Middle ear infectionstechnically called otitis mediaare the most common cause of earache. They can occur at any age, though they are especially common among children up to age eight. Some children will experience these infections only occasionally, but in other children the infections can be chronic, occurring frequently and/or not clearing up readily.
Symptoms develop when the eustachian tube, which helps drain fluid from the middle ear into the nasal passages, becomes swollen and then blocked. This is often preceded by a cold or other upper respiratory infection.
Fluid and pressure build up in the cavity between the eardrum and the inner ear, and the discomfort this causes can range in severity from a mild, dull ache that won’t let up to an intense searing pain felt in front of, above, or behind the ear. Typically, the fluid that accumulates in the middle ear allows bacteria and viruses drawn in from the back of the throat to breed and cause infection. Sufferers often experience some temporary hearing loss.
Middle ear infections can afflict one or both ears, and they typically occur in the winter and early spring months, when respiratory tract infections are common.
Symptoms of Middle Ear Infection
- Congested feeling in the affected ear(s)
- A sharp or sudden pain, or a dull, continuous pain in the ear
- Muffled hearing or temporary hearing loss
- Pain when pulling on the earlobe
- Fever (when bacterial infection is present), nausea or vomiting
- Foul-smelling, yellowish discharge from the ear, headache, dizziness, and profound hearing loss are serious symptoms
- Young children may act extremely irritated and/or cry persistently as well as tug at their ears
What Causes Middle Ear Infection?
Viral or bacterial infections of the upper respiratory tract, especially a cold or sore throat, are often the cause of middle ear infections. Some allergies can also cause middle ear infections, as can the abrupt change in altitude when flying.
The fact that the eustachian tube is smaller and more horizontal during early childhood, which helps spread infection from the upper respiratory tract to the middle ear, may be why children are more vulnerable to the infection.
What If You Do Nothing?
Otitis media can clear up spontaneously within 10 days. Some infections can persist for weeks. Because the pain and discomfort are often too much to bear, treatment by a physician, supplemented by home treatment, is advisable. Also, in some cases an untreated ear infection can worsen to the point where the eardrum becomes inflamed or pressure causes the eardrum to rupture. Hearing loss is another possible complication, though it is usually reversible.
Home Remedies for Middle Ear Infection
Whenever you (or a child) develop middle-ear symptoms, these measures can alleviate some of the discomfort. Nonetheless, you should also contact your doctor, since most middle ear infections can be cleared up quickly with medication.
- Warm the ear. Hold a heating pad or warm compress to the ear.
- Try baby oil. Warm the oil to room temperature and put a few drops into the sore ear. While this won’t treat the cause of the ear infection, it may offer some relief before you get to see your physician.
- Raise your head when sleeping. Use pillows to keep your head comfortably raised. This will help drain fluids from your middle ear.
- Relieve pain and fever. Over-the-counter anti-inflammatories—aspirin, naproxen, and ibuprofen—or acetaminophen may help relieve pain symptoms and fever. (Children should not be given aspirin for fever because of its association with Reye’s syndrome.) Nonprescription ear drops may also bring some pain relief.
- Take an over-the-counter decongestant. Decongestants can help shrink mucous membranes to open the eustachian tube and relieve middle ear pressure and discomfort. It’s important to follow warnings and instructions carefully when taking these medications. Some are made for adults and contain ingredients that are harmful when taken by children.
- Sugarless gum may help. In a Finnish study, children chewing gum containing xylitol, a sugar substitute, had 40 percent fewer ear infections than those chewing regular gum. But kids in the study had to chew two pieces of gum five times daily—quite a mouthful, even if the child loves gum.
- Avoid exposure to smoke.
It is usually not possible to prevent otitis media. But children who have recurrent infections may be able to take medications to prevent bacterial infections. You can also take steps to prevent ear pain when flying.
Beyond Home Remedies: When To Call Your Doctor
Contact your doctor if you or your child has symptoms of middle ear infection. Also call your doctor if symptoms have not cleared up after a week.
What Your Doctor Will Do
Your physician will examine the ears, checking for redness and fluid. Once an ear infection has been diagnosed, medications, including prescription nose drops, may be prescribed to help open up the eustachian tubes. Antibiotics may be prescribed to fight infection and reduce the chance of complications. Your physician may also recommend that drainage tubes be inserted into one or both ears to keep the passage open at all times
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media