Essential Facts About Ear Infections

Essential Facts About Ear Infections

Find out the most common causes, treatments and prevention strategies for ear pain.

While ear infections tend to affect kids—5 out of 6 children will experience this condition by the time they’re 3 years old—adults are not immune. And no matter the age of the patient, one thing is certain: an earache is not pleasant.

“An 'ear infection' can mean a lot of things,” says Ear, Nose and Throat (ENT) specialist Michael Foster, DO, from Mercy Health Saint Mary's in Grand Rapids, Michigan. “It can mean having an actual bacterial infection to just inflammation behind the ear drum.”

Here, Dr. Foster gives a rundown of everything you need to know about ear infections, from symptoms and risk factors to diagnosis and treatment.

Types of ear infections
There are two main types of ear infections, explains Dr. Foster. A middle ear infection, or otitis media (OM)—the most common type—is inflammation and fluid buildup behind the ear caused by eustachian tube dysfunction. “The eustachian tube is the passageway between the ear and the back of the nose that equalizes pressure in the space behind your ear drum. We experience it working every time our ears pop,” he continues. Otitis media can be viral or bacterial and leads to the following symptoms:

  • Pain
  • Feeling of ear fullness due to fluid or mucus
  • Decreased hearing
  • Ear drainage

It can also occasionally result in a fever.

The other type of ear infection is called an outer ear infection, or otitis externa (OE), which is commonly referred to as swimmer’s ear. “This can be usually due to a small abrasion in the ear canal,” says Foster. The typical symptoms associated with OE include moderate or severe pain, possible drainage, itching in the ear canal and a feeling of fullness in the ear “like it needs to pop.”

Causes and risk factors
In most cases, OM stems from a viral upper respiratory infection—a cold that tends to include sneezing, congestion, and post-nasal drip. The typical risk factors include seasonal or year-round allergies, smoking or exposure to second-hand smoke, and having a compromised immune system. “And having kids in daycare, which is a huge one,” adds Foster.

He says the risk factors are the same for OE, along with having diabetes and sticking objects in your ears. “The outer ear infection is most commonly caused by having a small abrasion in the ear canal from use of hearing aids, ear plugs or Q-tips, and exposure of the ear canal to water—especially pond or lake water,” he adds.

Treatments for ear infections
Foster recommends consulting with your primary care physician if ear pain or muffled hearing persists or worsens after three days. “But you should consult with an ENT doctor if an ear infection occurs more than twice a year or persists, despite antibiotics or an over-the-counter remedy.”

Patients who have been diagnosed with OM may initially be treated with over-the counter pain relievers, decongestants and antihistamines. “If the symptoms persist past 72 hours to one week, an antibiotic is usually prescribed for a period of 10 days.” If the symptoms continue up to 90 days, a doctor may perform a tympanocentesis, a minor procedure that removes the fluid from behind the eardrum. “It can be done in the office with a very small amount of numbing medication, so it’s a viable option for adults,” continues Foster. “They can go back to work the same day.”

OE is usually treated initially with an antibiotic ear drop. “Sometimes a small wick will be placed in the ear to help the antibiotics get into a really swollen ear canal,” he adds. In the more complicated cases, such as elderly patients or adults who have diabetes, an oral antibiotic is prescribed.

How to prevent ear infections
If you’re allergy prone, Foster suggests taking an over-the-counter oral antihistamine at the change of the seasons in order to help prevent a middle ear infection. “You may also want to use a neti pot with purified water up to twice a day,” he adds. Limit your exposure to environmental triggers, such as smoking, as well. “Tobacco smoke decreases the ability of the ear and sinuses to clear themselves, so it leads to a much worse congestion,” states Foster.

An outer ear infection may be prevented by “avoiding the use of Q-tips and sticking your fingers too far into your ear canals,” adds Foster.

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