Last Updated June 13th, 2021
What are ear infections?
An infection that affects the middle ear is called otitis media and more commonly known as an ear infection. The infection is mainly caused either by a virus or bacteria. The middle ear contains air-filled space behind the eardrum as well as tiny vibrating bones. When the middle ear is infected, it gets inflamed and causes a stinging pain. A mild case of ear infection clears on its own, but a severe case would require treatment with antibiotics.
Children are more prone to acquire ear infections due to underdeveloped ear anatomy and can sometimes lead to chronic ear infections. This may lead to hearing problems as well as other complications. A bacterial ear infection is generally caused by Streptococcus pneumoniae. Otitis media usually occurs after a bout of cold or allergies due to the congestion that is caused in the Eustachian tube.
The connection between the middle ear to the back of the throat is with the help of Eustachian tube. When there is congestion and pressure in the Eustachian tube, it provides an environment for bacteria or viruses to travel to the middle ear and multiply in numbers. This leads to the infection of the ear.
Facts about ear infection
- 6 to 24 months is considered to be the peak age to get an ear infection.
- Around 83% of children experience otitis media by the age of three years.
- Around 709 million cases of otitis media are reported worldwide every year.
- Every 30 out of 10,000 cases experience hearing loss due to ear infection.
- Deaths related to ear infection complications are around 21,000 to 28,000 around the world.
Types of ear infections
There are two types of ear infections namely middle ear infection and outer ear infection.
Middle ear infection
It is commonly known as otitis media. The middle ear is referred to as space just behind the eardrum. As discussed earlier, the Eustachian tube connects the middle ear to the back of the throat. Congestion and pressure in the middle ear cause the bacteria and virus to travel to the middle ear and multiply causing the infection. Cold and flu symptoms, sinus problems, as well as throat infections, can cause a middle ear infection. First hand and second-hand smokers too are at risk of acquiring this infection.
Outer ear infection
It is commonly known as swimmer’s ear. The outer ear includes the ear canal to the outer opening of the ear. People who swim frequently are at risk of acquiring this infection. Outer ear infections may occur even due to airborne bacteria or virus. The dark and warm environment of the ear canal is suitable for these pathogens to multiply and cause infection. The symptoms usually consist of redness and itching of the ear canal. Other factors such as inserting a foreign body like a cotton swab can cause an outer ear infection.
Causes of ear infection
Bacteria and virus are the two main causes of an ear infection. The outer ear infections are mild and generally clear on their own. Middle ear infections can be severe and are caused by another illness such as cold, flu or allergy. The middle ear infection can be caused due to two factors such as the role played by the adenoids and Eustachian tubes.
Infection caused due to Eustachian tubes
These are the narrow tubes that run from the middle ear to the back of the throat. The main function of these tubes is to regulate air pressure in the middle ear, drain any secretions from the middle ear, as well as refresh the air in the ear. As discussed earlier, an upper respiratory tract infection causes these tubes to become inflamed, which traps the fluid in the middle ear space. Bacteria or virus that travels from other parts accumulates in this space causing the infection. Children tend to have a very narrow and horizontal Eustachian tube. This makes it difficult for the fluids to drain from the tube and usually the tube gets clogged.
Infection caused due to adenoids
Adenoid is a mass of lymphoid tissue found in the posterosuperior wall of the nasopharynx. They trap harmful bacteria and viruses which we breathe in or swallow. Since adenoids trap germs that enter the body, adenoids tissue sometimes temporarily swells as it tries to fight off an infection. Anatomically, adenoids are placed near the opening of the Eustachian tubes. When the adenoids swell due to an infection, they can block the Eustachian tubes causing a middle ear infection. Since children have a weaker immune system, it is more common for the adenoids to swell and cause middle ear infections.
Health conditions similar to ear infection
Some of the medical conditions that may be related to middle ear infections and cause similar symptoms are discussed below.
Otitis media with effusion
Here effusion is referred to the fluid build-up in the middle ear. Generally, otitis media is associated with infection of the middle ear associated with fluid build-up. Once the infection subsides, the fluid build-up may not clear due to blockage in the Eustachian tube. This condition is referred to as otitis media with effusion.
Chronic otitis media with effusion
This condition occurs otitis media with effusion recurs. In this case, effusion can occur constantly without any viral or bacterial infection. This is considered to be quite serious as it may affect the hearing.
Chronic suppurative otitis media
Perforation or tearing of the eardrum due to persistent ear infection causes chronic suppurative otitis media.
What are the symptoms of an ear infection?
The most common symptom associated with otitis media is pain and pressure in the ear. This is mainly due to fluid build-up and inflammation in the middle ear. Pain is usually stinging and increases while lying down. A severe infection may even cause fever. Infants and children are at higher risk of acquiring this infection due to a partially developed Eustachian tube as well as an impaired immune system. Other symptoms associated with the infection include sensitivity to touch, hearing changes, vomiting, dizziness, nausea, headache, as well as swelling of the ear. A severe ear infection may even cause pus-like discharge to ooze out from the ear.
Risk factors associated with ear infection
Certain factors are responsible for the occurrence of ear infections and these include:
Poorly developed Eustachian tube, as well as an impaired immune system, put infants and children between the age group of 6 months and 2 years are at higher risk of acquiring the infection.
Children attending day-care
Children attending day-care centers are exposed to an individual with upper respiratory tract infection. This may cause the child to acquire cold or flu, which later leads to ear infections.
Infants who drink milk through bottle while lying down have a higher chance of causing blockage to the Eustachian tube leading to middle ear infections.
Weather plays an important role in causing ear infections. It is believed that colds and flu are more prevalent during the fall and winter and people are at higher risk of acquiring these infections.
Poor air quality
Air pollution and environment where there are a large number of smokers lead to poor air quality and increase the risk of ear infection.
Complications associated with ear infection
Ear infections generally do not cause complications unless it is left untreated. Certain anatomical abnormalities can cause chronic infections as well as effusion in the ear leading to complications and these include:
Hearing can be impaired due to chronic and persistent ear infections. Inflammation and pressure in the middle ear can cause temporary hearing loss, which is generally resolved after the infection subsides. Otitis media with effusion may cause damage to the eardrum or surrounding structures and can result in temporary or permanent hearing loss.
Speech or developmental delays
Children affected by temporary or permanent hearing loss due to ear infections can also suffer from development problems such as speech delay as well as studying difficulties.
Spreading of infection
Infection caused by an ear infection may spread to the surrounding tissues if it is left untreated. This is called mastoiditis, which is an infection of the mastoid (bony protrusion behind the ear). This infection causes the production of cysts that are filled with pus.
Tearing of the eardrum
Damage may be caused to the eardrum due to the pressure and inflammation in the middle ear. This generally heals within 72 hours, but may even require surgical intervention.
Home remedies for ear infection
The home remedies discussed here are only for mild ear infections and not for severe infections. Medical attention is necessary in case of severe infections. These remedies generally concentrate on reducing the pain associated with the infection.
This oil has several health benefits including antimicrobial, antiviral, and antifungal properties. It is also called “nature’s antibiotic.” Studies have claimed that garlic oil can kill the pathogens causing the infection. Use of antibiotics regularly is avoided by doctors and they prefer waiting for a couple of days to see if the infection subsides. During this period, using garlic oil can help greatly in reducing the symptoms.
The oil obtained from the flowers of the Mullein plant is widely used in various herbal drops as remedies for ear infections. This oil individually or in combination with other herbs is considered to be the best natural earache remedy. Studies have claimed that mullein oil is as effective as an anesthetic to relieve ear pain. It is also extensively used to treat ear infections in dogs.
Olive oil has been used for a very long time to treat earaches. Putting a few drops of warm olive oil in the ear canal can provide a soothing effect and relieve the pressure and pain associated with an ear infection. There is no scientific evidence to back this claim, but it has been observed that it can provide a certain amount of relief with ear pain. It is important to make sure that the oil is warm and not hot while putting it inside the ear canal.
Tea tree oil
Tea tree oil is known for several health benefits. It has antibacterial, antifungal, antiseptic, and anti-inflammatory properties. The oil can be mixed with a carrier oil such as olive oil and few drops can be applied to the ear canal, which can provide relief from pain and discomfort.
Ginger has powerful anti-inflammatory effects that can reduce the inflammation associated with a middle ear infection. Ginger juice can be mixed with a carrier oil and applied around the ear to provide relief from the inflammation caused by the infection. It is advised not to put the mixture directly inside the ear.
The use of onion juice to relieve earache has been followed since the 1800s. Quercetin which is a flavonoid present in the onion has anti-inflammatory properties. The onion needs to be heated at 450 degrees for 15 minutes and once it is cool, the juice from the onion should be extracted and applied to the ear canal, which can relieve the symptoms of earache. In some cases, the onion is cut into half and placed directly over the infected ear.
Applying a warm compress to the affected ear is one of the widely known home remedies that can relieve earache. Dip a soft cloth in warm water and then squeeze the water out of the cloth and apply it over the ear to provide a soothing effect. This process tries to reduce the inflammation associated with the infection and provide relief.
Herbal ear drops
Herbal ear drops containing several herbs such as Verbascum thapsus, calendula Flores, Allium sativum, Hypericum perforatum, lavender, and vitamin E in olive oil is known to relieve the symptoms of middle ear infection. Studies have claimed that these drops are as effective as prescription drops.
Alcohol and vinegar
A combination of alcohol and vinegar can be mixed together and applied to the ear which can relieve outer ear infections such as swimmer’s ear. Alcohol evaporates the water present in the ear whereas vinegar kills any bacteria present in the ear.
Since the middle ear infection is associated with pressure in the ear canal, certain neck exercises can help relieve this pressure. Particularly, neck rotation exercises are beneficial. You need to follow a particular method to do neck rotation exercises and these include sitting on the ground with both feet flat. Next, rotate the neck towards the right so that the head is parallel to the shoulder.
Similarly, rotate the head to the other direction so that the head is parallel to the shoulder on the other side. Now raise the shoulders up, trying to cover the ear with your shoulders. Do these motions gently and hold a particular position for a count of five. Repeat these movements often over a period of time.
Using the blow dryer to remove the water present in the ear canal can relieve symptoms of outer ear infections such as swimmer’s ear. The heat produced from the blow dryer evaporates the water present in the ear canal and outer ear, which can reduce the symptoms of swimmer’s ear.
How to prevent ear infections?
Ear infections cannot be completely avoided, but following certain instructions can reduce the risk of developing ear infections:
Avoid common colds and flu
Since cold and flu, as well as other upper respiratory tract infections, can lead to ear infections, try to avoid them as much as possible. Following healthy hygiene by washing hands thoroughly after an outdoor activity can reduce the spread of pathogens. Educate your children to stay away from others who are coughing or sneezing. Avoid your child from attending the day-care if there is a flu outbreak in your community.
Avoid second-hand smoke
Avoid both first hand and second-hand smoking as both of them are considered unsafe. Try to choose smoke-free environments when staying away from the house.
Avoid bottle-feeding your baby
It has been found that if the baby bottle feeds while lying down, there is a high possibility that the milk or formula might enter the Eustachian tube and lead to infection. It is important to hold your child upright while bottle feeding.
Discuss with your doctor about vaccinations
Seasonal flu and pneumococcal vaccines might come handy to avoid the risk of acquiring infections. These vaccines are generally provided once in a year and you need to discuss with your doctor for the appropriate vaccination.
Ear infections can affect anyone from children to adults. Children seem to be more prone to these infections due to the anatomical abnormalities. Avoiding triggers such as cold and flu can reduce the occurrence of these infections drastically. There are numerous home remedies available to relieve the symptoms of ear infection. Applying them wisely is the need of the hour.
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