Ear Infections: What You Can Do
Many of my patients have a history of repeated ear infections in early childhood. A typical case involves a 2-3 month-old infant who has been constantly pulling at his ears. The infant is taken to the pediatrician or family practitioner and the patients are told the child has “otitis media,” or a middle ear infection. The child is then given a brief course of antibiotics and sent home. In most cases this solves the problem and the parents have no more concern. However, in the patient population that I see, most of the people are “allergic” and so are their children. The infants I see don’t have just one or two ear infections; they have one infection after the other.
A common history goes something like this: “My baby has had ear infections since he was three weeks old. He gets one every three or four weeks. I keep going to the doctor and it’s always the same problem. The doctor gives him an antibiotic (usually a form of Ampicillin) and he gets better in a few days. But in two or three weeks, the symptoms slowly come back and he’s got it again. Now the doctor says we may have to take him to an ear specialist and have tubes put in.”
This is a typical history and I have heard the same story over and over again for the last 20 years. During this time I have treated hundreds of patients like this and I can only remember one case where the patient finally had to have pressure equalization tubes surgically installed. All of the rest of my patients were treated effectively for the underlying cause of the ear infections… their allergies. When the child is treated for their allergy, the side effect of severe allergic reactions, ear infections, no longer occur. As a result, the expensive proposition of surgical installation of ear tubes becomes unnecessary.
CAUSE OF EAR INFECTIONS
Ear infections occur because our tissues swell when we get allergic. Sometimes the swelling is caused by food allergies (see the link at the bottom of this page). The nasal mucous membrane swells, the mucous membrane swells, and the mucous membranes in the sinuses swell. Then, like dominoes, all the mucus membranes in the area begin to swell as well.
In the ear, the Eustachian tube normally allows the middle ear to drain into the throat. There is drainage because the middle ear has a fairly constant liquid which keeps the middle ear space moist and allows the liquid to drain down into the throat. When the soft tissue around the eyes and nose swells, the Eustachian tube often swells as well. If the Eustachian tube is very small it can swell shut. In small infants, the Eustachian tube can easily swell shut. If it does, two things occur:
- Pressure builds. Pressure from the constantly produced fluid in the middle ear pushes the eardrum out. The eardrum has many exquisitely sensitive stretch receptors that cause the child to feel pain when the pressure builds up. Sometimes the pain is quite severe and the eardrum may even rupture from the pressure.
- Flow stops. If the Eustachian tube is blocked or closed due to swelling from an allergic reaction then there is no flow of middle ear fluid from the ear to the throat. If there is no flow then ordinary bacteria that live in every creature’s mouth have the opportunity to migrate into the middle ear. The result of this is a middle ear infection.
The reason most people do not get ear infections is the continual flow of fluid from the ear down the Eustachian tube does not allow bacteria to collect in the middle ear.
TREATMENT OF EAR INFECTIONS
When I see a patient with an ear infection they usually have two problems. The first problem is pain. Pressure in the middle ear causes stretching of the eardrum, which results in severe pain. To treat this pain I begin at once with Auralgan Otic Ear Drops.
This medicine has a topical pain reliever which is suspended in a very thick oil. The oil (Grandma used warm olive oil quite effectively) causes the less thick middle ear fluid to cross the eardrum into the oil, thereby easing the pressure in the middle ear. It also reduces the pressure on the blocked or collapsed Eustachian tube. Another way to relieve pressure in adults is to have them “clear” their ears. Divers are familiar with this procedure as they use it frequently to neutralize the pressure in their ears. This is accomplished by holding the nose and blowing air into the middle ear. This is not something that children should do.
The second problem is keeping the Eustachian tube open. This is accomplished through general allergy principles that lead to a reduction in swelling throughout the body. The reduction of swelling is achieved through the five steps used in the treatment of all allergy:
- Appropriate nutrition
- Vitamins, minerals, and herbs as needed
- Appropriate medical treatment
- Optimum physical activity
- Spirituality or positive attitude
The main thrust of the medical therapy has to do with using adequate amounts of antihistamine to keep the mucous membrane from swelling, and avoiding the foods and environmental conditions that led to the swelling in the first place. Decongestants in LARGE doses and mucous-thinning medications (Guaifenesin) are useful in opening the tubes as well. These are safe medications and frequent, aggressive doses may be required to do the job.
Antibiotic therapy is rarely needed, as the organisms involved in this type of infection are generally the ordinary organisms that live in the mouth and throat.
Avoidance of foods to which one is allergic greatly reduces allergic swelling. The most common foods that my patients have reacted to are:
- Milk and milk products
- Tomatoes and tomato products
- Citrus fruits and citrus juices
- White wheat
- Dark drinks
Avoidance of foods alone has been demonstrated to greatly reduce ear problems in children.
Role of Food Allergy in Serous Otitis Media
by T M Nsouli, MD; S M Nsouli, MD; R E Linde, MD; F O’Mara, PhD; R T Scanlon, MD; and J A Bellanti, MD
Background. The relationship between IgE-mediated hypersensitivity and recurrent serous otitis media has not been completely established.
Objective. The purpose of the present study was to examine the prevalence of food allergy in patients with recurrent serous otitis media.
Methods. A total of 104 unselected patients (age range 1.5 to 9 years, mean 4.6 years) with recurrent seroud otitis media were evaluated for food allergy by means of skin prick testing, specific IgE tests, and food challenge. Patients who were allergic to food(s) underwent an exclusion diet of the specific offending food(s) for a period of 16 weeks. A noPn-double blinded (no placebo-controlled, double-blind) food challenge was performed with the suspected offending food(s). Their middle ear effusion was monitored and assessed by tympanometry (Welch Allyn Model 23600) during the pre-elimination, elimination and challenge diet phases.
Results. There was a significant statistical association, by chi-square analysis, between food allergy and recurrent serous otitis media in 81/104 patients (78%). The elimination diet led to a significant amelioration of serous otitis media in 70/81 (86%) patients as assessed by clinical evaluation and tympanometry. The challenge diet with the suspected offending foods(s) provoked a recurrence of serous otitis media in 66/70 patients (94%).
Conclusions. The possibility of food allergy should be considered in all pediatric patients with recurrent serous otitis media and a diligent search for the putative food allergen made for proper diagnostic and therapeutic intervention.