Otitis media is an ear infection of the middle ear, the area just behind the eardrum. It happens when the eustachian tubes, which connect the middle ear to the nose, get blocked with fluid. Mucus, pus, and bacteria can also pool behind the eardrum, causing pressure and pain.
Ear infections usually start with a cold. Although adults can get ear infections, they are most common in infants and young children. That's because a child's eustachian tubes are narrower and shorter than an adults', and it is easier for fluid to get trapped in the middle ear. In fact, 75% of all children get ear infections. They happen most often between the ages of 6 to 11 months. By age 1, 60% of children will have had at least one ear infection and 17% will have 3 or more.
Ear infections usually clear up on their own. Although it used to be common for doctors to give antibiotics to children with ear infections, now guidelines from the American Academy of Pediatricians (AAP) suggest taking a wait-and-see approach for the first 72 hours.
With a severe ear infection, pressure may build up and cause the eardrum to rupture. Pus and blood may drain out. This usually relieves pain and pressure, and in most cases the eardrum heals on its own.
Signs and Symptoms
There are two main types of ear infections: acute otitis media (AOM), and otitis media with effusion (OME), where fluid remains trapped in the ear even after the infection is gone.
Acute otitis media causes pain, fever, and difficulty hearing. If a child is too young to talk, signs of an ear infection can include crying, irritability, trouble sleeping, and pulling on the ears.
Other symptoms that may be associated with an ear infection include sore throat (pharyngitis), neck pain, nasal congestion and discharge (rhinitis), headache, and ringing (tinnitus), buzzing, or other noise in the ear.
Ear infections happen when the eustachian tubes are blocked. Blockages can be caused by:
Ear infections happen most often in the winter. They are not contagious, but a cold may spread among a group of children and cause some of them to get ear infections.
Risk factors for otitis media include:
The doctor will ask questions about whether you (or your child) have had ear infections in the past and ask you to describe the current symptoms. They will use an otoscope to look inside the ear. If infected, there may be areas of dullness or redness or there may be air bubbles or fluid behind the eardrum. The fluid may be bloody or filled with pus. The doctor will also check for any sign of perforation, a hole or holes, in the eardrum.
Your doctor may also do other tests:
You can reduce your child's risk of ear infection. Here are some tips:
The pneumococcal vaccine (Prevnar) prevents infections such as pneumonia and meningitis, and studies show it slightly reduces the risk of ear infections.
The goals for treating ear infections include curing the infection, relieving pain and other symptoms, and preventing future ear infections. If a bacterial infection is present, your doctor may prescribe antibiotics (see section titled Medications).
However, most ear infections clear up on their own. One review of the scientific literature found that the symptoms of otitis media got better in two-thirds of children by 24 hours and in 80% of children at 2 to 7 days. Because antibiotics tend to be overused for treating ear infections, and because children may become resistant to antibiotics most commonly used to treat otitis media, the AAP and the American Academy of Family Physicians guidelines suggest taking a wait and see approach for 72 hours if:
Your doctor may suggest using an over-the-counter pain reliever (see Medications). There are also alternative ways to treat the symptoms of ear infections and to prevent persistent and recurrent ear infections. For example, herbal ear drops and homeopathic remedies may help treat or prevent ear infections.
Before giving any medication to a child, whether over the counter, an herbal remedy, or a dietary supplement, you should talk to your pediatrician.
Applying a warm, moist cloth over the affected ear may help relieve pain.
Surgery and Other Procedures
Drainage tubes (myringotomy). If your child has recurring ear infections that do not respond to antibiotics, or if the fluid in the ear affects his hearing, your doctor may suggest putting in drainage tubes. During this surgery, which requires general anesthesia, the surgeon inserts a small drainage tube through the eardrum. Fluid behind the eardrum can drain out, equalizing the pressure between the middle and outer ear, which should improve your child's hearing. The tubes usually come out on their own as your child grows and the drainage holes heal.
If ear infections persist after age 4, your doctor may suggest having your child's adenoids (tonsils) removed.
Nutrition and Dietary Supplements
Because supplements (like those described below) may have side effects or interact with medications, you should take them only under the supervision of a knowledgeable health care provider. If you think your child has an ear infection, you should always talk to your doctor. DO NOT try to treat the child yourself.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care practitioner. Before giving any herbs to a child to treat an ear infection, talk to your pediatrician.
Although not many studies have examined the effectiveness of specific homeopathic therapies in general, there have been several studies evaluating homeopathy for ear infections. Some of the homeopathic remedies included in such studies or that a professional homeopath might consider for the treatment of ear infections are listed below. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.
Warnings and Precautions
If you think your child has an ear infection, especially if your child is under 2, call your pediatrician.
Let your doctor know if your child's symptoms such as pain, fever, or irritability do not get better within 24 to 48 hours.
If severe pain suddenly stops, it may indicate a ruptured eardrum.
Swimming and diving underwater may make an ear infection worse. If your child has a ruptured eardrum, he should avoid swimming or diving completely. If your child has ear tubes, use earplugs when swimming to prevent infection as directed by your physician.
Prognosis and Complications
Usually, an ear infection is a simple condition without complications. Most children will have minor, temporary hearing loss during and right after an ear infection. Permanent hearing loss is very rare, but the risk increases if the child has a lot of ear infections. Other potential complications include:
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Review Date: 2/3/2016
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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