Ailmemts & Remedies

Ear Infection

Alternative Names: Otitis media – acute; Infection – inner ear; Middle ear infection – acute
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Ear infections are one of the most common reasons parents take their children to the doctor. While there are different types of ear infections, the most common is called otitis media, which means an inflammation and infection of the middle ear. The middle ear is located just behind the eardrum.

There are two types of ear infection…Acute & Cronic.

The term “acute” refers to a short and painful episode. An ear infection that lasts a long time or comes and goes is called chronic otitis media.

You may click to learn more about ear infection:

An acute ear infection causes pain (earache). In infants, the clearest sign is often irritability and inconsolable crying. Many infants and children develop a fever or have trouble sleeping. Parents often think that tugging on the ear is a symptom of an ear infection, but studies have shown that the same number of children going to the doctor tug on the ear whether or not the ear is infected.


Common Ear Infection

Acute Ear Infection

Cronic Ear Infection

Ear Infection of Bone

Other possible symptoms include:
*Fullness in the ear
*Feeling of general illness
*Hearing loss in the affected ear
*The child may have symptoms of a cold, or the ear infection may start shortly after having a cold.

All acute ear infections include fluid behind the eardrum. You can use an electronic ear monitor, such as EarCheck, to detect this fluid at home. The device is available at pharmacies.

Possible Causes:
Ear infections are common in infants and children in part because their eustachian tubes become clogged easily. For each ear, a eustachian tube runs from the middle ear to the back of the throat. Its purpose is to drain fluid and bacteria that normally occurs in the middle ear. If the eustachian tube becomes blocked, fluid can build up and become infected.
Anything that causes the eustachian tubes and upper airways to become inflamed or irritated, or cause more fluids to be produced, can lead to a blocked eustachian tube. These include:

*Colds and sinus infections
*Tobacco smoke or other irritants
*Infected or overgrown adenoids
*Excess mucus and saliva produced during teething

Ear infections are also more likely if a child spends a lot of time drinking from a sippy cup or bottle while lying on his or her back. Contrary to popular opinion, getting water in the ears will not cause an acute ear infection, unless the eardrum has a hole from a previous episode.

Ear infections occur most frequently in the winter. An ear infection is not itself contagious, but a cold may spread among children and cause some of them to get ear infections.

Risk factors:

*Not being breast-fed
*Recent ear infection
*Recent illness of any type (lowers resistance of the body to infection)
*Day care (especially with more than 6 children)
*Pacifier use
*Genetic factors (susceptibility to infection may run in families)
*Changes in altitude or climate
*Cold climate
*Sudden change of weather


Signs and tests
The doctor will ask questions about whether your child (or you) have had ear infections in the past and will want you to describe the current symptoms, including whether your child has had any symptoms of a cold or allergies recently. Your doctor will examine your child’s throat, sinuses, head, neck, and lungs.

Using an instrument called an otoscope, the doctor will look inside your child’s ears. 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 purulent (filled with pus). The physician will also check for any sign of perforation (hole or holes) in the eardrum.

A hearing test may be recommended if your child has had persistent (chronic and recurrent) ear infections

Modern  Treatment
The goals for treating ear infections include relieving pain, curing the infection, preventing complications, and preventing recurrent ear infections. Most ear infections will safely clear up on their own without antibiotics. Often, treating the pain and allowing the body time to heal itself is all that is needed:

*Apply a warm cloth or warm water bottle.
*Use over-the-counter pain relief drops for ears.
*Take over-the counter medications for pain or fever, like ibuprofen or acetaminophen. DO NOT give aspirin to children.
*Use prescription ear drops to relieve pain.

Some ear infections require antibiotics to clear the infection and to prevent them from becoming worse. This is more likely if the child is under age 2, has a fever, is acting sick (beyond just the ear), or is not improving over 24 to 48 hours.

However, for several years there was a tendency to over-prescribe antibiotics, leading to the increasing numbers of bacteria that are resistant to these drugs. Joint guidelines from the American Academy of Pediatrics and the American Academy of Family Physicians are aimed at using antibiotics for ear infections when they are most needed. If the antibiotics do not seem to be working within 48 to 72 hours, contact your doctor to consider switching to a stronger antibiotic. Usually there is no benefit to more than two, or at the most three, rounds of appropriate antibiotics.

If there is fluid in the middle ear and the condition persists, even with antibiotic treatment, a healthcare provider may recommend myringotomy (surgical opening of the eardrum) to relieve pressure and allow drainage of the fluid. This may or may not involve the insertion of tympanostomy tubes (often referred to as ear tubes). In this procedure, a tiny tube is inserted into the eardrum, keeping open a small hole that allows air to get in so fluids can drain more easily down the eustachian tube. Tympanostomy tube insertion is done under general anesthesia. Usually the tubes fall out by themselves. Those that don’t may be removed in your doctor’s office.

If the adenoids are enlarged, surgical removal may be considered, especially if you have chronic, recurrent ear infections. Removing tonsils does not seem to help with ear infections.

Click to see:
Alternative Treatment for Ear Infections :
Alternative to Tubes for Ear Infection Treatment:
Natural Cures For an Ear Infection – More Than Home Remedies:

Ear infections are curable with treatment but may recur. They are not life threatening but may be quite painful.

What can kids do to prevent ear infections? You can avoid places where people are smoking, for one. Cigarette smoke can keep your eustachian tubes from working properly.
You can reduce your child’s risk of ear infections with the following practices:

*Wash hands and toys frequently. Also, day care with 6 or fewer children can lessen your child’s chances of getting a cold or similar infection. This leads to fewer ear infections.
*Avoid pacifiers, especially at daycare.
*Breastfeed — this makes a child much less prone to ear infections. But, if bottle feeding, hold your infant in an upright, seated position.
*Don’t expose your child to secondhand smoke.
*The pneumococcal vaccine prevents infections from the organism that most commonly causes acute ear infections and many respiratory infections.
*Some evidence suggests that xylitol, a natural sweetener, may reduce ear infections.
*Avoid overusing antibiotics.

Click to see:
Taking Care of Your Ears;
What’s Earwax?;
What’s Hearing Loss?

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.


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Ailmemts & Remedies Pediatric

Oh, that earache!

Ear infections frequently develop in children and is one of the commonest infections in childhood. A staggering 75 per cent of children have at least one episode of ear pain and infection by the time they reach the age of three.

Most ear infections occur when the weather changes or if there is an infection going around in school.
Most ear infections are acute and are accompanied by excruciating pain, and occur when the weather changes or if there is an infection “going around” in school. Although the child may not to be able to accurately express or localise the discomfort, most parents suspect there is an earache because the child has fever and pulls or tugs at the ear. Sometimes, however, it manifests itself only with unexplained irritability or continuous nerve-wracking screaming. Hapless parents cannot localise the symptoms and are forced to seek emergency medical care.

Most ear infections start innocuously as a viral infection with fever, a runny nose and irritability. There is a three-pronged connection among the nose, throat and the middle ear. As long as all the connections are open, there is very little chance of an ear infection despite an upper respiratory infection. If any connection is blocked, pressure and secretions build up behind the ear drum, causing pain. Later, these secretions can remain stagnant in the middle ear and lead to an infection.

Ear infections often settle by themselves with symptomatic treatment. Frequent (two-hourly) administration of saline nose drops unblocks the nose. Paracetamol administered as dispersible tablets, drops or suspension (10-15mg/kg/dose) every four to six hours reduces the pain and fever. A mild anti-histamine syrup dries up the secretions. Sometimes, anaesthetic (not antibiotic) eardrops may be required to ease the pain. But the technique of administration is very important for the drops to be effective. The child should be placed on a flat surface, not on a pillow or on the lap. The affected ear should face upwards. The outer ear should then be gently pulled upwards and the drops administered. This will not help with the infection but will definitely ease the pain.

About 80 per cent of the antibiotics used worldwide are prescribed for “colds, coughs and ear infections”. They do not work against viral infections, nor do they shorten the course of the disease or prevent progress to a bacterial infection. A wait and watch policy for viral ear infections helps avoid the unnecessary use of antibiotics.

It is advisable, however, to consult a paediatrician immediately if the child is less than six months old, or has some other complicating illness.

If the pain and fever persist even after 72 hours, a secondary bacterial infection may have occurred. This needs appropriate antibiotics in the correct dose and duration. The medication should not be stopped just because the child looks better. Nor should the same antibiotic be purchased OTC (over the counter) and be self administered for a subsequent infection.

Children are more likely to develop recurrent ear infection

* If the early feeding is improper. Breast milk protects from infection, especially during the first six months of life.

* If the head is not raised while feeding. A prone position or placing a bottle of milk in a sleeping baby’s mouth may lead to an ear infection.

* If solids are force fed to an uncooperative child while lying down.

There is also a marked increase in the number of ear infections in children exposed to cigarette smoke. Most ear infections subside with no sequalae.

Certain cases of acute infection require urgent attention —

* When there is a suspicion of short-term mild hearing loss. This can persist if the fluid in the ear does not clear.

* If the infection becomes chronic, leading to damage to the bones and other structures in the middle ear. This can lead to permanent hearing loss.

* If the infection spreads to the mastoid, a bone behind the ear.

* Eventually, pus may extend into the brain and cause abscesses.

Surgery may have to be considered if the infection becomes chronic, with persistent effusions from both ears for three months or from one ear for six months. There are two procedures — myringectomy or tympanostomy, whereby a tube may have to be inserted into the ear drum.

A hole in the ear drum may need to be closed with a skin patch. Eventually, the tonsils and adenoids may need to be removed.

Two of the common bacteria causing ear infections belong to the Pneumococcal and H Influenzae groups. The Hib and pneumococcal vaccines, if administered to children, reduce the incidence of ear infections.

This is because the vaccine incidentally lends immunity against 55 per cent of the organisms that cause an ear infection. These vaccines also have a multiplier effect — they increase herd immunity, that is, they protect other children and elders in the community against bronchitis, pneumonia and ear infections caused by these common organisms.

From: Dr Gita Mathai’s writing (Telegraph ,Kolkata,India)

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