Recurrent otitis media (i.e. frequent ear infections) can occur in patients of all ages, and are especially common in younger children. There are many causes that contribute to chronic ear infections in babies, children and adults. Let’s explore some of the most common causes of this condition.
Allergies cause swelling of the nose, throat, and near the opening of the Eustachian tube. Allergies will also cause an increase in mucous production and drainage. Allergies contribute to ear infections because the nose and the lining of the sinuses produce excessive mucous
This extra mucous, along with swelling of the area, will cause a back-up of mucous and bacteria. This may increase swelling at the opening of the Eustachian tube. Reducing this congestion is important and can be done with nasal steroid sprays (prescription only), antihistamines, decongestants and allergy injections (immunotherapy). There is some controversy whether or not antihistamines and decongestants will actually slow the movement of mucous and lead to a sinus infection.
Many people blame allergies for their constant nasal congestion, drainage and ear infections. Medicines for allergies are antihistamines. These medications only provide benefit if you are treating true allergies. Skin testing or a RAST test is the only way to know if allergies exist.
Children can become allergic after they have had three to four exposures to the allergen. When you bring a child home from the hospital, they are exposed to what is in the house; molds, dust mite, cockroach, cat and dog. Trees and grasses pollinate in the spring and weeds pollinate in the fall. After two or three years, the child has been exposed to the spring and fall allergens and at that time they can become allergic to the outdoor allergens. Visiting with an allergist can make a big difference in treating and addressing ear infections.
Gastro-esophageal reflux disease (GERD), also described as reflux, heartburn or spitting up, will add to inflammation and congestion in the Eustachian tube. As acid and food comes up into the esophagus from the stomach, the sinuses in the head and throat become congested. Excessive mucous is produced and this will keep the Eustachian tube closed and thus not functioning properly.
Infections cause swelling of the nose, throat, and opening of the Eustachian tube. Infections will cause increased mucous production and drainage. Some infections involve the middle ear. If the Eustachian tube is blocked, this allows fluid to build up in the middle ear.
If your child has frequent ear infections the doctor may be over diagnosing the ear infection, in other words there may be fluid that is still in the middle ear caused by the latest ear infection and giving it time to clear is what is needed, not another antibiotic. If your child does suffer with frequent ear infections please see us to asses the causes and to assure that your child does not have an immune reason for these frequent infections.
Please do not have tubes placed in your child’s ears until they have been evaluated by an allergist immunologist trained in treating frequent infections.
Exposure to irritants like tobacco smoke will cause the Eustachian tube opening to swell. This swelling closes the Eustachian tube opening and leads to hearing problems, fluid build up and a drop in oxygen in the middle ear, allowing anaerobic bacteria to grow in the middle ear. Anaerobic bacteria are more difficult to treat when they are the cause of the ear infection.
Again, the most important way to reduce ear infections is to address the inflammation and congestion in the back of the nose and throat where the Eustachian tube opening is found. Eustachian tube blockage happens with viral infections, sinus infections, allergies, GERD (gastro esophageal reflux disease), anatomical problems like a deviated septum, enlarged turbinates or enlarged tonsils and adenoids. If you or your child suffers from recurrent ear infections, you should see an allergist.
More About Recurrent Ear Infections