2].
  • Valsalva’s maneuver is a technique which can help in opening up the Eustachian tubes and provide relief from chronic stuffy which is a common symptom of otitis [7].

Prevention
Your kid will likely have at least one ear infection during childhood. But you can minimize their risk by taking steps to lower the chances that your child gets a cold or flu that causes an ear infection.

  • Keep your and your children’s hands clean especially when they have just come in contact with some playmates or visitors who might have a cold or flu.
  • Stop smoking: Second hand smoke increases the risk that your child will develop an ear infection.
  • Don’t feed your baby while lying down: The milk can irritate the Eustachian tubes leading to fluid building up inside.


Conclusion
Ear infections are one of the most common infections of babies and children. There are several telltale signs including ear pain, crankiness, and an inability to listen. While most kids experience at least one ear infection during childhood, they are easy to diagnose and treat. Often the body heals itself if the infection is not severe. Talk to your family physician to find out the best course of action.

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References
1. Levi JR, O’Reilly R. Complementary and integrative treatments: otitis media. Otolaryngol Clin North Am. 2013 Jun;46(3):309-27. doi: 10.1016/j.otc.2013.01.001. Epub 2013 Feb 26. Review. PubMed PMID: 23764811.

2. D’Alatri L, Picciotti PM, Marchese MR, Fiorita A. Alternative treatment for otitis media with effusion: eustachian tube rehabilitation. Acta Otorhinolaryngol Ital. 2012 Feb;32(1):26-30. PubMed PMID: 22500063; PubMed Central PMCID: PMC3324963.

3. Levi JR, Brody RM, McKee-Cole K, Pribitkin E, O’Reilly R. Complementary and alternative medicine for pediatric otitis media. Int J Pediatr Otorhinolaryngol.  2013 Jun;77(6):926-31. doi: 10.1016/j.ijporl.2013.03.009. Epub 2013 Apr 4. Review. PubMed PMID: 23562352.

4. Panahi Y, Akhavan A, Sahebkar A, Hosseini SM, Taghizadeh M, Akbari H, Sharif MR, Imani S. Investigation of the effectiveness of Syzygium aromaticum, Lavandula angustifolia and Geranium robertianum essential oils in the treatment of acute external otitis: a comparative trial with ciprofloxacin. J Microbiol Immunol Infect. 2014 Jun;47(3):211-6. doi: 10.1016/j.jmii.2012.10.002. Epub 2012 Dec 27.  PubMed PMID: 23274083.

5. Linday LA, Dolitsky JN, Shindledecker RD, Pippenger CE. Lemon-flavored cod liver oil and a multivitamin-mineral supplement for the secondary prevention of otitis media in young children: pilot research. Ann Otol Rhinol Laryngol. 2002 Jul;111(7 Pt 1):642-52. PubMed PMID: 12126022.

6. Aladag I, Guven M, Eyibilen A, Sahin S, Köseoglu D. Efficacy of vitamin A in experimentally induced acute otitis media. Int J Pediatr Otorhinolaryngol. 2007 Apr;71(4):623-8. Epub 2007 Feb 14. PubMed PMID: 17303254.

7. Alper CM, Swarts JD, Doyle WJ. Middle ear inflation for diagnosis and treatment of otitis media with effusion. Auris Nasus Larynx. 1999 Oct;26(4):479-86. PubMed PMID: 10530745.

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