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July 11th, 2011
08:46 AM ET
My ear is clogged. Should I get antibiotics?Every weekday, a CNNHealth expert doctor answers a viewer question. On Mondays, it's pediatrician Dr. Jennifer Shu. Asked by Nerisa from New York Thanks for your question, and sorry to hear about your continuing discomfort. The short answer to your question is maybe, but probably not. If you have a middle ear infection (otitis media) or sinus infection associated with your symptoms, then antibiotics may help. Your doctor can make the diagnosis and prescribe antibiotics if needed. However, the scenario you describe sounds typical of a problem with the Eustachian tube, which connects the middle ear with the throat. I consulted Dr. Aaron Rogers, an otolaryngologist in Atlanta, to provide more information about the symptoms you describe. He shares the following: "The ear feeling clogged and the clicking during a cold or sinus infection are a result of the Eustachian tube, the ear's natural drainage tube, getting swollen shut - or, more commonly, partly shut. "That swelling can give you a clicking or popping noise, a feeling of ear fullness, a mild earache or even a sense of disequilibrium (being off balance). The swelling can commonly last a couple of weeks. If the tube stays completely swollen for more than a couple of days, you could even begin to build up fluid behind the eardrum. "In addition to colds, nasal allergies, sinus infections and even stomach acid reflux can cause the Eustachian tube swelling. "A middle ear infection from infected fluid behind the eardrum will cause muffled hearing and usually severe pain. This is usually the end result of the Eustachian tube being swollen completely shut for several days. "Usually, antibiotics are not needed for the sensation of fullness, clicking and mild pressure. In fact, for just plain Eustachian tube dysfunction (or ETD) without infection or allergies, we do not really have a proven medical treatment that is any better than just 'waiting it out.' "If there are other signs of a lingering sinus infection or the beginnings of an ear infection, antibiotics may be helpful. Other medications such as prescription nasal sprays can at times help treat Eustachian tube dysfunction as well, especially if there is a lot of swelling in the nose from the remnants of a cold or allergies. "Occasionally, some cold viruses can damage the hearing nerve and may mimic ETD. Other prescription medications may help if started quickly enough. "Finally, try not to worry about the popping and clicking when you blow your nose - that is just the Eustachian tube trying to open up to get the ear aired out again. These symptoms will go away once the Eustachian tube is working properly. "If your ear congestion is not clearing in about three to four weeks' time, then getting evaluated by your primary care doctor or an otolaryngologist may be helpful. If needed, hearing and ear pressure tests can be done to see if draining any fluid is needed or whether medications may help."
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My infant son has single sided canal atresia (canal doesn't go through) and so we see one of the world's foremost experts on this condition. In his normal ear, they carefully watch to be sure nothing is affecting hearing (and therefor speech development). Fluid in the ear can impact hearing and cause speech delays. When he was approximately 4 months old, he had fluid build-up (not caused by an illness) and the doctor elected to put him on a 10 day course of antibiotics to see if the fluid would clear. After 2 courses, the fluid did clear. This allowed us to not need ear tube surgery for our baby. According to the otologist, the antibiotics help expedite the fluid loss in some cases. I think it's important that CNN thoroughly report on stories regarding health, not just take the word of one ENT.
It is totally appropriate to use an antibiotic for middle ear infections in children under two according to present evidence based medicine, primarily to avoid a complicating bacterial infection such as mastoiditis. That was not the case in the vignette presented.
Its depressing that the article , both the question and response, revolves around the inappropriate use of antibiotics. As an emergency physician we are confronted daily with patients requests for antibiotics to treat viral illnesses and allergies. Not only can't they help but may cause a serious allergic reaction, and contributes to growing antibiotic resistant found worldwide. Doctors need to STOP prescribing antibiotics just to keep the uninformed patients happy.
As for this case,over the counter anti-histamines, with or without a decongestant would be most helpful along with a nasal steroid spray. In refractory cases an oral steroid may be needed. Antibiotics? Almost vever.
THANK GOD, finally to hear from someone who is NOT on the antibiotics bandwagon. I had pretty much the same experience as the person asking for advice. Everyone (friends, family, etc.) kept telling me "antibiotics" "antibiotics" I said "No" "No" One person said if I didn't get anitbiotics I would get a brain infection (?). Anyway, I waited it out, took 3 weeks but I'm fine & dandy now.
If I am not mistaken there was a recent study done that says that antibiotics should be used for children with ear infections since they can be very painful. The antibiotics, it said, will help the infection heal quicker and the child will not be suffering as long as they would be if they do not take the antibiotic.
Nasal spray is helpful, but so is lots of Vitamin C. I used to get chronic ear infections until I started avoiding dairy, especially milk and ice cream. Avoiding dairy, ice-cold drinks, and sugar is extremely helpful in preventing sinus problems. I had to learn this the hard way by trial and error. Why don't doctors ever mention diet?
They will NEVER EVER suggest natural remedies that are time tested and have been used for thousands of years. Prescription drugs should almost never be the FIRST LINE OF DEFENSE.
I use a natural nasal spray that has cayenne pepper in it and it works IMMEDIATELY! There are many natural ear drops and other things that can be done without the use of antibiotics. Its not surprising that CNN will suggest only drugs seeing as how they are just another vehicle for the pharmaceutical industry.
@ GetReal, I agree 100%. Diet is very important. We are the only species that drink's another species milk and into adulthood.
It is NOT a necessity. The dairy council pays big bucks to make it seem crucial to our diet. IT IS NOT.
But that is still falling back on medications. My family and I have had plenty of infections requiring antibiotics, and I sure see the need for them. That being said, there are many ways to minimize the need for them. A healthy baseline diet makes a big difference. Drinking more water, or hot water with lemon can help drainage. What about chicken soup? Nasal irrigation works wonders to keep the sinuses clear. In fact, when my 2 year old is sick, she asks to be irrigated so she can breathe better. (actually she says irrirgeted, but we know what she means) This is from a family filled with asthma and allergies. Boy has it helped.
@ Tina, keep in mind antibiotics are ONLY effective with bacterial infections. The do absolutely nothing for viral infections, which, most of the time is what someone has.
Marc, you must not be handcuffed by the P4P (Pay for Performance) bandwagon that administrators are on these days. If don't give the uninformed patient an antibiotic, they either report you to the administrator or give you bad scores on your patient satisfaction survey. Poor patient satisfaction scores result in either withholding of bonuses or "adjustment" of your base pay in the following year. Given the volume of patients doctors are required to see, there is no time for "education" of patients and besides their neighbors kid got the antibiotics from a "great doctor".
We all know the dangers of the over prescribing of antibiotics and most of us know the evidence based medicine well.
But when evidence based medicine is in conflict with patient satisfaction scores, science be damned, antibiotics for every kid whose mother demands them.
I had ear fullness and popping for years. Nasal spray helped a little for the swelling. After going to an otolaryngologist it turns out that it is from TMJ. Because I clench my jaw the joint at my jaw (TMJ) it swells my eustachian tube. Once I used a night guard and relax my jaw during the day, the pain has goin away. No more allergy medicine and thnking I have an ear injection. I was amazed that the jaw joint is so close to the ear channel. It is so nice not to have full popping ears all of the time!
Thanks for this info. I was just told by my ENT doctor that I probably have the same issue, and that I should get a night guard. It's nice to hear that it helped someone else out there!
I suffered for months and the END specialists gave me the same story...just wait it out. So, went online and searched and discovered many were using Mucinex-D to alleviate/eliminate this problem. Tried it and within 6 days it totally cleared up.
Mucinex is good stuff. It's basically Guaifenisen which is a mucous thinner. Usually no side effect. Drink lots of water with it to maximize the draining.
Can person with hearing lost use this antibiotics? may be for a miracle.
Me too
You can always just jam a kntting needle in there.
Unfortunately, I had a problem with my right ear due to severe allergies. The doctor failed to prescribe antibiotics when he noticed the beginning of an ear infection. Four days later my eardrum ruptured (felt like someone was stabbing me in the ear with an ice pick – very, very painful). Because of this mistake, it took two months for me to fully recover my hearing, all the while I had to wear an ear plug to prevent infection in the inner ear due to the hole that exposed the sterile portion of my ear. Antibiotics can be very helpful when administered for the proper causes. Always have your doctor make sure there is no infection and if he or she does see signs of one, I would recommend insisting on antibiotics. The other choice is risking a painful rupture and temporary to permanent hearing loss.
Chinese medicine works best in this case because the herbs can drain the ear & also treat the allergies or nasal infection at the same time. Yes, can also treat ear infection because the nasal & ear are connected.
I was sort of in the same boat several years ago. I had the pain and throbbing and sense of 'fullness' in the ear. Knowing our doctor never prescribes antibiotics for this sort of stopped up ear UNLESS you have a high fever, I waited. And waited. And waited. I treated myself with Advil for pain and a decongestant for the stuffiness, and the symptoms waxed and waned. Two months later, I went in to find a very severe ear infection and some permanent hearing loss. Bottom line: Yes, DO wait. But wait a *reasonable* amount of time...I would say if you are not doing better in 3 weeks, it is indeed time to call your doctor. Don't wait too long, as I did.
Interesting article and even better comments.
The most natural remedy for this condition in an otherwise healthy individual is to do nothing. And pepper spray up the nose is natural? In what space-time dimension?
In addtion to a diet change that eliminates dairy, etc., in the short term why not just take an anti-inflamatory pain reliever like Ibuprophen. I've used this pain reliever with a lot of success whenever I suffer from pain and inflamation at the same time. If used properly for a few days, It definitely alleviates swelling and pain and it's not harmful or expensive.
Hmmm... Anti-inflamatory like ibuprophen? I thought NSAIDS were harmful to the heart?
I can't fly on planes. My ear hurts so bad and stays stopped up for a week all the way down into my shoulder. I wish there was somethiing I could do about this. I went to the doctor, but he says that he cannot find anything wrong, just chew gum. Well, I was sitting by a doctor and believe me nothing helped. It was so severe that I thought my ear drum was about to break.
8 years ago my ears clogged...from a KISS concert. They stayed clogged for over a month. Several doctors told me there is nothing wrong and nothing they can do. One day I couldn't stand it anymore.. I plugged my nose shut and blew as hard as I could. My ears went POP!!! I almost passed out, and I have been dizzy since. Yep.. 8 years of 24/7 dizziness. So please be careful with your ears and don't ever try to "blow them clear"
You are supposed to go to the ear specialist every decade or so sometimes less years than that and get the wax fully cleaned out of your ear canals. Of course you have to make the appointment through your physician. In an effort to clean your ears you regularly push a lot of the wax in even deeper and it ends up as a plug in your ears. If you try to clean it out yourself with a sharper instrument which the specialist uses along with another funnel targeting too, you may pierce your eardrums and cause permanent damage. so don't try too hard to clean your ears out. if you are one that suffers a lot of acne problems you may develop acne cysts in your ears just like on your back and arms and they need surgical removal. don't drink caffeine products if you have that type of acne breakout regularly.
i was needing to know if medicaid will pay for me to go to a dr. that can clean my eas, and noise out?